Formative and process evaluation of a healthcare-associated infection surveillance program in residential aged care facilities, Grampians region, Victoria
Mary Smith A D , Ann L. Bull B , David Dunt C , Michael Richards B , Badrika Suranganie Wijesundara C and Noleen J. Bennett B
+ Author Affiliations
- Author Affiliations
A Department of Health, Grampians Region, 21 McLachlan Street, Horsham, Vic. 3400, Australia.
B Victorian Healthcare Associated Infection Surveillance System (VICNISS) Co-ordinating Centre, 10 Wreckyn Street, North Melbourne, Vic. 3051, Australia.
C Centre for Health Policy, Program and Economics, School of Population Health, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, Vic. 3053, Australia.
D Corresponding author. Email: Mary.Smith@health.vic.gov.au
Healthcare Infection 17(2) 64-69 https://doi.org/10.1071/HI12009
Submitted: 2 March 2012 Accepted: 2 May 2012 Published: 31 May 2012
Abstract
Background: In 2010, a standardised healthcare associated infection surveillance program was implemented and evaluated in 30 residential aged care facilities (RACF) located in the Grampians rural region, Victoria.
Methods: High level care residents were monitored for trachea-bronchitis, cellulitis, conjunctivitis, gastroenteritis and symptomatic urinary tract infections. Infection data was collected and reported by RACF staff or infection control (IC) consultants. ‘Infections’ reported by RACF staff were confirmed or excluded by an IC consultant after reviewing medical records.
Results: Of the 297 true infections, 89.9% were reported by RACF staff. IC consultants excluded 206 ‘infections’ reported by RACF staff. Eight infections were detected by IC consultants after checking microbiology reports. The sensitivity and positive predictive value of data reported by RACF staff was calculated as 97.1% and 56.5% respectively. The average time for IC consultants to retrospectively check data reported by RACF staff was 2.2 h month–1. Over 6 months, the time taken by one regional IC consultant to follow up data queries was 11 h.
Conclusions: The evaluation of the pilot HAI surveillance program demonstrated that the collection, collation and analysis of accurate infection data in the participating RACF can be difficult and resource intensive. If the program is to continue as currently structured, the identified issues associated with data validity and limited resources will need to be addressed.
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