Category Archives: Point prevalence

Results of the National healthcare associated infection point prevalence study (CHAINS)

On behalf of everybody involved in this exciting study, I am delighted to share the main outcomes that have now been published in Antimicrobial Resistance and Infection Control. We specifically targeted this journal given its significant international status, and importantly all articles are open access. This means that it is available to everybody all the time, and also allows for a pdf download.

Some key points on the study:

  • First national study of its type in Australia for over 30 years
  • Identified that 1 in 10 adult acute inpatients has an infection as a result of their healthcare
  • Most common infections were those following surgery, urinary tract infections and pneumoniaI
  • Identified many infections that hospitals would not normally be detected in routine surveillance processes
  • 1 in 10 patients were being managed for a multi-drug resistant organism
  • Australia is one of the few OECD countries that does not have a national surveillance program
  • Data was collected from19 large hospitals across the country over four months in 2018

A major strength of the study is the use of the same trained data collectors across all sites. This ensured consistency in the application of definitions and datas collection, and also negated any subjective influences if it were data from hospital-based collectors. This is a critical difference to other international PPS and adds reliability to our study.

Importantly, we did not include smaller or specialty hospitals, private hospitals and excluded all patients under 18. Future studies should be funded to all patients across all sites.

This is the first time in 34 years we have had an estimate of HAI prevalence across Australia. In the absence of a national HAI surveillance program, we suggest data from repeated national HAI PPS in all facilities could be used to inform and drive national prevention initiatives.

To read more about the findings, we have written an article in The Conversation, and access to the journal article is here. See highlights from the study in our brief animation below.

Again, a sincere thank you to the infection prevention teams from the participating sites, your support and cooperation was crucial to the success of this study.

We will discuss implications and other outcomes from the study in future blogs

Sincere thanks to the wonderful dedicated infection prevention teams from each of the participating sites for their cooperation and hospitality.

  • Alfred Hospital, Vic
  • Bendigo Health, Vic
  • Calvary Hospital, ACT
  • Fiona Stanley Hospital, WA
  • Frankston Hospital, Vic
  • Gold Coast University Hospital, QLD
  • Hornsby Ku-ring-gai Hospital, NSW
  • Launceston General Hospital, Tas
  • North West Regional Hospital, Tas
  • Redcliffe Hospital, QLD
  • Royal Brisbane and Women’s Hospital, QLD
  • Royal North Shore Hospital, NSW
  • The Prince of Wales Hospital, NSW
  • The Queen Elizabeth Hospital, SA
  • The Royal Adelaide Hospital, SA
  • Westmead Hospital, NSW

Acknowledgements

The authors acknowledge the work of the CHAINS Project Manager, Bridey Saultry, Research Assistants Ms Stephanie Curtis and Ms Sophie Robinson, Infection Prevention teams, site investigators and key stakeholders at the participating hospitals. The Centre for Quality and Patient Safety Research, Deakin University, for supporting and administering the project. We also acknowledge Kalisvar Marimuthu, Professor Jacqui Reilly and Professor Jennie Wilson for expert advice and guidance in the planning stages of this project

National HAI PPS Update – July 2019

On behalf of the research team I am delighted to inform you that data analysis from the CHAINS project has now been completed.

We have recently submitted a manuscript for publication and look forward to sharing the primary outcomes with you, hopefully in the near future.

In April this year, I was fortunate to present some preliminary data at the 29th European Congress of Clinical Microbiology & Infectious Diseases, in Amsterdam, The Netherlands. Interestingly, I received many comments from Europeans who couldn’t believe that regular HAI point prevalent surveys are not undertaken in Australia.

I was also recently invited by Safer Care Victoria to present some data to the Infection Control Clinical Network 2019 forum.  We are in the process of planning similar updates to all jurisdictions over the next few months. I will also be presenting some findings to the Healthcare Infection Advisory Committee of the Australian Commission for Safety and Quality in Health Care later this year.

Another important part of our dissemination strategy is to provide each participating hospital with a report that will allow them to compare their own data with other (de-identified) participating sites. This report is due later in the year.

We are looking forward to providing you with more detailed updates soon.

Phil

National HAI Point Prevalence Survey – August 2018 update

Data collection commencing!!

It has been an exciting month for the National Healthcare Associated Infection Point Prevalence Survey team. Our two Research Assistants, Sophia Robinson and Stephanie Curtis, have commenced their appointments and spent the past month undergoing surveillance training. After rigorously testing the data collection tool, they are now experts in utilising the tool to investigate HAIs and are excited to commence the data collection at our sites.

Site visits for data collection across Australia will commence next week, August 8th and continue until November 30th. We have locked in several dates with sites, starting with Geelong, Bendigo, Launceston, Burnie and Adelaide.

As previously announced, 19 hospitals will be participating in the study, these hospitals are listed below. We sincerely thank all the hospitals for their involvement, particularly the site Principal Investigators who have worked hard to progress ethics approvals and organise the logistics of our visits. We look forward to visiting you all soon!

  • Alfred Hospital, Vic
  • Bendigo Health, Vic
  • Calvary Hospital, ACT
  • Fiona Stanley Hospital, WA
  • Frankston Hospital, Vic
  • Gold Coast University Hospital, QLD
  • Hornsby Ku-ring-gai Hospital, NSW
  • Launceston General Hospital, Tas
  • North West Regional Hospital, Tas
  • Redcliffe Hospital, QLD
  • Royal Brisbane and Women’s Hospital, QLD
  • Royal North Shore Hospital, NSW
  • Westmead Hospital, NSW
  • The Prince of Wales Hospital, NSW
  • The Queen Elizabeth Hospital, SA
  • The Royal Adelaide Hospital, SA
  • The Royal Melbourne Hospital, Vic
  • The Tweed Hospital, Vic
  • University Hospital Geelong, Vic

 

​We will continue to provide updates on the project through this blog and Twitter via @PLR_aus and @1healthau , or for further information please contact either Dr Philip Russo or Professor Brett Mitchell 

 


Stephanie Curtis, Research Assistant, Australian National Healthcare Associated Infection Point Prevalence Survey

Australian HAI point prevalence survey – update

As you might know, I am leading a team of investigators to conduct the first national HAI point prevalence survey in Australia in over 30 years.

We are grateful to have received so many expressions of interest from hospitals across Australia. Of course if we had endless resources we would survey all hospitals, however as you would appreciate, we have limited funding, and therefore are focussing on 20 public hospitals classified as either Principal Referral or Group A hospitals (AIHW peer group).

Data collection in our study will be undertaken by two trained research assistants, who will collect data from each participating site. This will avoid the burden of data collection  from hospital resources, and importantly add consistency to application of definitions and data collection processes (a current gap in Australian HAI surveillance).

On top of HAI data, we are also looking to estimate device usage and explore some issues around single rooms and MRO’s, and so have developed some secondary objectives specific for these.

Primary objectives

  1. To estimate the total prevalence of HAIs among inpatients aged ≥18 in public acute care hospitals in Australia
  2. To describe the HAIs by site, type of patient, specialty, type of facility and geographical location

Secondary objectives

  1. To determine the prevalence of patients:
    • managed under transmission based precautions isolation in a single room
    • with an indwelling urinary catheter device
    • with vascular access device(s)
    • with a multi drug resistance organism (infection or colonisation)

Ethics submission is close, and we are working hard on ensuring this is processed efficiently so we can turn our attention to Site Specific Assessments and Research Collaborative Agreements.

Finally a welcome to Bridey Saultry who will be commencing soon as Project Manager for our study. Bridey will be working with us half time to ensure we keep on track with this exciting study.

If you have any questions about the study, you can contact us by completing the form below.

More updates to follow.

Phil

 

The burden of HAIs in Australia

Today, we published an article in Infection, Disease and Health estimating the number of HAIs occuring in Australia each year. [1]

To do this, we undertook a systematic review of the peer reviewed literature between 2010 and 2016. We identified 24 articles that reported the incidence of HAIs in Australian hospitals.

Overall, data from these multi centred studies suggested 83,000 HAIs per year in Australia. UTIs are were the most common, followed by C.difficile, SSIs, respiratory infections and Staphylococcus aureus bacteraemia. HAI burden.png

Of course, these numbers are a very  large underestimate given the lack of or incomplete data on common infections. It is also limited to data published in the peer reviewed literature.

Incidence data on infections such as pneumonia, gastroenterological and bloodstream infections (other than SAB) were not identified, thus potentially
missing up to 50% of infections. That being the case, the

PPS blog incidence of HAIs in Australia may be closer to 165,000 per year.

Don’t believe me? Have a look at the results of point prevelance studies in Europe (right). Respiratory tract infections, bloodstream infections and others account for a large proportion of HAIs.  Of course, Australia has not had a PPS undertaken in 30 years, so we don’t really know. However, for readers of this blog, you will know that will soon change.

A figure of 200,000 HAIs per year in Australia is commonly cited, however, this figure was derived from one study undertaken several years ago (a sign of what was available at the time). Our study, may, in part, demonstrate the increasing number of publications on HAIs in Australia. We are certainly not suggesting a reduction in HAIs and any such claim based on the findings of our study should be immediately dismissed.

There are some other equally important findings from our study:

  • There needs to be a determination and action by state and national government bodies to achieve consensus on national HAI definitions
  • We need national approaches to HAI surveillance and transparent regular reporting. Australia is so far behind other countries in this regard [2] [3]
  • In the absence of action by government, we call on those undertaking HAI surveillance (especially incidence) to report your data in the peer reviewed literature

We also found there is little information about healthcare associated respiratory infections, such as pneumonia. Maybe it is in the too hard basket (nice blog by Martin Keirnan which says it all). Well, I think we should do something about healthcare associated pneumonia – at the very least, understand the incidence and risk factors a little better. I am working on it…..

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Footnote: Some of the research I have been involved with has been supported by donations from the public. For that, I am very grateful. Should you or your company wish to make a tax deductible donation, you can do so here.

References

  1. Mitchell, BG., Shaban, R., MacBeth, D., Wood, CJ., Russo, PL (2017). The burden of healthcare-associated infection in Australian hospitals: A systematic review of the literature. Infection Disease and Health. https://doi.org/10.1016/j.idh.2017.07.001
  2. Russo, P. L., Cheng, A. C., Richards, M., Graves, N., & Hall, L. (2015). Healthcare-associated infections in Australia: time for national surveillance. Australian Health Review, 39(1), 37-43.
  3. Russo PL, Cheng AC, Mitchell BM, & L, H. (2017). Healthcare associated infections in Australia – Tackling the “known unknowns”! Australian Health Review, (published online 7 March 2017), http://dx.doi.org/10.1071/AH16223