|Title:||Healthcare-Associated Infection Surveillance in Western Australia|
|Document ID:||Operational Directive OD 0071/07|
|Date of issue:||Wednesday, 26 September 2007|
|Status:||NO LONGER APPLICABLE|
|Description:||This Operational Directive describes the Healthcare-associated Infection Surveillance Program in WA. It also outlines accountability and actions for compliance for the mandatory reporting of clinical indicators by WA public hospitals and licensed private healthcare providing services for public patients.|
|Period of effect:||from 1 October 2007 to 1 January 2009|
|Review date:||1 January 2009|
|Authorised by:||Dr Neale Fong, DIRECTOR GENERAL, DEPARTMENT OF HEALTH, 26-Sep-2007|
|Print version:||View print version|
Healthcare-Associated Infection Surveillance in Western Australia
Infections that occur as a result of a healthcare procedure or while in a healthcare facility are significant adverse events. Outcomes include not only morbidity and mortality for patients, but also increased costs for treatment, prolonged hospital stay, lower staff morale and legal risks. Healthcare-associated infection (HAI) prevention has been identified as a major priority by expert groups including the Australian Commission on Safety and Quality in Healthcare, the Australian Council of Healthcare Standards, the National Health Service (NHS UK), the Joint Commission on Accreditation of Healthcare Organisations (USA) and the World Health Organisation (WHO).
Monitoring the incidence of these HAIs is an essential step in assessing the safety and quality of healthcare provided, prioritising targets and evaluating preventive initiatives. WA hospitals have been contributing data to a successful voluntary HAI surveillance program (Healthcare Infection Surveillance WA – HISWA) since 2005. Building on the success of HISWA, key HAI indicators are mandatory for collection and submission by Area Health Services in 2007/08.
The selected indicators mandated in this directive have been selected by a process of review and consultation. They are applicable to a variety of healthcare settings within WA Health, are feasible to collect and are credible indicators of significant adverse events. Improvements in patient care, and evaluation of local infection control program efficiency, will be facilitated by collecting this standardised data throughout WA.
The effectiveness and efficiency of the mandated aspects of the Healthcare-associated Infection Surveillance program will be regularly reviewed by members of the Healthcare Infection Council of WA (HICWA).
2. THE IMPACT OF HEALTHCARE-ASSOCIATED INFECTIONS
HAI prevention has been identified as a priority initiative by WA Health, due in part to the size of the problem. In 2001, the Australian Infection Control Association Expert Working Group estimated that, in Australia, there may be as many as 150,000 HAIs contributing to 7,000 deaths each year. It was further estimated that at least one third of HAIs are preventable, with coordinated monitoring and prevention programs.
If the national HAI and costs data is extrapolated to the WA health system, it is postulated that HAI results in an increased cost of at least $95 million to the WA health system annually for additional treatments and length of stay due to HAIs.
International statistics are similar with the USA reporting HAIs, resulting in 2 million infections, 90,000 deaths and $4.5 billion excess in costs each year (CDC, 2006).
3. HEALTHCARE-ASSOCIATED INFECTION SURVEILLANCE PROGRAM 2007/08
Measuring the size of the problem of HAIs in WA is an essential step to their effective and efficient prevention. This complements other key elements to effective prevention strategies including adequate provision of staff with appropriate training in infection control and prevention, adoption and use of evidenced-based best practice, outbreak identification and management and appropriate infection control education for healthcare workers.
The goals of the Healthcare-associated Infection Surveillance Program are to:
Results of the program will be collated by the Healthcare-associated Infection Unit at the Communicable Diseases Control Directorate (CDCD), summarised, and then provided to all participating hospitals. Infection rates will be risk adjusted where possible in the report to better reflect differences in clinical case-mix between participating hospitals. Hospitals and Area Health Services are also encouraged to internally review the data more frequently to identify issues and trends in a timely manner.
The indicators included in the Healthcare-associated Infection Surveillance Program will be reviewed regularly and, where appropriate, changes to the monitoring system methodology and priorities may be implemented, according to future trends and feedback from participating facilities.
Healthcare-associated Infection Surveillance WA (HISWA) can collect, analyse and report the indicators listed in Table 1 from any public or private hospital in WA. The indicators mandated for reporting by Area Health Services in 2007/08 and the timeline for implementation is in Table 2. All WA public hospitals and licensed private healthcare facilities providing services for public patients will be required to implement and support systems to monitor clinical indicators as described in the following table.
Table 1: Clinical indicators reported to HISWA
Table 2: Clinical indicators for mandatory reporting by WA public hospitals and licensed private healthcare facilities providing services for public patients
4. ACTIONS REQUIRED TO COMPLY WITH OPERATIONAL DIRECTIVE
Hospitals and Area Health Services are responsible for ensuring the accuracy and timeliness of data provided, according to the requirements of this directive.
The Healthcare-associated Infection Unit and the Healthcare-associated Infection Council of WA will be available to support implementation of this directive.
Reports of the mandatory component of the Program will be provided annually to:
Data will be held in strictest confidence by the Healthcare-associated Infection Unit, used only for the purposes stated and not otherwise disclosed without consultation between the Unit and the relevant hospital/Area Health Service.
Dr Neale Fong
This circular last updated: Wednesday, 26 September 2007 at 9:34am