Healthcare – associated infection outside the hospital walls: benefits of including ambulatory and primary healthcare services in case reviews

Ms Annmaree Wilson, Ms Beth  Bint, Ms Joanna Harris, Ms Fiona Hamilton

1Illawarra Shoalhaven Local Health District, Nowra, Australia


Introduction: Within the hospital setting considerable work is dedicated to the review of serious healthcare-associated infections (HAI) e.g. bacteraemias, to identify factors that have contributed to the infection and enable a risk management approach to identify opportunities to improve practice. However, historically cases associated with community-based services have not been included in these investigations. This presentation outlines the process one NSW Local Healthcare District (LHD) has implemented to broaden the scope of HAI reviews to improve patient safety.


Surveillance of all HAI Staphylococcus aureus, Vancomycin resistant Enterococcus and Carbapenamase-producing Enterobacteriacaie bloodstream infections are entered into the incident management system and investigated by a multi-disciplinary team. ISLHD has broadened the scope of reporting and investigation to include community-based services where healthcare provided by these teams has been identified as relevant to the case.


Within a 12 month period 2 bacteraemias were identified as attributable to healthcare provided in the community.  The inclusion of community-based teams in the review process has enabled practice review and identification of policy/procedure and training/education gaps. It has also provided evidence-based feedback to community based colleagues of HAI directly associated with their service, which was not previously readily available.


The inclusion of community-based teams in the review of serious HAI has added another risk management strategy to improve patient safety and reduce the risk of HAI wherever people access healthcare services within our LHD.

Conflict of interest

No conflict of interest to declare


Annmaree Wilson is an Infection Prevention and Control Clinical Nurse Consultant who works for Illawarra Shoalhaven Local Health District. Annmaree has worked in Infection Control in Australia since 1990 and prior to this gained experience in Infection Control in America. Annmaree has a strong passion for consumer engagement and policy development and analysis within her current portfolio.

Recent Comments