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How Infection Preventionists Better Their Programs with Surveillance

Surveillance of healthcare-associated infections provides the essential foundation for infection prevention—and much of the information an infection preventionist needs to create a continually improving program.

Infection preventionists (IPs) must focus first on identifying at risk patients from the mountain of data from multiple sources that they receive, sort through and cross check. Then, they turn to meeting regulatory and management reporting requirements. For IPs with a manual, paper-based system, those two functions often take up most of the the time available for infection prevention duties. With an electronic surveillance system (ESS), however, IPs use the data from the surveillance system to create a feedback loop, freeing up the IP’s time from manual reporting and allowing the IP to steadily improve their infection prevention program.

An electronic surveillance system aggregates and analyzes data from information systems across the hospital, including admissions/discharge/transfer, laboratories, the electronic medical record and pharmacy, freeing up nearly 50% of an infection preventionist’s time.1 Because these systems process data in real time and generate alerts immediately when potential problems are detected, they minimize the time needed to identify patients with healthcare-associated infections and multidrug resistant organisms. An ESS also dramatically reduces the likelihood that an emerging infectious disease issue will go undetected.

Flagging more infections improves surveillance strategies, but an electronic surveillance system enables infection prevention programs to do even better. These surveillance systems can also monitor antimicrobial agent selection within the facility, by unit and by provider to identify patterns of overuse as well as “bug/drug” mismatches. An ESS with clinical decision support provides guidance for appropriate agent selection and recommended dosage and duration, which improves patient safety and outcomes while reducing costs associated with inappropriate or excessive use of antimicrobial agents. Automatically generated antibiograms help ensure providers and pharmacists know the most effective therapies for each infection and alert infection preventionists and others to emerging multidrug resistant organisms (MDROs) by trending the percent susceptible for a given antibiotic/organism combination over multiple years. 

Electronic surveillance systems can also track and generate reports on the impact of interventions on infection rates/standardized infection ratios over time. This allows the infection preventionist to see where the hospital’s program can improve, what interventions worked well and which areas need further improvement. In addition, the clinician can identify which providers consistently follow treatment guidelines, to provide positive feedback and enlist their support in reaching their colleagues. They can also review the trends of providers that accept interventions less often to see if there is a pattern—an unwarranted reliance on a specific antibiotic, a preference to treat a particular kind of infection with a less effective drug—that they can identify and intervene in a timely manner to enhance patient safety.

Auto-populated report forms further reduce the time IPs spend meeting regulatory requirements to provide hospital data to the National Health Safety Network and make it much easier to report on trends, successes and challenges to managing data reporting. Graphical, easy to read reports provide evidence of the IP program’s success, while showing where additional support from hospital management may be required. 

For infection preventionists determined to take their programs to ever higher standards and greater success, electronic surveillance systems provide the time and tools needed to move beyond patient identification and reporting to continuous quality improvement and enhanced patient safety.

How have you used electronic surveillance to improve your infection prevention program?

1. Stone PW, Dick A, Pogorzelska M, Horan TC, Furuya EY, Larson E. Staffing and structure of infection prevention and control programs. Am J of Infect Control. June 2009;37(5):351-7.

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