A national point prevalence measurement of healthcare-associated infections in somatic care in Sweden,2008

Abstract number: P625

Erntell M., Isaksson B., Melander E., Prag M., Qvarfordt I., Ström D., Tammelin A., Wallin S., Wetterbrandt S., Zetterqvist I.

Objectives: The objective was to perform a nation wide web-based point prevalence measurement (PPM) of healthcare associated infections (HAI) and risk factors. The PPM is part of the national patient safety initiative and will be performed twice during 2009.

Method: A national cross sectional PPM of HAI was performed within a two-week period in November 2008. Demographic data, five defined risk factors for HAI and antibiotic therapy for all admitted patients was recorded by the staff of each ward. HAI was recorded in relation to 18 pre-defined diagnosis groups. Type of HAI was referred to as postoperative, device or drug related, and others.

Results: 101 hospitals included 22,746 patients, close to all admitted patients in Sweden. 20,131 were admitted in somatic wards. 1,203 were children and 54% women. 52.1% were admitted to specialities of internal medicine, 18.2% to surgery and 10.4% to orthopedics. 2,227 patients with 2,385 diagnoses of HAI were recorded. The most frequent HAI diagnoses were infections of the lower urinary tract, 20.5% (68% device related), skin and soft tissues 16.5%, lower respiratory tract 14%, fever 7.7%, septicaemia 6%, contagious gastrointestinal infections 5.9%. The overall HAI prevalence was 11.1%. Large variations of HAI were observed between different hospitals; tertiary hospitals 7.4–19.8%, secondary hospitals 6.2–15.1% and primary hospitals 2.8–23.8%. The risk factors for HAI was central venous lines, present in 12.8% of all patients, catheter á demeur in 21.9%, immuno-suppression in 8.4%, surgery 30.8%, mechanical ventilation 2.1%. 4.4% of the patients were treated in an ICU. 32.7% were treated with antibiotics and 9.7% were treated for HAI, corresponding to 89% of all HAI.

Conclusions: The PPM method was successfully introduced including almost all patients in Swedish hospitals. The results give us specific knowledge of HAI including the role of the risk factors. The facilitation of the national patient safety initiative is important as well as the tutorial aspects of self-assessment of HAI. Local results are available for immediate analysis.