Healthcare associated infection surveillance

The Australian Commission on Safety and Quality in Health Care (ACSQHC) National Quality Safety and Health Service (NQSHS) Standards require that health service organisations have a surveillance strategy for infections.

Healthcare associated infections (HAI) are infections that are acquired as a direct or indirect result of healthcare. HAI is one of the most common complications affecting patients in hospital. As well as causing unnecessary pain and suffering for patients and their families, HAI can prolong a patient’s hospital stay and add considerably to the cost of delivering healthcare.

Surveillance to determine the incidence of HAI is important to help identify strategies to minimise the occurrence of these infections.

The Australian Guidelines for the Prevention and Control of Infection in Healthcare provides information about the role and types of HAI surveillance.

SA Health HAI Surveillance Requirements

SA Health Local Health Network (LHN) mandatory HAI Surveillance requirements are as per the SA Health Healthcare associated infection surveillance program, Service agreements and Performance framework and key performance indicators. Also refer to the SA Health Infection Prevention and Control and Healthcare Associated Infection Surveillance and Reporting Policy.

Infection Control Service (ICS) HAI Surveillance Program

The SA Health ICS is responsible for the coordination of the ICS HAI Surveillance Program, this includes the collection, analysis and reporting of HAI surveillance data from Local Health Networks (LHN) and some private SA hospitals who voluntary participate in the ICS HAI Surveillance Program.

The ICS HAI Surveillance Program assists SA Health staff understand and implement an effective HAI Surveillance Program and support consistent terminology and best-practice methodologies for accurate data collection, analysis and reporting to facilitate compliance with the parent policy:   Infection Prevention and Control and Healthcare Associated Infection Surveillance and Reporting Policy and also the requirements of the ACSQHC NQSHS Standards.

Methodology

Contributing hospitals provide data collected according to standard surveillance definitions (see below). Data is quality controlled and converted into rates of infection per 10,000 days of hospital care. Aggregate rates are calculated for the state and risk adjusted according to the type of hospital (size and patient acuity).

Surveillance definitions

The HAI Surveillance Program consists of the following standardised surveillance definitions. These are reviewed annually in consultation with contributors.

Reporting

Data is reported back to the local health networks (LHN) and private contributors quarterly for the purposes of data governance and quality improvement monitoring.

Data is discussed by the South Australian Reference Group (SAIRG) on a quarterly basis.

Annual HAI surveillance reports are produced by the ICS for the following:

  • Bloodstream infections (BSI)
  • Clostridioides difficile infection (CDI)
  • Multidrug-resistant organisms (MRO)
  • Surgical site infections (SSI)

These reports include detailed epidemiological analysis of aggregated and de-identified data as provided by contributors from the LHNs (and some private hospitals voluntary contributing to the ICS HAI Surveillance Program).

The ICS HAI Surveillance Program annual reports are publicly available and published on the SA Health Healthcare infection statistics webpage.

National HAI surveillance reporting

The Australian Commission on Safety and Quality in Health Care (ACSQHC) also provides information and report national data as follows:

The Australian and New Zealand Intensive Care Society also report on national central-line associated bloodstream infection (CLABSI) national data.  

Alternative HAI surveillance methodology and programs

Healthcare facilities not participating in the SA Health ICS HAI Surveillance Program should refer to local policies and procedures for the requirements relevant to their facility.

Some healthcare facilities may consider undertaking signal HAI surveillance. This is a type of surveillance that focuses on monitoring HAI that are relevant to the HCF.  

For further information regarding healthcare facility HAI surveillance requirements, contact your relevant LHN Infection Prevention and Control Unit and/or relevant governance group/committee.

Further information

For further information on the SA Health surveillance program, contact SA Health's Infection Control Service.