Third HCAI Prevalence Survey

1. Third HCAI Prevalence Survey Organisation of the survey and role of the regional co-ordinator

2. HIS ICNA HCAI Prevalence Survey 2006 2 Four components Prevalence survey which will provide HCAI prevalence rates in Northern Ireland and to individual hospitals Similar studies to be carried out in England, Wales and the Republic of Ireland Access to the HCAI prevalence component of the Scottish National Prevalence Survey Collation of all data to produce HCAI prevalence rates for the UK and Ireland

3. HIS ICNA HCAI Prevalence Survey 2006 3 Data collection In order to ensure the validity and accuracy of data, these will be collected by: ICTs trained in the diagnosis of HCAI according to the Centers for Disease Control & Prevention (CDC) definitions of HCAI Northern Ireland co-ordinator will help local staff with educational and methodological issues regarding HCAI diagnosis, co-ordinate data returns and participate in a validation study

4. HIS ICNA HCAI Prevalence Survey 2006 4 Eligibility - Trusts Inclusion criteria Acute Trusts with adult inpatients Exclusion criteria Trusts providing non-acute services Trusts with fewer than 50 inpatient beds Paediatric units (to avoid the complexity of introducing additional HCAI definitions suitable for children) Trusts without access to Infection Control Team

5. HIS ICNA HCAI Prevalence Survey 2006 5 Exclude Paediatric patients Psychiatric patients Day centre rehabilitation patients Day-case patients Emergency department patients Acute medical admission units

6. HIS ICNA HCAI Prevalence Survey 2006 6 Data collection Hospitals have provided details of bed numbers for calculation of the number of surveillance questionnaires required All patients (infected or not) who occupy beds in the selected wards will be included in the survey and data collection will be undertaken utilising the HCAI questionnaires A record will be made on a ward questionnaire of the number of eligible patients

7. HIS ICNA HCAI Prevalence Survey 2006 7 Organisation in Northern Ireland Funded by DHSSPSNI Lead by HISC UK & Ireland coordinated by Hospital Infection Society Monitored by the HCAI Prevalence Survey Steering Group appointed by the HIS 10.5 regional co-ordinators appointed in England 1 co-ordinator in Northern Ireland

8. HIS ICNA HCAI Prevalence Survey 2006 8 Statistical Issues A detailed rationale for the sampling approach for the study, sample size and estimates of precision and data analysis methods has been developed

9. HIS ICNA HCAI Prevalence Survey 2006 9 Data collection Data will be collected in each hospital over a period of days or weeks All data collection in a ward must be completed within one day Data collection will be undertaken on weekdays Data items will be collected on specially designed scannable questionnaires

10. HIS ICNA HCAI Prevalence Survey 2006 10 Data management Consistent with Data Protection Act 1998 Databases will be password protected Only members of the data management team at HISC and the HIS HCAI Prevalence Survey Steering Group will have access to the overall data Local ICTs involved in data collection will have access to their own hospital�s data

11. HIS ICNA HCAI Prevalence Survey 2006 11 Ethical approval �Ethical committee approval is not required for the Prevalence Survey. It is part of a surveillance programme to monitor outcomes in NHS services and is part of a high level audit cycle that will enable individual Trusts to look at their own performance against the national picture. Neither audit nor surveillance comes under research.� Department of Health - 13th January 2006 DHSSPSNI � 23rd January 2006

12. HIS ICNA HCAI Prevalence Survey 2006 12 Confidentiality Patient confidentiality is protected Patient identifiers are not recorded Age will be collected and not date of birth Regional co-ordinator will sign confidentiality agreements in the hospitals before having access to patient data Permission to examine patients� notes has been sought from the Medical Director of each Trust

13. HIS ICNA HCAI Prevalence Survey 2006 13 Validation studies The robustness and accuracy of the information collected will be examined in two studies: A validation study conducted by the data management team will examine the accuracy of the data A validation study conducted by the regional co-ordinators will examine the accuracy of data collection

14. HIS ICNA HCAI Prevalence Survey 2006 14 Feedback Interim results will be presented at the HIS International Conference in Amsterdam � October 2006 Participating hospitals will have access to a web based reporting system for production of their indivdual hospital�s results � October 2006 A final report will be published in the Journal of Hospital Infection

15. HIS ICNA HCAI Prevalence Survey 2006 15 Role of Co-ordinator Facilitate smooth running of the project in the allocated hospitals: Education Planning Administration Support and communication Queries and clarification Validation Encouragement

16. HIS ICNA HCAI Prevalence Survey 2006 16 Validation Regional co-ordinator requires permission to access notes prior to validation Regional co-ordinator will validate two wards per hospital To check for correct interpretation of definitions between hospital team and regional co-ordinators

17. HIS ICNA HCAI Prevalence Survey 2006 17 Problems Regional co-ordinator is the first point of contact for hospital teams for queries and operational difficulties

18. HIS ICNA HCAI Prevalence Survey 2006 18 Prevalence survey will run: 13th February 2006 to 12th May 2006