1. Surveillance… Changing Hats Association for Professionals in Infection Control and Epidemiology (APIC) Greater New York Chapter 13 Sandra Hardy, MA, RN December 18, 2013

2. How surveillance has changed We wear many hats We juggle many hats

3. Infection Control Practitioner - Then  Collects data on hospital infections  Analyzes the data to identify patterns and trends  Infection rates are shared and discussed at the Infection Control Committee with representatives from various departments  Infection rates are shared with physicians and nursing administration

4. Surveillance  Surveillance is a comprehensive method of measuring outcomes and related processes of care, analyzing the data and, providing information to members of the healthcare team to assist in improving those outcomes and processes.  Surveillance can be used to quickly identify outbreaks.

5. Surveillance Data – Then  National Nosocomial Infection Surveillance System ( NNIS)  Total House - positive blood cultures  Surgical Site Infections – Cardiac  High Risk Surgical Procedures  Data was entered into the NNIS data base and analyzed  Spreadsheets, graphs, analysis,and reports were done by the IP

6. Collection of Data – Then  Manual review of computerized microbiology reports and other laboratory reports  Patient care information from a variety of sources – i.e. patient chart, OR  Limited in scope  Time consuming and labor intensive  Limited resources

7. One Infection Preventionist & Surveillance

8. Surveillance – Drivers of Change In Healthcare  Joint Commission  Center For Medicare/Medicaid Services (CMS)  National Guidelines  State Mandates  Institute of Medicine (IOM)  Institute of Healthcare Improvement (IHI)

9. Surveillance & Data Collection - Now  Use of automated surveillance technologies  ICIS EPIC system  Electronic Medical Record  Commercial software  APIC Tool Kit  National Healthcare Safety Network (NHSN)

10. Infection Preventionists - Now  The new team members to our Infection Prevention department - Data analysts/specialists  Normally Data analysts/specialist: collects, organize and interprets statistical information

11. Infection Prevention Department Data Analysts / Specialists  Orientation to the IP department  Surgical Site Infections  Analytics – downloading of data  Hand Hygiene Observers  Collection of Central line checklist data  Environmental culturing  Influenza Vaccinations

12. IP: Validate Surveillance Data  Case review meeting  Reviewing the download data  Randomly review cases – over a period of time  Make sure data have been reviewed by the Director or Associate Director of the department

13. Conclusion  Surveillance is an esse ntial part of an effective infection prevention & control program, and technology has alter the manner in which it is done.  The electronic data technologies should decrease the time spent on data management and more time spent on prevention and intervention.  When the hospital begin to invest in newer technology a representative from the IP department should be on the committee.

14. References 1. Green l, et al. APIC Position Paper: The Importance of Surveillance Technologies in the Prevention of Healthcare- Associated Infection(HAIs) 2009-5-29-09 2. Grota PG, Stone PW, Jordan S. Electronic surveillance systems in infection prevention: organizational support, programs characteristics, and user satisfaction. Am J Infection Control. 2010 Sep:38(7):509-14 3. Tagalicod R, Jacob R, Progress on Adoption of Electronic Health Records CMS. gov http://www.cms.gov/eHealth/ListServ_Stage3Implementation.html 4. Birdsall C, Health Information Management http://www.healthline.com/galecontent/health-information-management

15. APIC Greater New York Chapter 13 2013 Champion