كتاب
Surveillance of Healthcare associated Infections in Healthcare Facilities
- Indicators for Monitoring
To ensure the surveillance of HAIs practices in hospitals and reduce the risk of HAIs, specific indicators should be monitored regularly. These are some indicators which can provide measurable data to assess compliance, identify areas for improvement, and guide interventions. Here are some key indicators that can be included in hospital guidelines for surveillance of HAIs:
a) Calculation of incidence: The incidence of an HAI is a specific rate that represents the occurrence (number) of new cases of a disease (e.g., a specific HAI) occurring in a defined patient population during a defined period. All individuals in the population being surveyed must be at risk of developing the outcome.
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Incidence Rate = |
Number of patients diagnosed with new specific HAI during the surveillance period |
x 100 |
|
Number of patients at risk of the specific HAI during the surveillance period |
b) Infection rates is calculated by (per 1000 patient-days)
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Rate of infection / 1,000 patient-days = |
Number of specific infections cases over specified time period (e.g. surveillance quarter) in a specific location |
x 1000 |
|
Total number of patients days in a specific location in same time period |
In this rate a patient with 2 infections is counted twice
|
Rate of Patients infected/ 1,000 patient-days = |
Number of patient infected over specified time period (e.g. surveillance quarter) in a specific location |
x 1000 |
|
Total number of patients days in a specific location in same time period |
In this rate a patient with 2 infections is counted only once
c) Incidence Density Rates (adjusts for patient/resident length of stay)
If patients are followed for the occurrence of an HAI but the time of follow-up varies for each patient, a more precise measure of incidence called incidence density is used.
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Incidence density= |
Number of cases over specified time period |
x10,000 |
|
Total number of days patients in hospital (facility) over time period |
d) Device-Associated Infection Rates (Per 1000 device days)
Example infections
● Central line-associated bloodstream infections (CLABSI)
● Ventilator-associated Events (VAE)
● Indwelling catheter-associated urinary tract infections (CAUTI)
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Device-Associated Infection Rates (Per 1000 device days) = |
Number of cases over the specified time period in a specific location |
x1000 |
|
Total number of device days in a specific location |
e) Device Utilization Ratio (DUR): The device utilization ratio is the number of device-days per number of patient-days in a given period. This is a measure of the total patient-days in which a high-risk device was used and can be used as a marker for risk of infection.
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Device Utilization Ratio= |
Number of device days in a specific location |
|
Total number of patient days in a specific location |
According to the approved center of disease control (CDC) criteria,
*Device days are the total number of days of exposure to each device (Ventilators, central venous catheter or urinary catheter) for all the patients during the selected time period.
*Patient days are the total number of days patients are in the intensive care unit (ICU) during the selected time period
f) Surgical Site Infection Rates (SSIs)
|
SSI Rate = |
Number of cases over specified time period following specific operative procedure |
x 100 |
|
Total number of the same operative procedure in the same time period |
*SSIs will be included in the numerator of a rate based on the date of procedure, not the date of the HAI event
*SSI rates can be calculated separately for different types of operative procedures and stratified by the wound classification (clean, clean contaminated, contaminated, dirty)
