Abstract
BackgroundAustralia has commenced public reporting and benchmarking of healthcare associated infections (HAIs), despite not having a standardised national HAI surveillance program. Annual hospital Staphylococcus aureus bloodstream (SAB) infection rates are released online, with other HAIs likely to be reported in the future. Although there are known differences between hospitals in Australian HAI surveillance programs, the effect of these differences on reported HAI rates is not known.ObjectiveTo measure the agreement in HAI identification, classification, and calculation of HAI rates, and investigate the influence of differences amongst those undertaking surveillance on these outcomes.MethodsA cross-sectional online survey exploring HAI surveillance practices was administered to infection prevention nurses who undertake HAI surveillance. Seven clinical vignettes describing HAI scenarios were included to measure agreement in HAI identification, classification, and calculation of HAI rates. Data on characteristics of respondents was also collected. Three of the vignettes were related to surgical site infection and four to bloodstream infection. Agreement levels for each of the vignettes were calculated. Using the Australian SAB definition, and the National Health and Safety Network definitions for other HAIs, we looked for an association between the proportion of correct answers and the respondents’ characteristics.ResultsNinety-two infection prevention nurses responded to the vignettes. One vignette demonstrated 100 % agreement from responders, whilst agreement for the other vignettes varied from 53 to 75 %. Working in a hospital with more than 400 beds, working in a team, and State or Territory was associated with a correct response for two of the vignettes. Those trained in surveillance were more commonly associated with a correct response, whilst those working part-time were less likely to respond correctly.ConclusionThese findings reveal the need for further HAI surveillance support for those working part-time and in smaller facilities. It also confirms the need to improve uniformity of HAI surveillance across Australian hospitals, and raises questions on the validity of the current comparing of national HAI SAB rates.
Highlights
Despite the absence of a standardised national healthcare associated infection (HAI) surveillance program in Australia, public reporting of healthcare associated infections (HAIs) rates has commenced
Using the Australian Staphylococcus aureus bloodstream (SAB) definition, and the National Health and Safety Network definitions for other HAIs, we looked for an association between the proportion of correct answers and the respondents’ characteristics
Those trained in surveillance were more commonly associated with a correct response, whilst those working part-time were less likely to respond correctly
Summary
Despite the absence of a standardised national healthcare associated infection (HAI) surveillance program in Australia, public reporting of HAI rates has commenced. A national definition for SAB does exist [5], a major difference is the varying use of the National Health and Safety Network (NHSN) definitions [6] with or without local modifications to identify other HAIs [4]. It is unclear how much this variation influences the interpretation and application of definitions and subsequent HAI rates. Australia has commenced public reporting and benchmarking of healthcare associated infections (HAIs), despite not having a standardised national HAI surveillance program. There are known differences between hospitals in Australian HAI surveillance programs, the effect of these differences on reported HAI rates is not known
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