Healthcare-associated staphylococcus aureus bloodstream infections (HA-SABSI) per 10,000 occupied bed-days 

Rationale

Staphylococcus aureus bloodstream infection is a serious infection that may be associated with the provision of health care. Staphylococcus aureus is a highly pathogenic organism and even with advanced medical care, infection is associated with prolonged hospital stays, increased healthcare costs and a marked increase in morbidity and mortality (SABSI mortality rates are estimated at 20-25%).

HA-SABSI is generally considered to be a preventable adverse event associated with the provision of health care. Therefore this KPI is a robust measure of the safety and quality of care provided by WA public hospitals.

A low or decreasing HA-SABSI rate is desirable and the WA target reflects the nationally agreed benchmark.

Target

The 2021 target for HA-SABSI is ≤1.0 per 10,000 occupied bed-days. Improved or maintained performance is demonstrated by a result below or equal to target. 

Results

Commentary

During 2021, EMHS did not achieve the target for HA-SABSI with a result equating to 37 infections from 338,112 bed-days.

EMHS participates in a state-wide surveillance program and has robust processes for the review of all cases of HA-SABSI by infection control specialists and treating clinicians, to identify the factors that contributed to the individual cases and closely monitor infection rates. 

EMHS sought an independent review of HA-SABSI during 2021 to identify any contributing factors related to healthcare that may have contributed to the 2021 result. The review identified and made recommendations for improvement during 2022, which EMHS are currently implementing. These include a stronger focus on the application of guidelines for the management of invasive devices; embracing electronic journey boards and nursing care plans to incorporate visual prompts for clinicians monitoring invasive device sites; and ongoing education, training and regular hand hygiene auditing.

The EMHS Hospital-Acquired Complications (HAC) Strategy also includes strategies to reduce bloodstream infection rates across EMHS that are based on findings and lessons arising from the clinical review of cases.

Period: 2019 – 2021 calendar years 

Contributing sites: Armadale Health Service, Bentley Health Service, Kalamunda Hospital, Royal Perth Hospital 

Data source: Healthcare Infection Surveillance Western Australia (HISWA) Data Collection