Ward Link Nurse WLN

Policies and Procedures on Infection Control Ministry of Health Malaysia 8

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” patients