2. 2
Continuous systematic collection of data on
illness in a defined population
Uses standard definitions for the outcome of
interest; e.g., infection, sharps injuries,
employee illness
Involves collection, analysis, interpretation,
and dissemination of data for the purpose of
improving health & preventing disease
3. 3
Active surveillance
Proactive approaches such as:
Concurrent
monitoring of the patients with a
central line and urinary catheter and/or on the
ventilator
Reviewing important culture results generated by
various microbiology laboratories (local,
regional, national, and international) daily
Walk-around or surveillance rounds
Surveillance cultures of targeted patients to plan a
preemptive IPC plans: Examples-MRSA, MDROs.
4. 4
Active surveillance (cont’d)
Reviewing daily census in AM
Environment of Care (EOC) rounds
Hand hygiene compliance
monitoring
Reviewing all patients in isolation
Outbreak/exposure investigation
Construction Risk Assessment
before construction begins
5. 5
Passive surveillance
Retroactive activities such as:
Reviewing medical records, culture results
(wound, blood, urine, etc.), various reports
(SSI summary after discharge, water tests,
sterilization indicators, sharps injury rates,
etc..)
Collecting data on surgical antibiotic
prophylaxis (see antibiotic stewardship)
7. 7
1. Total or universal surveillance – a lot of
work!
2. Targeted or focused surveillance –
pneumonia,
blood stream infection, surgical site
infection, ---.
Based on risk-assessment.
3. Prevalence survey – MRSA colonization
once a month, SSI, device data.
8. 8
High risk infections
High volume procedures
Preventable adverse outcomes
Critical processes
Infection rates associated with
specific devices, procedures, care
processes, employee issues
9. 9
Data Mining – detect patterns
and likely infections or
outbreaks; uses clinical,
pharmacological, laboratory
data
10. 10
Definition of healthcare-associated infection
related with each target condition or area
Review medical records
Clinical symptoms and signs compatible with an
infection
Conference with clinicians, nurses, and others
Review medical records
Confirm HAI
Documentation
Tabulation and analysis
Reporting
Follow up
12. 12
Population at risk
Patient days / residents days
Device days
central
line days
ventilator days
Foley catheter days
Procedures performed
# patients discharged
13. 13
HAIs cases-SSI, VAP, CLABSI,
CAUTI,etc.
Positive blood cultures
Positive VRE in stool
Positive MRSA in
nares/axilla/groin
Patients on vancomycin
14. 14
Incidence =
new cases x constant (1000)
population at risk
Prevalence = existing cases x constant
population at risk
15. 15
E.g; A 34 year old male underwent an open repair
and internal fixation of right ankle fracture. The
wound became infected 5 days later with S. aureus.
Old fashioned?
Difficult to aggregate at the end of the surveillance
No visual impact
