Information for Action HCAI Surveillance Data Laboratory data

Information for Action HCAI Surveillance Data: Laboratory data 15 th July 2015 Mari Morgan WHAIP Surveillance

Laboratory Surveillance Schemes • Staphylococcus aureus bacteraemia • Clostridium difficile WHAIP Surveillance

Source of Data • Specimen data entered into Trak • Data. Store extracts results from Trak • Records that meet certain criteria are extracted from Data. Store for use in surveillance • Data is processed, denominators applied, used for report production WHAIP Surveillance

Criteria for Extraction from Data. Store S. aureus bacteraemia • Specimen type = blood culture • Organism identified = S. aureus • MRSA & MSSA distinguished on basis of antimicrobial sensitivity pattern • Specimen date (based on date received) is within date range of report WHAIP Surveillance

Criteria for Extraction from Data. Store C. difficile • • • Test type = C. difficile GDH result = positive Test type = C. difficile toxin test Toxin test result = positive Specimen date (based on date received) is within date range of report • Age is > 2 years or unknown WHAIP Surveillance

Data Processing Deduplication • S. aureus bacteraemia – if < 14 days between consecutive positives, excluded as a duplicate episode • C. difficile – if < 28 days between consecutive positives, excluded as a duplicate episode WHAIP Surveillance

Data Processing • Samples from patients in private hospitals, privately run dialysis units and postmortem samples excluded • Samples assigned as inpatient / noninpatient based on the type of ward and the type of patient • Where inpatient/non-inpatient unknown, assumed to be inpatient until updated by HB • Where age is unknown for C. difficile, assumed to be > 2 years until updated by HB WHAIP Surveillance

Denominators • Monthly admissions data by HB and hospital provided by NHS Wales Informatics Service (NWIS) – where up to date data unavailable, data from the equivalent month in the previous year is used • Mid year population estimates from Office for National Statistics (ONS) – 2014 data published at end of June (a proportion of the population is used for calculating monthly rates) • http: //www. ons. gov. uk/ons/publications/rereference-tables. html? edition=tcm%3 A 77368259 WHAIP Surveillance

Reports Monthly Dashboard • C. difficile, MRSA bacteraemia and MSSA bacteraemia • Released on or before 7 th of month • Monthly update tab – data for current and previous financial years – numbers, rates per 1000 admissions and rates per 100, 000 population • Target reduction tab – progress against current Tier 1 target, Apr 14 – Sep 15 WHAIP Surveillance

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Reports 6 monthly reports • C. difficile, MRSA bacteraemia and MSSA bacteraemia • Released in November for Apr – Sep data • Released in May for previous financial year – numerator data for FY does not change after that report published WHAIP Surveillance

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WHAIP Surveillance

Reports Maps • A package of sample C. difficile maps was sent out in March and prescribing maps in April for data to end Sep 14 plus an evaluation form • Additional data on the location of residence of patient and the GP of the patient are used to produce these maps • All prescribing maps and the most popular C. difficile maps (Wales and HB) will be sent out by the end of July for the 2014/15 FY data WHAIP Surveillance

Clostridium difficile surveillance Maps by HB of diagnosis WHAIP Surveillance Update

Clostridium difficile surveillance Maps by HB of residence WHAIP Surveillance Update

Clostridium difficile surveillance Maps by GP of patient WHAIP Surveillance Update

Clostridium difficile surveillance • 2014/15 FY report has been issued – 16% reduction in numbers, but variable across HBs • Wales rate = 43/100, 000 population (51 in 2013/14) • Target = 31/100, 000 population WHAIP Surveillance Update

Future Reports • Conversion of current monthly dashboard to Tableau • Development of early warning system in Tableau – weekly unprocessed data to identify unusually high numbers WHAIP Surveillance

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Thank you to all the healthcare organisations in Wales for their help with these surveillance schemes. WHAIP Surveillance