Infection Control Today

DEC 2018

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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10 ICT December 2018 www.infectioncontroltoday.com A r tificial intelligence could become a busy infection preventionist (IP)'s best friend and should be embraced where feasible to help reduce the burdens associated with traditional surveillance methodologies. As Russo, et al. (2018) remind us, "Key to preventing and controlling healthcare-associated infections (HAIs) is their identifi cation and reporting through standardized classifi cation, which comprises a major component of surveillance. Surveillance is a fundamental tool to successful infection prevention and control programs. The purpose of HAI surveillance is to provide quality data that can act as an effective monitoring and alert system and reduce the incidence of preventable infections. Effective surveillance systems deliver information that can be used to inform decisions." In a review by de Bruin, et al. (2014) the researchers found some studies indicated that surveillance rules are complex and open to subjective interpretation, causing considerable variability in manual surveillance results, both within and between healthcare institutes. They say that electronic surveillance systems lack variability as they consistently apply surveillance defi nitions; studies that directly compared electronic and manual surveillance performance showed that electronic surveillance achieves equal or better sensitivity than manual surveillance. They note, "Driven by the increased availability of electronic patient data, electronic HAI surveillance systems use more data, making systems more sensitive yet less specifi c, but also allow systems to be tailored to the needs of healthcare institutes' surveillance programs." Studies have demonstrated that automation and the use of electronic surveillance systems (ESS) result in improved data accuracy and sensitivity when compared to traditional methods. This is particularly important with the increasing requirements for public reporting of HAIs and their use for performance measurement associated with fi nancial penalties. It is also claimed that ESS can assist IP staff with surveillance by decreasing the burden of data collection, resulting in signifi cant time savings. In their review, Freeman, et al. (2013) found an emphasis was on the linkage of electronic databases to provide automated methods for monitoring infections in specifi c clinical settings. The studies they examined assessed the performance of their method with traditional surveillance methodologies or a manual reference method. Where sensitivity and specifi city were calculated, these varied depending on the organism or condition being surveyed and the data sources employed. They concluded that, "The implementation of electronic surveillance was found to be feasible in many settings, with several systems fully integrated into hospital information systems and routine surveillance practices. The results of this review suggest that electronic surveillance systems should be developed to maximize the effi cacy of abundant electronic data sources existing within hospitals." Despite widespread availability, Hebden notes that the adoption of ESS is slow, and suggests that this may be due to a lack of understanding the barriers to implementing ESS. Grota, et al. (2010); Halpin, et al. (2011) and Masnick, et al. (2014) report that between 23 percent and 56 percent of facilities in the U.S. have ESS. "Certainly by now, the vast majority of both acute-care and critical-access hospitals have acquired electronic medical records (EMR) systems as a result of the Health Information Technology for Economic and Clinical Health (HITECH) Act, and the Centers for Medicare and Medicaid Services (CMS) incentive programs for hospitals to transition from paper to digital patient-care systems," confi rms Gwen Borlaug, MPH, CIC, FAPIC, an infection prevention consultant and former director of the HAI Prevention Program at the Wisconsin Division of Public Health. "But although EMRs aid in conducting HAI surveillance by delivering more comprehensive patient care data faster to the IP, there is more to electronic surveillance that just the use of EMRs. Electronic surveillance systems integrate patient data from multiple databases—medical records, laboratory results, pharmacy—and apply an electronic algorithm to determine whether a case defi nition for a particular HAI has been met, enabling more effi cient surveillance." Ò Studies have demonstrated that automation and the use of electronic surveillance systems (ESS) result in improved data accuracy and sensitivity when compared to traditional methods. feature Electronic Surveillance: Slow Adoption Could Hamper Enhanced HAI Prevention Efforts By Kelly M. Pyrek

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