Report from HAI-Net sessions. Rapporteur: Ana Budimir (Croatia)
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The 3rd joint meeting of the ARHAI networks focused on changes to ICU protocols for antimicrobial resistance and healthcare-associated infections, emphasizing the need for improved data collection and surveillance practices. Key issues discussed included the validation of ICU data, the legal implications of data sharing, and the development of methods for measuring attributable mortality related to HAIs. The meeting concluded with plans for enhanced participation in future PPS protocols and international validation efforts.
Report from HAI-Net sessions. Rapporteur: Ana Budimir (Croatia)
- 1. 3rd Joint Meeting of the Antimicrobial Resistance and Healthcare-Associated Infections (ARHAI) Networks Report from HAI-Net sessions Rapporteur: Ana Budimir (Croatia) Organised jointly with
- 2. HAI-Net ICU session 11/2/2015 1. HAI-Net ICU protocol changes agreed for piloting • Indicators of staffing, hand hygiene, antimicrobial stewardship, indicators of intubation care, CVC care; attributable mortality needs more discussion 2. Presentation of HELICSWin.Net ICU software 3. Rationale for validation of ICU data 4. Expansion of surveillance of ICU-acquired infections to more countries
- 3. Conclusions ICU surveillance HAI prevention indicators: • Agreed: 1-2 weeks data collection of • aggregated reporting per year /surveillance period, • unit based at least 30 opportunities per indicator • Attributable mortality • direct measurement of relationship of HAI to death: – Very strong reservations about the feasibility of acquiring valid data, from national experience – Concerns over negative effect on hospital participation/submission data to ECDC , fear that data would reach lawyers, press etc • Further develop methods in mortality via working group (email to recruit members)
- 4. 1. Presentation • Overview of legal basis; Overview of agreements from ECDC Management Board (EU countries, EC); Possibilities to say no (“Article 4”); possible annual policy review 2. Discussion • Very strong feeling from people, most were ICU people • Not notifiable in some countries, so no legal basis to share e.g. AT, SL. • Deductive disclosure of hospitals, units, patients, doctors is big fear. • Broad acceptance that use of data good for public health • HAI data acquired voluntarily based on trust for limits. Third party access to TESSy data
- 5. 1. Overview of PPS activities and changes to PPS protocol 2. US CDC presentation • 2011 PPS, 2015 PPS; comparability of results with EU? 3. Indicators for PPS II protocol • ‘SIGHT’ was ECDC systematic review of evidence base • Includes: Hosp organization, management, structure for prevention: key components and indicators for PPS protocol • Indicators of antimicrobial stewardship (TATFAR) 4. National and international PPS validation 5. PPS training and further planning 6. National PPS planning HAI-Net PPS session 12-13/2
- 6. Conclusions PPS PROTOCOL CHANGES • Agreement of SIGHT-based structure and process indicators • Antimicrobial stewardship and use: • 2 TATFAR indicators • Dosage to inform US/EU comparison Few other changes : HAI association to ward, neonatal birth weight, specialty for healthy babies…
- 7. Conclusions: PPS validation • Significant differences were noted between the teams of data collectors in terms of: • Completeness of data • Identifying patients who had undergone surgery in the previous month, • The number of HAI detected • No internationally agreed standard/protocol? • National validation-at the same time as the primary PPS • Recommended: 750 in 25 hosp, minimum 250 in 5 hospitals • International validation • Validation of national validation teams • Accompany national VT in 1-2 hospitals /country • Who? Part of HA-Net support call for tender (published soon): contractors +ECDC experts
- 8. Perspectives 1. HAI Net-ICU: new software, efforts to include more countries in surveillance, duration of surveillance, pilot on prevention indicators, mortality data… 2. 2nd PPS in 2016-new forms, changes in indicators 3. Pilot-PPS indicators based on SIGHT project findings 4. Participation in PPS II: almost all confirmed, 4 countries uncertain, validation almost all