Brief Report
Implementation of a pilot surveillance program for smaller acute care hospitals

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Background

An infection control (IC) surveillance program for smaller (<100 acute beds) hospitals was piloted for 18 weeks in 14 hospitals. The aim of the pilot stage was to test a theoretical program in the context in which it was to be implemented.

Method

An evaluation framework was developed, outlining the program's intended activities for data collection, management, analysis, reporting, and use. This framework was used as a reference to interview each of the 12 IC nurses participating in the pilot stage.

Results

The preferred case finding methodologies were not uniformly applied. Management, analysis, and reporting of data were delayed because of infrequent and irregular IC hours and laboratory reporting. Reports were not always distributed to key persons. Specific action was only taken in response to the process (and not outcome) module reports.

Conclusion

Discrepancies between the theoretical and actual implementation of a surveillance program for smaller hospitals were highlighted. The program will need to be revised before it is rolled out to all 89 eligible hospitals across Victoria.

Section snippets

Methods

A theoretic evaluation framework (Table 1) was developed after consultation with the programs key stakeholders and an analysis of the relevant literature.3 For each pilot hospital, this framework was used as a reference to collect information about the program's implementation. Each of the 12 IC nurses who were primarily responsible for the program's implementation was interviewed at least once by the same Victorian Hospital Acquired Infection Surveillance System (VICNISS) Coordinating Centre

Data collection

Fifty percent of the surveillance plans were submitted by the due date. One hospital had planned to participate in the “Surgical Antibiotic Prophylaxis” module, but surgical procedure numbers were unexpectedly low. No hospitals were eligible to participate in the “Surgical Site Infection” module.

All 12 IC nurses agreed that the standard paper data collection forms were “simple to use.” The program's manual was used at least once by 11 of the IC nurses to check reporting instructions. The use of

Discussion

Working closely together during the pilot stage, the VICNISS CC and pilot hospital IC nurses were able to obtain useful information about the implementation of a surveillance program in smaller hospitals. Discrepancies between intended and actual activities in regard to the collection, management, analysis, reporting, and use of the program's data were highlighted. This included, most notably, prospectively case-finding methodology not being uniformly applied; management, analysis, and

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Cited by (2)

  • A user assessment of a smaller hospital surveillance program

    2008, American Journal of Infection Control
    Citation Excerpt :

    Unfortunately, the reasons for the lesser percentages for the other listed “uses” (18.3%-56.5%) were not explored. It may have been that there was insufficient IC allocated time to implement these other uses, or, as previously explained during the pilot stage,4 “no major issues were detected” or “the reports were not statistically meaningful.” It was especially important to assess the educational strategies because the literature describes the many barriers to educating rural nurses and the development of these strategies was resource intensive.7-9

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