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Macau Periodical Index (澳門期刊論文索引)
- Author
- Koon, Kin Veng; Lao, Ngai Mei; Lai, Sok Cheng; Ung, Sam In; Chiang, Siau Wei; Mclaws, Mary-louise; Whitby, Michael
- Title
- Healthcare associated infection surveillance in Macau: a new approach
- Journal Name
- 澳門醫學雜誌
- Pub. Info
- 2006年3月26日, Vol.6, No.1, pp. 5-9
- Keyword
- Healthcare associated infection (HAI)；Surgical site infection (SSI)；Infection Control Committee；Methicillin-resistant staphy lococcus aureus (MRSA)；Infection control software (EICAT)
- Abstract
- Objective: The Infection Control Committee of Centro Hospitalar Conde de San Januario had followed the SENIC study in monitoring healthcare associated infection (HAI) for more than a decade. A new approach to surveillance has been implemented which allows real-time analysis of SSI data and MRSA infection to provide for fast intervention. Methods: The components of the surveillance system include: (1) Introduction of targeted surveillance of SSI. Internationally accepted definitions and denominator data are being utilized to regularly analyse infection rates. (2) Expression of HAI using process control charts provides infection control staff and clinicians with results in real time. Results: During a 12-month period in 2002, 190 aorto-femoral and femoro-popliteal by-pass procedures were performed with 7.4% (14/190) of patients developing an SSI. A line for a satisfactory rate (5% in this case) and one for unsatisfactory outcomes (in this case 10%), is also continually drawn on the CUSUM chart. Comparison of the slope of hte infection line (CUSUM line) with the lines for satisfactory and unsatisfactory SSI rates allows rapid recognition of staistically important variation in HAI. Between mid-March and mid-August, the CUSUM line sloped upwards more acutely than the unsatisfactory rate and at the time there was a 14% SSI rates in 70 operations. However, between mid-August and December, the CUSUM line was almost horizontal, reflecting inhis period an SSI rate of only 2.6%. A Shewhart-EWMA Control Chart indicates a low number of MRSA inflections for the first three months of 2004. However in late April 2004, there was an increase in the number reported with both infection lines cutting their respective statistical (dotted) lines and indicating a significant increase. Thereafter, no statistical increase in the number of casese was seen. Conclusions: The introduction of these statistical methods into HAI surveillance provides clinicians with real-time analysis, which also allows a rapid reaction by both inflection control nurses and the Infection Control Committee to any adverse results. Paragraph Headings: 1. Introduction 2. SSI rates 2.1. Calculation 2.2. Results 2.3. Expression of outcomes 3. Mrsa rates 3.1. Calculations 3.2. Results 3.3. Expression of outcomes 4. Discussion Tables: 1. Surgical site infection for January to June 2002 2. Infection Rates for HISS Sentinel Surgical Procedures and the Distribution Risk Factors Figures: 1. Example of a cusum observational chart (Vascular surgical site infections, Jan-Dec) 2. Example of a cusum statistical chart (Vascular surgical site infections, Jan-Dec) 3. CHCSJ/Macau hospital-wide incidence of MRSA (January-September, 2002) 4. Shewhart/ewma chart MRSA macau hospital (all wards 9/Jan-26/Oct, 2004)