RESUMO
Background: Although Canada has both a national active surveillance system and administrative data for the passive surveillance of healthcare-associated infections (HAI), both have identified strengths and weaknesses in their data collection and reporting. Active and passive surveillance work independently, resulting in results that diverge at times. To understand the divergences between administrative health data and active surveillance data, a scoping review was performed. Method: Medline, Embase and Cumulative Index to Nursing and Allied Health Literature along with grey literature were searched for studies in English and French that evaluated the use of administrative data, alone or in comparison with traditional surveillance, in Canada between 1995 and November 2, 2020. After extracting relevant information from selected articles, a descriptive summary of findings was provided with suggestions for the improvement of surveillance systems to optimize the overall data quality. Results: Sixteen articles met the inclusion criteria, including twelve observational studies and four systematic reviews. Studies showed that using a single source of administrative data was not accurate for HAI surveillance when compared with traditional active surveillance; however, combining different sources of data or combining administrative with active surveillance data improved accuracy. Electronic surveillance systems can also enhance surveillance by improving the ability to detect potential HAIs. Conclusion: Although active surveillance of HAIs produced the most accurate results and remains the gold-standard, the integration between active and passive surveillance data can be optimized. Administrative data can be used to enhance traditional active surveillance. Future studies are needed to evaluate the feasibility and benefits of potential solutions presented for the use of administrative data for HAI surveillance and reporting in Canada.
RESUMO
Background: National surveillance of healthcare-associated infections (HAIs) is necessary to identify areas of concern, monitor trends, and provide benchmark rates enabling comparison between hospitals. Benchmark rates require representative and large sample sizes often based on pooling of surveillance data. We performed a scoping review to understand the organization of national HAI surveillance programs globally. Methods: The search strategy included a literature review, Google search and personal communications with HAI surveillance program managers. Thirty-five countries were targeted from four regions (North America, Europe, United Kingdom and Oceania). The following information was retrieved: name of surveillance program, survey types (prevalence or incidence), frequency of reports, mode of participation (mandatory or voluntary), and infections under surveillance. Results: Two hundred and twenty articles of 6,688 identified were selected. The four countries with most publications were the US (48.2%), Germany (14.1%), Spain (6.8%) and Italy (5.9%). These articles identified HAI surveillance programs in 28 of 35 countries (80.0%), operating on a voluntary basis and monitoring HAI incidence rates. Most HAIs monitored surgical site infections in hip (n=20, 71.4%) and knee (n=19, 67.9%) and Clostridoides difficile infections (n=17, 60.7%). Conclusion: Most countries analyzed have HAI surveillance programs, with characteristics varying by country. Patient-level data reporting with numerators and denominators is available for almost every surveillance program, allowing for reporting of incidence rates and more refined benchmarks, specific to a given healthcare category thus offering data that can be used to measure, monitor, and improve the incidence of HAIs.