402 / Implementation of a computerized surveillance programme for nosocomial infections

AUSTRIA
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Infection control / Prevention of surgical site infections
Documentation There is no specified text here
Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
Health care-associated infections from invasive medical devices in Intensive Care Units and Surgical Site Infections are a substantial risk for the patient, are associated with considerable morbidity, extended hospital stay and result in a considerable financial burden to healthcare providers.
A modular Nosocomial Infection Surveillance System (NISS) was introduced in 2010 in selected Styrian hospitals in order to collect relevant data on the occurrence of hospital-acquired infections and to allow corrective measures.
Now NISS-ITS (for Intensive Care Units) and NISS-OP (for Surgical Units) is ready for roll out to all other 35 Intensive Care Units and 80 Surgical Units of the Steiermärkische Krankenanstaltenges.m.b.H.
Description of the Patient Safety Practice
 
Started in 2008 an interdisciplinary workforce (surveillance-intelligence-centre, SIC-Team) consisting of experts from several medical disciplines (surgeons, intensive care doctors, hospital hygiene personal, epidemiologist, microbiologists), IT- and database specialists, statistician and a consultant for IT-based nosocomial infection control was formed to develop and implement a documentation system allowing continuous computer assisted documentation, processing and interpretation of surveillance data. Integration within the existing SAP(R)-IT Environment and Documentation System (openMEDOCS(R)) and automatic retrieval of information from other NISS modules (NISS-Multi Drug Resistance and NISS Microbiology) were prerequisites to enhance acceptance among users.

NISS-ITS was introduced to three Styrian Intensive Care Units and NISS-OP was introduced to two Styrian surgical units in 2010. Educational courses for participating physicians and nurses were held at each unit. Individual sessions at the documentation site were offered to documenting or responsible medical doctors at the wards. A surveillance manual, step-by-step documentation guide and the CDC-criteria were handed out and a help hot-line was established. Nosocomial Infections were strictly diagnosed and classified applying criteria of the Center for Disease Control and Prevention (CDC). Infection rates were then compared with data from the European Reference Center in Berlin (NRZ). Surgical Site Infections were analysed by infection site, pathogen distribution and resistance pattern within a one year period.
Tasks of the SIC-Team now are analyses of data and proof of validity, frequent reporting of data and benchmarking results, provide help and support for documenting units, warrant absolute anonymisation of data, communication with reference centres, training courses, development of new modules and lots more. A summary report is annual or biannual provided to all participating units, to be used in internal quality management.

Now (after a 2-year-Pilot-Phase) NISS-ITS (for Intensive Care Units) and NISS-OP (for Surgical Units) is ready for roll out to all other 35 Intensive Care Units and 80 Surgical Units of the Steiermärkische Krankenanstaltenges.m.b.H.
448_WP4_KAGes_NISS_Poster.pdf (attachment)
Attachment of relevant written information and/or photos, as appropriate
448_WP4_KAGes_NISS_Poster.pdf
There is no specified text here
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Unit or ward level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
448_WP4_KAGes_NISS_Poster.pdf
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Yes
Specification of implementation in another health care setting(s)
Hospital
Successful implementation's level  of this Patient Safety Practice across settings
Yes, across multiple specialities within the same setting
Involved health care staff
 
Physicians
Nurses
Technical support / technician
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
Bogiatzis A., Neuper O., Vander K. (2012): "Surveillance" - Die Überwachung nosokomialer Infektionen als Beitrag zur Patientensicherheit. In: Becker A., Glaser A., Kröll W., Schweppe P., Neuper O.(2012): Klinisches Risikomanagement. Beiträge zur Patientensicherheit. Wien-Graz: Neuer Wissenschaftlicher Verlag, S. 67-77.
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
Yes
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Not sufficient financial resources available
Not sufficient human resources available
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
Not relevant
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Athanasios Bogiatzis
Country: AUSTRIA
Organisation: Steiermärkische Krankenanstaltenges.m.b.H
E-mail: athanasios.bogiatzis@kages.at
Phone: +43(0)316/340-5701
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