Ward Link Nurse WLN
2.4 Types of Surveillance
1. National surveillance 2. Hospital – wide total surveillance 3. Periodic surveillance 4. Prevalence studies 5. Targeted surveillance National Surveillance Type of Surveillance Methods Targeted organisms : Results collected daily and submitted monthly to Quality MRSA ESBL in Medical Care section, MOH refer Appendix B for sample form Point Prevalence 1 day prevalence surveillance, hospital wide. Conducted Study twice a year on the same day throughout the nation refer appendix C for sample form Needle stick injury Reported yearly during the National Infection and Antibiotic Control Committee meeting. Participated by all state hospitals, specialist hospitals, Universities hospitals USM UKM UM and district hospitals providing microbiology cultures. Hospital Surveillances Choice of types of surveillance depends on the requirements of the individual hospital and must be agreed by the Hospital Infection and Antibiotic Control Committee members. Type of Surveillance Methods Total Surveillance The most comprehensive surveillance method; it entails collection of data for all infections in all hospitalized patients. Monthly infection rates are calculated to determine overall hospital rates and rates by site, care unit, service, pathogen, and surgical procedure. Advantage: this is useful for establishing baseline and comparative data. Disadvantage: requires enormous amounts of time and labor. Policies and Procedures on Infection Control Ministry of Health Malaysia 9 Periodic Surveillance Surveillance performed at specified intervals e.g. every three months; each time, the focus is on one specific infection site or on a definite patient population at increased risk of infection. In another version, periodic surveillance is performed on one or several units for a specified time period and then shifts to another unit or units. By rotating from unit to unit, infection control specialists are able to survey the entire hospital during the year. Advantage: leaves more time for other measures. Disadvantage: protracted time required to accumulate sufficient data for establishing valid baselines. Prevalence studies The number of active infections is counted over a specified time period. Active infections are defined as all manifest infections present at the time of the survey or patient is still under treatment for the infection. Advantage: this is usually a quick method. It can provide adequate data on epidemiologically important infections within a facility and can serve as a basis for developing of future targeted surveillance. Disadvantages: Results must be very carefully interpreted. Prevalence rates are usually higher than incidence rates One cannot draw conclusions infection risk factors. It is important to choose the correct denominator. This method can be useful for validating data from of total surveillance. Targeted : The focus in this type of epidemiological surveillance is on patients at increased risk of nosocomial infections e.g: post-surgical patients, ICU patients, and patients receiving mechanical ventilation. The denominator of the incidence rate formula should contain only data on patients belonging to the “high risk” group. Infection risk indices can and must be used. Type of Surveillance Methods - “High risk” patientsParts
» Bacaan Penuh ( bersaiz 5.5 MB)
» Roles of Hospital Infection and Antibiotic Control Committee
» Infection Control Doctor ICD
» Chairman of HIACC Bacaan Penuh ( bersaiz 5.5 MB)
» HOSPITAL INFECTION AND ANTIBIOTIC CONTROL COMMITTEE
» Frequency of meetings Circulation of minutes
» Emergency meetings and outbreak control
» Duties and responsibilities of the infection Control Nurse
» HEALTHCARE ASSOCIATED INFECTION SURVEILLANCE
» Types of Surveillance Bacaan Penuh ( bersaiz 5.5 MB)
» Data Collection Tabulation of Data
» Analysis and interpretation of data
» Preparation and dissemination of reports
» ISOLATION PRECAUTION Standard Precautions
» Respiratory hygienecough etiquette: Instruct symptomatic persons and health
» Signs, BHT, Isolation traytrolley
» Visitor Policy for Infection Control
» Dishes, Glasses, Cups, Eating Utensils and Medications
» Transportation of patients Transmission-based
» Hand Hygiene Bacaan Penuh ( bersaiz 5.5 MB)
» Natural ventilation Personal Protective Equipment PPE
» Use of mechanical ventilation
» Minimizing bacteria at entry points
» Maintaining sterility of instruments disposable items during a procedure
» Catheter change interval Urinary Catheter Care
» General principles of wound care 1.
» Spatial separation of catheterized patients Technique
» Environment Urinary Catheter Care
» Wound Care Bacaan Penuh ( bersaiz 5.5 MB)
» Procedure for insertion of catheter
» A dedicated lumen used for PN line should be identified and not be used for
» Nursing considerations for PN
» Storage Replacement of PN tubing and filters
» General Principles. Replacement of PN tubing and filters
» Specific practices transport, storage, transfusion, dispose
» Blood and Blood Products Transfusion
» Hand hygiene Urinary Tract Infection
» Catheter Insertion Urinary Tract Infection
» Closed Sterile Drainage Urinary Tract Infection
» Irrigation Urinary Tract Infection
» Specimen Collection Urinary Tract Infection
» Urinary Flow Urinary Tract Infection
» Meatal Care Urinary Tract Infection
» Catheter Change Interval Urinary Tract Infection
» Critical items - instruments or objects that enter directly into the vascular
» Semi-critical items - instruments or objects that come into contact with
» Developed a good surveillance system to study the incident of SSI.
» Nosocomial Respiratory Infection Bacaan Penuh ( bersaiz 5.5 MB)
» Introduction INFECTION CONTROL IN SPECIFIC HEALTHCARE SETTING
» Personal Protective Equipment Personnel .1
» Neonatal Intensive Care Unit
» Outer zone: This zone should contain:
» Laminar Flow Ventilation Ultra Clean Ventilation
» Wall Mounted Air Conditioners:
» Protective Clothing for Use in the Operating Theatre
» Surgical Hand Scrubbing Refer to hand hygiene section
» Gowning Free-standing Air Conditioners:
» Gloving Free-standing Air Conditioners:
» Draping Free-standing Air Conditioners:
» Establishing a Sterile Field
» Dispensing of the Sterile Supplies
» Maintaining the Sterile Field
» Waste and Linen Post operative
» Cleaning of the Operation theatre
» Intra operative Initial cleaning at the beginning of the day
» Concurrent cleaning between cases
» Haemodialysis unit water supply and air conditioning
» Staff health Terminal cleaning end of the day
» Hand hygiene Terminal cleaning end of the day
» Nephrology and Hemodialysis Unit
» Instrument processing area in the dental clinic
» Instrument cleaning refer to CSSD chapter
» Cleaning and Disinfection of Treatment Room 1.
» Dental Radiology Asepsis Components permanently attached to dental unit waterlines
» Dental Laboratory Materials and Equipment
» Storage and preparation rooms
» Movement of instruments Safety
» Collection of body from ward
» Routine case autopsy Mortuary
» Specimen handling Procedure for post-mortem examination of known or suspected CJD
» Clinical waste Procedure for post-mortem examination of known or suspected CJD
» Visitors Procedure for post-mortem examination of known or suspected CJD
» Quality control Procedure for post-mortem examination of known or suspected CJD
» Care Givers For Patient In The Burn Unit 1.
» Visitors Full time Care givers
» Culturing and Surveillance Full time Care givers
» Antibiotic Policy Full time Care givers
» Haematology and Oncology Unit
» Laboratory Bacaan Penuh ( bersaiz 5.5 MB)
» Introduction Bacaan Penuh ( bersaiz 5.5 MB)
» Personel protective equipment PPE
» Screening for HCW TUBERCULOSIS
» Infection control in specific area .1
» HOSPITAL OUTBREAK MANAGEMENT Steps in Outbreak Investigation and Management
» Introduction Introduction Bacaan Penuh ( bersaiz 5.5 MB)
» Policy Statement Training Bacaan Penuh ( bersaiz 5.5 MB)
» Arrangements Bacaan Penuh ( bersaiz 5.5 MB)
» Infection Control During Construction and Renovation
» Operation Theatre Commissioning Bacaan Penuh ( bersaiz 5.5 MB)
» Administrative monitoring Mechanical Monitoring
» Distribution of sterile items
» Establish a system Bacaan Penuh ( bersaiz 5.5 MB)
» Monitoring antimicrobial use using aggregated data on Defined Daily
» Each hospital shall send report on DDD every 6 months to National Infection
» However, individual local data shall be reported according to discipline
» It is recommended to have a national benchmark data specifically for Intensive
» It is also beneficial if each state have their own benchmark data from their
» A report of local monitoring data for hospital compared with national
» The aggregate benchmark data included numeric presentation of pooled
» Correlation between antimicrobial use and resistance rate
» Costquantity of empiric antimicrobial administered in a specified period.
» Antimicrobial management programstrategies Antimicrobial policy
» Multi-Resistant Organism 13. Bacaan Penuh ( bersaiz 5.5 MB)
» Methicillin Resistant Staphylococcus Aureus
» Vancomycin Resistant Enterococci Bacaan Penuh ( bersaiz 5.5 MB)
» HIV Bacaan Penuh ( bersaiz 5.5 MB)
» Dengue Bacaan Penuh ( bersaiz 5.5 MB)
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