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American Journal of Epidemiology Vol. 103, No. 3: 251-260
Copyright © 1976 by The Johns Hopkins University School of Hygiene and Public Health

research-article

HOSPITAL-ACQUIRED INFECTIONS I. SURVEILLANCE IN A UNIVERSITY HOSPITAL

RICHARD P. WENZEL1,, CHARLES A. OSTERMAN2, KATHRYN J. HUNTING1 and JACK M. GWALTNEY, JR.1

1Department of Internal Medicine Box 370, U. of Virginia School of Medicine, Charlottesville, VA 22901
2Department of Nursing, U of Virginia Medical Center

Address for reprint requests which should be sent to Dr. Wenzel

A new system of surveillance is described for detecting hospital-acquired infections. Surveillance begins on the ward where a weekly review of the nursing care plan (Kardex) is used to select high risk patients (approximately 65% of the total polulation) for a subsequent chart review. A nurse-epidemiologist required 16–25 hr per week to perform surveillance and 4 more hr to organize line listings of infected patients. The Kardex review was 82 to 94 percent accurate in detecting nosocomial infections when compared to prospective reviews of the charts of all hospitalized patients. The new surveillance method was more accurate than a system based on weekly chart reviews of all patients receiving systemic antibiotics and/or of all patients with fever (temperature ≤37.8 C orally). In addition, it was more accurate and offered advantages over a system in which surveillance depended primarily on the bacteriology laboratory. Over a 12-month period 1154 hospital-acquired infections were identified for a 7% annual infection rate. Data from ongoing surveillance are used to record accurate infection rates by service, to define the risk of various hospital procedures, and to monitor for common source outbreaks of infection.

hospital-acquired infections; infections, nosocomial


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