Evidence based recommendations for a national healthcare associated infection surveillance program

Philip Russo 1,2, Allen Cheng 3, Mike Richards 4, Nick Graves 1, Lisa Hall 1

Queensland University of Technology, Brisbane, QLD, Australia

Griffith University, Brisbane, QLD, Australia

Infectious Diseases Epidemiology Unit, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia

Faculty of Medicine, Dentistry and Health, University of Melbourne, Melbourne, VIC, Australia


Australia does not have a national healthcare associated infection surveillance program (HAISP). Several State-wide HAISPs based on the National Health and Safety Network developed independently. This body of research aimed to map out a pathway for a national HAISP in Australia.

To identify variation in current surveillance practices across Australia, infection prevention staff in hospitals with >50 acute beds were invited to complete an online survey. The survey explored surveillance methods and, through a series of clinical vignettes, agreement in HAI identification. We then used a discrete choice experiment (DCE) to identify key stakeholder (KSH) preferences when considering a national HAISP. A total of 184 participants were purposively selected to participate in the DCE.

A total of 104 participants responded to the online survey. Variation in methodology, staff skill and support was identified across Australia. Moderate agreement in HAI identification (range 53%-75) was found. Response rate t the DCE was 66%. The strongest preferences for national HAISP were: 1) mandatory program with continuous targeted surveillance 2) a protocol with risk adjustment 3) annual competency assessments 4) very accurate data, 5) hospital level data publicly reported.

Whilst the true epidemiology of HAIs in Australia remains unknown, the national HAI surveillance landscape is now understood. This body of research has identified gaps, opportunities, and preferences of KSHs to enable progress towards a meaningful national HAISP. Data from this research will now be considered along with best practice, feasibility, resources and implementation requirements in developing a national program.

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