Major Articles
The state of infection surveillance and control in Canadian acute care hospitals*,**,

https://doi.org/10.1067/mic.2003.88Get rights and content

Abstract

Background: Nosocomial infections and antibiotic-resistant pathogens cause significant morbidity, mortality, and economic costs. The infection surveillance and control resources and activities in Canadian acute care hospitals had not been assessed in 20 years. Methods: In 2000, surveys were mailed to infection control programs in all Canadian hospitals with more than 80 acute care beds. The survey was modeled after the US Study on the Efficacy of Nosocomial Infection Control instrument, with new items dealing with resistant pathogens and computerization. Surveillance and control indices were calculated. Results: One hundred seventy-two of 238 (72.3%) hospitals responded. In 42.1% of hospitals, there was fewer than 1 infection control practitioner per 250 beds. Just 60% of infection control programs had physicians or doctoral professionals with infection control training who provided services. The median surveillance index was 65.6/100, and the median control index was 60.5/100. Surgical site infection rates were reported to individual surgeons in only 36.8% of hospitals. Conclusions: There were deficits in the identified components of effective infection control programs. Greater investment in resources is needed to meet recommended standards and thereby reduce morbidity, mortality, and expense associated with nosocomial infections and antibiotic-resistant pathogens. (Am J Infect Control 2003;31:266-73.)

Section snippets

Methods

In the fall of 2000, a survey was sent to infection control programs in the 238 acute care hospitals in Canada that were identified as having more than 80 acute care beds. A list of eligible hospitals was compiled from listings provided by CNISP, the Canadian Health Facilities Directory,14 Surveillance Provinciale Des Infections Nosocomiales,11 and the Community and Hospital Infection Control Association (CHICA) Canada. The survey was sent to the staff member most responsible for the infection

Respondent hospitals' characteristics

The response rate was 72.3%; 147 surveys were received, representing 172 of 238 eligible facilities. Fifteen surveys were received from larger health organizations that represented up to 4 eligible hospitals. Two surveys were not included in the analysis because of incomplete information.

Hospitals owned and/or operated by larger entities comprised 90 of 143 (62.9%) of the sample. One third of infection control programs, 45 of 138 (32.6%), had direct responsibility for more than 1 acute health

Discussion

This is the first comprehensive examination of the status of infection control programs in acute care hospitals in Canada in 20 years. The high response rate to this survey permits Canada wide generalizations to medium and large acute care hospitals.

Methodologic differences between earlier Canadian surveys and this survey hindered direct comparisons; however, some conclusions can be drawn.18, 19, 20 In 1981, 88.1% of general hospitals with more than 99 beds and teaching hospitals engaged in

Acknowledgements

We are grateful to the survey respondents for taking the time and effort to complete the lengthy survey, CHICA-Canada and its chapters for their input, Dr. Charles Frenette for helping to identify eligible hospitals in Quebec, and Health Canada for funding the project.

References (25)

  • WR Jarvis

    Selected aspects of the socioeconomic impact of nosocomial infections: morbidity, mortality, cost, and prevention

    Infect Control Hosp Epidemiol

    (1996)
  • AE Simor et al.

    The evolution of methicillin-resistant Staphylococcus aureus in Canadian hospitals: 5 years of national surveillance

    CMAJ

    (2001)
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    **

    Supported by Health Canada.

    Reprint requests: Dick E. Zoutman, MD, FRCPC, Department of Pathology, Queen's University and Infection Control Service, Kingston General Hospital, 76 Stuart St, Kingston, Ontario, K7L 2V7, Canada.

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