ICD

Outcome Surveillance

Helathcare Associated Infections

Kuwait National Healthcare-associated Infections Surveillance System (KNHSS):

Objectives of the KNHSS

Surveillance Methodology:

  1. It is carried out in all Ministry of Health hospitals.
  2. It is conducted by a well trained infection control team (doctors and nurses).
  3. It in an active, patient-based, prospective, priority-directed and comprehensive that yields risk-adjusted incidence rates.

Active

The trained Infection Control Team vigorously looks for and identifies HAIs. Information is obtained from multiple data sources.

Patient-based

It identifies HAIs, assesses risk factors, monitor patient care procedures and practices. This requires ward rounds and discussion with caregivers.

Prospective

Monitor patients during their hospitalization. For surgical site infections (SSIs), also monitor during the post-discharge period.

Comprehensive

Continuous monitoring for all events and/or processes for all patients.

Priority-directed

KNHSS targets device-associated infections in critical care areas.

Numerator data collection:

The following data are collected:

  1. Demographic: name, date of birth, gender, file number, admission date .
  2. Infection: onset date, site of infection, patient care location of HAI onset.
  3. Risk factors: devices, procedures, other factors associated with HAI.
  4. Laboratory: pathogens, antibiogram, serology, pathology.
  5. Radiology: X-ray, CT scan, MRI, etc.

Data are collected from:

  1. Admission/discharge/transfer records and microbiology laboratory records and data base.
  2. Patient medical records and hospital information system for case confirmation. The Infection Control Team members revise nursing and physicians‘ notes, laboratory and radiology results, temperature chart and medication chart for administration of antibiotics.
  3. Visits to patient wards for observation and discussion with caregivers.
  4. For post-discharge detected SSI, sources include records from surgery outpatient clinics, emergency departments and primary healthcare centers.

Denominator Data Collection

The infection control team visits patient care areas under surveillance at the same time each day. Records are revised to count the total number of patients in addition to the total number of patients on central lines, mechanical ventilators and urinary catheters. The sum of these daily counts at the end of the month is used as denominators (numbers of patient days and device days).

For SSI surveillance, Infection Control Team records information on the operative procedures selected for surveillance (e.g., type of procedure, date, risk factors, etc.).Information is obtained from detailed logs of the operating room and from patient files.

Data analyses

Numerators and denominators are used to calculate risk adjusted incidence rates .These rates allow inter- and intra-facility rate comparisons.

Participating Hospitals

  1. Al-Jahra Hospital
  2. Mubarak Al-Kabeer Hospital
  3. Al- Farwaniya Hospital
  4. AL- Adan Hospital
  5. Al-Amiri Hospital
  6. Al-Sabah Hospital
  7. Al-Razi Orthopaedic Hospital
  8. Physical Medicine and Rehabilitation Hospital
  9. Infectious Diseases Hospital
  10. Maternity Hospital
  11. Chest Diseases Hospital
  12. Ibn Sina Hospital and associated centres: Burn, Organ transplant, Dialysis and Ophthalmic Centres.
  13. Kuwait Cancer Control Centre