How Provinces Track and Report Hospital-Acquired Infections
Marketplace asked each province for their procedures for dealing with hospital-acquired infections, and below are their responses. Note: CBC does not endorse and is not responsible for the content of external links.
AHS [Alberta Health Services] is committed to providing public IPC (Infection Prevention Control) surveillance reports through our quarterly performance measures. Currently, AHS reports on CVC-BSI (Central Venous Catheter-Related Bloodstream Infection) and MRSA-BSI (Methicillin-Resistant Staphylococcus Aureus) and will soon be providing CDI (C. Difficile Infection) rates. Additionally we are developing province-wide reporting related to surgical site infections and hand hygiene compliance rates.
see pages 87-88 http://www.albertahealthservices.ca/Publications/ahs-pub-pr-2011-12-performance-report.pdf (PDF 3.2MB)
Government established the Provincial Infection Control Network in 2005 to coordinate infection prevention, surveillance and control activities for the entire province using a consistent approach. Since it was established, health authorities have been working to standardize and collect information on C. difficile, MRSA rates and VRE.
Currently, health authorities are required to collect and report out on their C. difficile rates; this information is available on the PICNet website. We've recently standardized reportable information on MRSA, and health authorities will soon be reporting this information to PICNet at regular intervals. Once the work is finished on MRSA, the province will begin to standardize collection and reporting of VRE rates
At the provincial level, the reporting of individual cases of reportable diseases is legislated under the Public Health Act. This includes C. Difficile, MRSA and VRE. The reporting of outbreaks, hospital acquired or otherwise, is not legislated under the Public Health Act, but it is required by provincial policy. When an outbreak occurs, individuals responsible for infection control and infectious disease are required to provide notice to the Public Health Branch of Manitoba Health.
An outbreak is considered when there is an increase in cases above what is normally seen in a particular facility or region. It should be noted that C. Difficile, MRSA and VRE are also present in the community and it is often very difficult to determine if disease outbreaks originate in hospital or in the community.
Monthly communicable disease reports and monthly surveillance unit reports are available online at: http://www.gov.mb.ca/health/publichealth/surveillance/reports.html#influenza
All of our reporting guidelines are also available online at: http://www.gov.mb.ca/health/publichealth/cdc/ipc.html
Specific reporting procedures may vary from region to region, depending on resources. Winnipeg Regional Health Authority does extensive online reporting. You may want to check out their site at: http://www.wrha.mb.ca/healthinfo/a-z/aro/080930_table1-2.php
In New Brunswick the Reporting and Diseases Regulation — Public Health Act outlines the regulations for the reporting of communicable and notifiable diseases.
C. difficile is a notifiable disease which is reported to the Chief Medical Officer of Health (provincial Department of Health). The regulations state that it must be reported in writing within seven days.
MRSA & VRE are not reportable under the Public Health Act however they are under surveillance by the Department of Health.
This information is not reported online.
Under the Provincial Government of Newfoundland and Labrador's Communicable Diseases Act, communicable diseases that threaten the health of the public are required to be reported to a health officer. The legislation identifies the list of communicable diseases that are required to be reported. Information pertaining to these reported communicable diseases is published and made available to the public both in print and online.
A copy of the legislation can be found here:
Communicable Diseases Act
Surveillance and Disease Reports
In addition to the legislation, an agreed upon list of communicable diseases, including hospital and community acquired infections, are monitored and shared among the four regional health authorities and the Public Health Division of the Department of Health and Community Services. This list includes the organisms Clostridium difficile (C. difficile), Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant Enterococci (VRE) which are significant hospital acquired infections.
• In Nova Scotia, notifiable diseases and conditions are regulated under the Health Protection Act.
• There are currently 72 diseases and conditions that must be reported to Public Health under the Act.
• Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant Enterococcus, or vancomycin-resistant enterococci (VRE) are both included on that list and are reportable whether they are hospital or community acquired.
• C. difficile will be reportable as of April 1 through an amendment to the communicable disease regulation of the Health Protection Act.
• For a complete list of notifiable diseases and conditions in Nova Scotia visit: http://gov.ns.ca/hpp/publications/Guide_HPA_05.pdf
In Ontario its mandatory for hospitals to report C. Difficile and rates for C. Difficile and other Hospital Acquired Infections at your hospital can be accessed online at the following site:
A province-wide survelliance program for health care and community associated infections was established in 2008 to meet the standards of Accreditation Canada and provide safe patient care.
• Since January 2010, it includes three pathogens: MRSA, VRE and CDI
• Each health care facility on PEI has an Infection Prevention and Control Practitioner (ICP). These ICP along with the CPHO, conduct surveillance on all new cases occuring in their respective areas of practice. The data is stored in an Infection Control database.
In Quebec there is a requirement to report Hospital-Acquired Infections like C. Difficile and that information is available online.
Saskatchewan is piloting a surveillance system for C. difficile Infection (CDI) in hospitals and long-term care facilities. Regional Health Authorities have been testing the surveillance protocol and report form, and will be going live in April.
We do not yet have systematic surveillance for MRSA or VRE. One for MRSA is planned for development in 2012-13.
In the past, information has not been routinely compiled. When requested, we have provided what we have (such as numbers of positive lab tests).