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Sasie SD, Ayano G, Mamo F, Azage M, Spigt M. Assessing the performance of the integrated disease surveillance and response systems: a systematic review of global evidence. Public Health 2024; 231:71-79. [PMID: 38636279 DOI: 10.1016/j.puhe.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/27/2024] [Accepted: 03/13/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES Public health surveillance systems are critical for detecting and responding to health threats. This review aims to analyze international literature on the performance of these systems in terms of core, support, and attributes of surveillance system. STUDY DESIGN Systematic review. METHODS Following the preregistered protocol (PROSPERO: CRD42022366051), a systematic search was conducted on PubMed/MEDLINE, CINHAL, CABI, Web of Science, and Google Scholar for articles evaluating Public Health Surveillance System performance from inception to July 21, 2023. Various study designs were included, and quality assessment was performed. Thematic analysis categorized findings into key surveillance system functions. RESULTS Nine studies from different countries assessed core and supportive functions, as well as surveillance attributes. Performance varied among countries, with some excelling overall and others showing poor performance in specific areas. Many countries' surveillance systems had inadequate performance in key measures in terms of the core and supportive functions, as well as the attributes of the surveillance system. CONCLUSION This review shows significant variations in the performance of public health surveillance systems across countries. Further research is needed to understand underperformance reasons and inform global policymaking for strengthening surveillance systems.
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Affiliation(s)
- S D Sasie
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia; Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands.
| | - G Ayano
- School of Population Health, Curtin University, Australia.
| | - F Mamo
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - M Azage
- Department of Environmental Health, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - M Spigt
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands; General Practice Research Unit, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.
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Watson E, Rajkhowa A, Dunt D, Bull A, Worth LJ, Bennett N. Evaluation of an Infection surveillance program in residential aged care facilities in Victoria, Australia. BMC Public Health 2024; 24:254. [PMID: 38254078 PMCID: PMC10801934 DOI: 10.1186/s12889-023-17482-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Infection surveillance is a key element of infection prevention and control activities in the aged care sector. In 2017, a standardised infection surveillance program was established for public residential aged care services in Victoria, Australia. This program will soon be expanded to a national level for all Australian residential aged care facilities. It has not been evaluated since its inception. METHODS The current study aimed to evaluate the Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre Aged Care Infection Indicator Program (ACIIP), to understand its performance and functionality. A mixed methods evaluation was performed using the Updated Guidelines for Evaluating Public Health Surveillance Systems developed by the United States Centers for Disease Control and Prevention as a framework. VICNISS staff who coordinate and manage the ACIIP were invited to participate in interviews. Residential aged care staff who use the program were invited to participate in a survey. Document analysis was also performed. RESULTS Four VICNISS staff participated in the interviews and 38 aged care staff participated in the survey. The ACIIP is stable and able to be adapted quickly to changing definitions for infections. Users found the system relatively easy to use but have difficulties after the long intervals between data entry year on year. VICNISS staff provide expert guidance which benefits users. Users appreciated the benefit of participating and many use the data for improving local practice. CONCLUSIONS The ACIIP is a usessful state-wide infection surveillance program for aged care. Further development of data validation, IT system capacity and models for education and user support will be required to support future scalability.
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Affiliation(s)
- Eliza Watson
- Doherty Institute for Infection and Immunity, Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, 792 Elizabeth St, Melbourne, VIC, 3000, Australia
| | - Arjun Rajkhowa
- Department of Infectious Diseases, National Centre for Antimicrobial Stewardship, The University of Melbourne, Melbourne, VIC, 3000, Australia
| | - David Dunt
- The University of Melbourne, Melbourne, VIC, 3000, Australia
| | - Ann Bull
- Doherty Institute for Infection and Immunity, Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, 792 Elizabeth St, Melbourne, VIC, 3000, Australia
| | - Leon J Worth
- Doherty Institute for Infection and Immunity, Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, 792 Elizabeth St, Melbourne, VIC, 3000, Australia
- Department of Oncology, Department of Infectious Diseases, University of Melbourne Cancer, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
- Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, 3065, Australia
| | - Noleen Bennett
- Doherty Institute for Infection and Immunity, Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, 792 Elizabeth St, Melbourne, VIC, 3000, Australia.
- Department of Infectious Diseases, National Centre for Antimicrobial Stewardship, The University of Melbourne, Melbourne, VIC, 3000, Australia.
- Department of Nursing, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, 3065, Australia.
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Verberk JD, van der Kooi TI, Derde LP, Bonten MJ, de Greeff SC, van Mourik MS. Do we need to change catheter-related bloodstream infection surveillance in the Netherlands? A qualitative study among infection prevention professionals. BMJ Open 2021; 11:e046366. [PMID: 34408033 PMCID: PMC8375748 DOI: 10.1136/bmjopen-2020-046366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Catheter-related bloodstream infections (CRBSI) are a common healthcare-associated infection and therefore targeted by surveillance programmes in many countries. Concerns, however, have been voiced regarding the reliability and construct validity of CRBSI surveillance and the connection with the current diagnostic procedures. The aim of this study was to explore the experiences of infection control practitioners (ICPs) and medical professionals with the current CRBSI surveillance in the Netherlands and their suggestions for improvement. DESIGN Qualitative study using focus group discussions (FGDs) with ICPs and medical professionals separately, followed by semistructured interviews to investigate whether the points raised in the FGDs were recognised and confirmed by the interviewees. Analyses were performed using thematic analyses. SETTING Basic, teaching and academic hospitals in the Netherlands. PARTICIPANTS 24 ICPs and 9 medical professionals. RESULTS Main themes derived from experiences with current surveillance were (1) ICPs' doubt regarding the yield of surveillance given the low incidence of CRBSI, the high workload and IT problems; (2) the experienced lack of leadership and responsibility for recording information needed for surveillance and (3) difficulties with applying and interpreting the CRBSI definition. Suggestions were made to simplify the surveillance protocol, expand the follow-up and surveillance to homecare settings, simplify the definition and customise it for specific patient groups. Participants reported hoping for and counting on automatisation solutions to support future surveillance. CONCLUSIONS This study reveals several problems with the feasibility and acceptance of the current CRBSI surveillance and proposes several suggestions for improvement. This provides valuable input for future surveillance activities, thereby taking into account automation possibilities.
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Affiliation(s)
- Janneke Dm Verberk
- Medical Microbiology and Infection Control, UMC Utrecht, Utrecht, The Netherlands
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Tjallie Ii van der Kooi
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Lennie Pg Derde
- Department of Intensive Care Medicine, UMC Utrecht, Utrecht, The Netherlands
| | - Marc Jm Bonten
- Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands
| | - Sabine C de Greeff
- Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Maaike Sm van Mourik
- Medical Microbiology and Infection Control, UMC Utrecht, Utrecht, The Netherlands
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Chen H, Yu P, Hailey D, Cui T. Identification of the essential components of quality in the data collection process for public health information systems. Health Informatics J 2019; 26:664-682. [PMID: 31140353 DOI: 10.1177/1460458219848622] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study identifies essential components in the data collection process for public health information systems based on appraisal and synthesis of the reported factors affecting this process in the literature. Extant process assessment instruments and studies of public health data collection from electronic databases and the relevant institutional websites were reviewed and analyzed following a five-stage framework. Four dimensions covering 12 factors and 149 indicators were identified. The first dimension, data collection management, includes data collection system and quality assurance. The second dimension, data collector, is described by staffing pattern, skill or competence, communication and attitude toward data collection. The third, information system, is assessed by function and technology support, integration of different data collection systems, and device. The fourth dimension, data collection environment, comprises training, leadership, and funding. With empirical testing and contextual analysis, these essential components can be further used to develop a framework for measuring the quality of the data collection process for public health information systems.
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Affiliation(s)
- Hong Chen
- University of Wollongong, Australia; Jiangxi Provincial Centre for Disease Prevention and Control, China
| | - Ping Yu
- University of Wollongong, Australia; Illawarra Health and Medical Research Institute, Australia
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Fasugba O, Koerner J, Bennett N, Burrell S, Laguitan R, Hoskins A, Beckingham W, Mitchell BG, Gardner A. Development and evaluation of a website for surveillance of healthcare-associated urinary tract infections in Australia. J Hosp Infect 2018; 99:98-102. [PMID: 29341882 DOI: 10.1016/j.jhin.2018.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 01/09/2018] [Indexed: 11/29/2022]
Abstract
Phase II of the Surveillance to Reduce Urinary Tract Infections project piloted a website for point prevalence surveys of healthcare-associated (HAUTI) and catheter-associated urinary tract infection in Australian hospitals and aged care homes. This report describes development and evaluation of the website for online data collection. Evaluation findings from 38 data collectors indicated that most respondents found website registration and web form use easy (N = 22; 58% and N = 16; 43%, respectively). The need for improved computer literacy skills and automated data systems were highlighted. This study demonstrated a novel approach for Australian HAUTI data collection; however, refinements are needed before national roll-out.
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Affiliation(s)
- O Fasugba
- Nursing Research Institute, Australian Catholic University and St Vincent's Health Australia (Sydney), Australian Capital Territory, Australia; Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia.
| | - J Koerner
- Faculty of Health Sciences, Australian Catholic University, Canberra, Australian Capital Territory, Australia
| | - N Bennett
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre (VICNISS), Melbourne, Victoria, Australia
| | - S Burrell
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre (VICNISS), Melbourne, Victoria, Australia
| | - R Laguitan
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre (VICNISS), Melbourne, Victoria, Australia
| | - A Hoskins
- Victorian Healthcare Associated Infection Surveillance System Coordinating Centre (VICNISS), Melbourne, Victoria, Australia
| | - W Beckingham
- Infection Prevention and Control, Canberra Hospital and Health Services, Canberra, Australian Capital Territory, Australia
| | - B G Mitchell
- Faculty of Arts, Nursing and Theology, Avondale College of Higher Education, Wahroonga, New South Wales, Australia
| | - A Gardner
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Canberra, Australian Capital Territory, Australia
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Tseng YJ, Wu JH, Lin HC, Chen MY, Ping XO, Sun CC, Shang RJ, Sheng WH, Chen YC, Lai F, Chang SC. A Web-Based, Hospital-Wide Health Care-Associated Bloodstream Infection Surveillance and Classification System: Development and Evaluation. JMIR Med Inform 2015; 3:e31. [PMID: 26392229 PMCID: PMC4705006 DOI: 10.2196/medinform.4171] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 06/07/2015] [Accepted: 07/24/2015] [Indexed: 11/16/2022] Open
Abstract
Background Surveillance of health care-associated infections is an essential component of infection prevention programs, but conventional systems are labor intensive and performance dependent. Objective To develop an automatic surveillance and classification system for health care-associated bloodstream infection (HABSI), and to evaluate its performance by comparing it with a conventional infection control personnel (ICP)-based surveillance system. Methods We developed a Web-based system that was integrated into the medical information system of a 2200-bed teaching hospital in Taiwan. The system automatically detects and classifies HABSIs. Results In this study, the number of computer-detected HABSIs correlated closely with the number of HABSIs detected by ICP by department (n=20; r=.999 P<.001) and by time (n=14; r=.941; P<.001). Compared with reference standards, this system performed excellently with regard to sensitivity (98.16%), specificity (99.96%), positive predictive value (95.81%), and negative predictive value (99.98%). The system enabled decreasing the delay in confirmation of HABSI cases, on average, by 29 days. Conclusions This system provides reliable and objective HABSI data for quality indicators, improving the delay caused by a conventional surveillance system.
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Affiliation(s)
- Yi-Ju Tseng
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
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Ridelberg M, Nilsen P. Using surveillance data to reduce healthcare-associated infection: a qualitative study in Sweden. J Infect Prev 2015; 16:208-214. [PMID: 28989432 PMCID: PMC5074157 DOI: 10.1177/1757177415588380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/05/2015] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Healthcare-associated infection (HAI) surveillance data can be used to estimate the scope, spread and location of infections, monitor trends, evaluate preventive efforts, and improve practices, policy and facility planning. In Sweden, national point prevalence surveys (PPS) have been conducted twice yearly in all county councils since 2008. AIM The aim of this study was to identify key obstacles concerning the HAI surveillance process. METHODS Twenty-two infection control practitioners (ICPs) from all county councils in Sweden were interviewed, using semi-structured interview guides. Data were analysed using qualitative content analysis. RESULTS Sixteen types of obstacles pertaining to four surveillance stages were identified. Most obstacles were associated with the first two stages, which meant that the latter stages of this process, i.e. the use of the results to reduce HAI, were underdeveloped. The ICPs observed scepticism towards both the PPS methodology itself and the quality of the HAI data collected in the PPS, which hinders HAI surveillance realising its full potential in Swedish healthcare.
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Affiliation(s)
- Mikaela Ridelberg
- Department of Medical and Health Sciences, Division of Health Care Analysis, Linkoping University, Linköping, Sweden
| | - Per Nilsen
- Department of Medical and Health Sciences, Division of Health Care Analysis, Linkoping University, Linköping, Sweden
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Point-prevalence surveillance of healthcare-associated infections in Swedish hospitals, 2008-2014. Description of the method and reliability of results. J Hosp Infect 2015; 91:220-4. [PMID: 26365826 DOI: 10.1016/j.jhin.2015.07.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 07/28/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND In 2007 the Swedish Association of Local Authorities and Regions (SALAR) decided to establish a nationwide system for point-prevalence surveillance of healthcare-associated infections (HCAIs) among hospitalized patients. Surveillance started in 2008 and has since then been performed twice a year (April and October). The documentation of HCAIs is performed by regular clinical physicians and nurses on each hospital ward aided by oral and written instructions. All Swedish publicly financed hospitals (>95% of all hospitals) are included (25,862 beds in 2008 and 24,905 beds in 2013). A total of 88-92% of all inpatients has been covered in each survey. The overall prevalence of HCAI (including psychiatric inpatients) has ranged from 7.8% to 10.0%. AIM In 2012 SALAR decided to assess the reliability of the prevalence data. METHODS In all, 1216 patients were assessed for HCAIs by both the regular surveillance teams and teams with expert knowledge on HCAI independently of each other. FINDINGS The prevalence of HCAI was 8.3% (95% confidence interval: 6.7-9.9) according to the regular teams and 13.1% (11.2-15.0) according to the expert teams. The sensitivity of the regular point-prevalence surveillance was 47% and the specificity 97%. CONCLUSION The Swedish system for repeated nationwide point-prevalence surveillance of HCAI has had a high coverage of about 90% since it commenced. However, the surveys underestimate the true prevalence of HCAI.
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Reilly JS, Price L, Godwin J, Cairns S, Hopkins S, Cookson B, Malcolm W, Hughes G, Lyytikaïnen O, Coignard B, Hansen S, Suetens C, National Participants in the ECDC pilot validation study C. A pilot validation in 10 European Union Member States of a point prevalence survey of healthcare-associated infections and antimicrobial use in acute hospitals in Europe, 2011. Euro Surveill 2015; 20. [DOI: 10.2807/1560-7917.es2015.20.8.21045] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- J S Reilly
- Glasgow Caledonian University, Glasgow, United Kingdom
| | - L Price
- Glasgow Caledonian University, Glasgow, United Kingdom
| | - J Godwin
- Glasgow Caledonian University, Glasgow, United Kingdom
| | - S Cairns
- Health Protection Scotland, Glasgow, United Kingdom
| | - S Hopkins
- Public Health England, London, United Kingdom
| | - B Cookson
- Public Health England, London, United Kingdom
- University College London, United Kingdom (current affiliation)
| | - W Malcolm
- Health Protection Scotland, Glasgow, United Kingdom
| | - G Hughes
- Public Health England, London, United Kingdom
| | - O Lyytikaïnen
- National Institute for Health and Welfare, Helsinki, Finland
| | - B Coignard
- Institut de Veille Sanitaire, Saint-Maurice, France
| | - S Hansen
- Charité University Medicine Berlin, Germany
| | - C Suetens
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Hübner NO, Fleßa S, Jakisch R, Assadian O, Kramer A. Review of indicators for cross-sectoral optimization of nosocomial infection prophylaxis - a perspective from structurally- and process-oriented hygiene. GMS KRANKENHAUSHYGIENE INTERDISZIPLINAR 2012; 7:Doc15. [PMID: 22558049 PMCID: PMC3334955 DOI: 10.3205/dgkh000199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In the care of patients, the prevention of nosocomial infections is crucial. For it to be successful, cross-sectoral, interface-oriented hygiene quality management is necessary. The goal is to apply the HACCP (Hazard Assessment and Critical Control Points) concept to hospital hygiene, in order to create a multi-dimensional hygiene control system based on hygiene indicators that will overcome the limitations of a procedurally non-integrated and non-cross-sectoral view of hygiene. Three critical risk dimensions can be identified for the implementation of three-dimensional quality control of hygiene in clinical routine: the constitution of the person concerned, the surrounding physical structures and technical equipment, and the medical procedures. In these dimensions, the establishment of indicators and threshold values enables a comprehensive assessment of hygiene quality. Thus, the cross-sectoral evaluation of the quality of structure, processes and results is decisive for the success of integrated infection prophylaxis. This study lays the foundation for hygiene indicator requirements and develops initial concepts for evaluating quality management in hygiene.
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