What does the evidence say?

The Australian Commission for Safety and Quality in Health Care has recently developed 16 “Hospital acquired complications” (HACs) that have been published on their website.

Whilst the website provides information on the development of these HACs, it does not specifically detail their purpose. One of the 16 HACs is “Healthcare Associated Infection”, which is comprised of eight different HAI “diagnoses”, including “multiresistant organisms” and “gastrointestinal infections”.

There is clear evidence, both locally and internationally, that coding data does not accurately identify HAIs, and any attempt to do so would misrepresent the truth.

Successful infection prevention efforts rely on valid data. If the data are not accurate, then not only do we run the risk of misdirecting interventions and misinterpreting the outcome of interventions, we are also wasting precious resources.

It is a wonder why, in this field where so often we don’t have good evidence for certain practices, that when good evidence does exist, it still does not seem to influence policy and practice.

Phil

Declaration: Philip Russo is a member of the ACSQHC HAI Advisory Committee. 

4 thoughts on “What does the evidence say?

  1. Deborough Macbeth

    This is absolutely absurd. What possible benefit could be gained from this initiative? The only outcome I can see is that the hard won credibility of the Commission’s healthcare associated infection program will be undermined if these ‘data’ are considered useful or representative of the current infection control situation in Australian healthcare settings. Furthermore, it is likely that Infection Control Professionals will in future, have to spend precious time explaining to hospital Executive how and why the data are useless as a mechanism for determining the standard of infection control in any healthcare context.

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  2. Brett Mitchell @bgm_2012

    My emotions on this are mixed, but none are positive.
    Looking at the widely accepted elements of a good surveillance system, how does this approach match? Well, I would say it doesn’t on almost any point.

    Why are we going down the route of:
    – providing meaningless data that we know is fundamentally flawed and inaccurate
    – measures that are not aligned to any quality improvement process, nor could they be
    – going against the grain for what I suspect most in infection prevention and control would advise

    This is going to stir up some responses Phil, thanks for highlighting this. I would encourage people to comment and share on social media.

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  3. Tim Spencer

    Although this does raise this issue of poor compliance for data validation with these directives, I do welcome the addition of peripheral intravenous devices, including midline catheters (which is still a peripheral device), to be included in the HAC reporting process. These devices have been slipping under the radar, with the exception of the current SAB reporting, but hopefully the reporting of these devices will capture a greater issue with PIVs. As a vascular access specialist, I welcome the addition of full reporting for ALL vascular access devices, not just allowing some devices to be reported and others not – they all contribute to patient related complications! Shoe leather surveillance with these devices is the only way to ensure accurate data and reporting.

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  4. Michelle Bibby

    To this day, I am bewildered when coders determine based on scratchy notes at best what is an infection and what is not when I review histories post discharge and see some glaring over sites. Thanks for posting Phil, food for thought…

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