The establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: A report from the VICNISS Coordinating Centre

doi:10.1016/j.ajic.2005.06.013

American Journal of Infection Control

Volume 34, Issue 7, September 2006, Pages 430-436

https://doi.org/10.1016/j.ajic.2005.06.013 Get rights and content

Background

A 1998 survey of acute Victorian public hospitals (VPH) revealed that surveillance of hospital-acquired infections (HAI) was underdeveloped, definitions and methodology varied considerably, and results disseminated inconsistently. The survey identified the need for an effective surveillance system for HAI.

Objective

To develop and support a standardized surveillance program for HAIs in large acute VPH and to provide risk-adjusted, procedure-specific, HAI rates.

Methods

In 2002, the independent Victorian Nosocomial Infection Surveillance System (VICNISS) Coordinating Centre (VCC) was established to develop and support the standardized surveillance program. A multidisciplinary team was recruited. A communication strategy, surveillance manual, user groups, and Web site were developed. Formal education sessions were provided to participating infection control nurse consultants (ICCs). Surveillance activities were based on the US Centers for Diseases Control and Prevention's National Nosocomial Infection Surveillance System (NNIS) surgical site infection and intensive care unit (ICU) components. NNIS methods were modified to suit local needs. Data collection was paper based or through existing hospital software. An advisory committee of key stakeholders met every second month.

Results

The surveillance program was rolled out over 12 months to all 28 large adult VPH. Data on over 20,000 surgical procedures performed at participating sites between November 11, 2002, and December 31, 2004, were submitted. Thirteen hospitals contributed to the ICU surveillance activities. Following aggregation and analysis by the VCC, hospital- and state-level results were posted on the Web page for hospitals to review.

Conclusion

A standardized approach for surveillance of HAI was established in a short time frame in over 28 VPH. VICNISS is a tool that will continue to provide participating hospitals with a basis for continuous quality improvement.

Section snippets

The VCC

To develop and implement VICNISS in hospitals, the VCC was established and funded by the DHS for an initial period of 3 years. Colocated at the Victorian Infectious Diseases Reference Laboratory, a site of established epidemiologic, microbiologic, and database expertise, the VCC is independent of DHS and participating hospitals. The VCC provided support and education to the participating hospitals and collated, analyzed, and reported risk-adjusted, procedure-specific infection rates.

Results

Surveillance commenced on November 11, 2002 in 10 hospitals. By July 2003, all 28 hospitals were contributing data for the SSI surveillance activities, and 13 had contributed to the ICU surveillance activities. Not all hospitals collected data for the whole duration of the surveillance period. The minimum period of surveillance was 3 months. The number of hospitals listed in the Tables as contributing data is the total number that have contributed to the pool. Data presented here were submitted

Discussion

A standardized hospital-acquired infection surveillance program for large adult Victorian public hospitals has been successfully implemented. This required adequate resourcing, including establishment of a coordinating center with a multidisciplinary staff, and a strong educational and communication focus. The VICNISS system adheres closely to the US NNIS methods, with some amendments made for local infection control feedback.

Communication with some hospitals raised early challenges. The

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Surveillance of nosocomial infections in ICUs: is postdischarge surveillance indispensable?
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Seven semi-structured interviews were conducted over a 6-month period during 2014-2015. Analysis of the data generated 5 distinct characteristics of large HAISPs: (1) triggers: surveillance was initiated by government or a cooperative of like-minded people, (2) purpose: a clear purpose is needed and determines other surveillance mechanisms, (3) data measures: consistency is more important than accuracy, (4) processes: a balance exists between the volume of data collected and resources, and (5) implementation and maintenance: a central coordinating body is crucial for uniformity and support.
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The VICNISS program is supported by the Department of Human Services, Victoria (DHS).

Disclosure: All authors are employees at the VICNISS Coordinating Centre.

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Major ArticleThe establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: A report from the VICNISS Coordinating Centre

Background

Objective

Methods

Results

Conclusion

Section snippets

The VCC

Results

Discussion

Guideline for the prevention of surgical site infection

Infect Control Hosp Epidemiol

Surgical-site infection rates and risk factor analysis in coronary artery bypass graft surgery

Infect Control Hosp Epidemiol

Nosocomial infections in combined medical-surgical intensive care units in the United States

Infect Control Hosp Epiemiol

Surveillance of nosocomial infections in ICUs: is postdischarge surveillance indispensable?

Infect Control Hosp Epidemiol

Major Article
The establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: A report from the VICNISS Coordinating Centre