#### Specifying surveillance period data, General tab

The General tab contains the surveillance protocol option (Light or Standard), the denominator data (optional in Standard surveillance, required in Light surveillance) and the other structure and process indicators: nurse-to-patient ratio and five indicators collected during an evaluation of practices (or audit) in the ICU. Table 14 describes the variables in this form. Further details are provided in the HAI-Net ICU protocol (see Related documents).

To define the ICU surveillance period:

1. Specify values for the fields in the ICU surveillance period General tab. Descriptions of the variables in this form are given in Table 14. Mandatory fields are indicated by a red asterisk *. Required fields are indicated by a black asterisk *.

2. Click the Save icon or press Ctrl+S.

If any mandatory or required data field is empty when you save, e.g. because you do not yet have the data, an error and/or warning message is shown and the field label is highlighted as a reminder - in red for a mandatory field (you cannot save) or blue for a required field. See Understanding reported errors.

3. Click Select this ICU surveillance period to be able to enter Patient/ Antimicrobial use/ HAI data.

Table 14: ICU surveillance period General tab variables

Variable | Description
Hospital code | Inserted automatically based on the hospital selected during Hospital definition.
Surveillance year | The year previously selected for the survey. Inserted by system.
ICU code | Unique identifier for each intensive care unit within a hospital, should remain identical in different surveillance periods/years. Inserted by system.
Start date * | Start date of the ICU surveillance period. Cannot be changed after saving.
End date * | End date of the ICU surveillance period. The recommended surveillance period is minimum 3 months, maximum 1 year. Can be entered later.
ICU protocol * | Select either Standard or Light. Cannot be changed after saving. Standard: Patient-based option allows advanced risk adjustment of healthcare-associated infection rates for inter-hospital comparisons. Risk factors are collected for each patient (infected or not). Light: Unit-based option is less labour-intensive solution, produces partially the same indicators as Standard option for follow-up of trends, as well as the same descriptive results about infections and antimicrobial resistance, but with less possibility for risk-adjusted comparisons. Denominator data are aggregated at the unit (ICU) level. Case definitions, included patients, and infection data (including antimicrobial resistance data and mortality review data) are identical in both versions. Refer to the HAI-Net ICU protocol (see Related documents) for further details.
Number of new ICU admissions (all) * | Total number of new admissions in the intensive care unit during the period. Used for burden estimates of HAIs in ICUs, assessing the ICU workload for patients staying 1 or 2 days in the ICU and comparing some indicators with ICU surveillance systems that include all ICU patients. Optional, but strongly recommended.
Number of ICU patient-days (all patients) * | Total number of patient-days in the intensive care unit during the period. Used for burden estimates of HAIs in ICUs, assessing the ICU workload for patients staying 1 or 2 days in the ICU, comparing some indicators with ICU surveillance systems that include all ICU patients and cross-checking the plausibility of the denominator of the alcohol hand rub consumption and nurse-to-patient ratio indicators. Optional, but strongly recommended.
Number of new ICU admissions staying > 2 days * | Required for light surveillance. Number of new admissions of patients staying more than 2 days in the intensive care unit during the period. Main denominator for the indicator ‘cumulative incidence of HAIs’. In standard surveillance, this variable is optional and allows verifying the exhaustiveness of the entered patient-based data.
Number of ICU patient-days for patients staying > 2 days * | Required for light surveillance. Number of patient-days for patients staying more than 2 days in the intensive care unit during the period. Main denominator for the indicator ‘incidence density of HAIs’. In standard surveillance, this variable is optional and allows verifying the sum of patient-days reported on patient level.
Observations/ patient chart review period | Start date and end date of the period during which HAI prevention and antimicrobial stewardship practices are evaluated.
Total number of registered nurse hours in ICU over 7 day period | Total number of hours of real presence of registered nurses during a period of 7 days, including hours of presence during the night (presence of 1 full-time nurse 24/7=168 hours). Only include registered nurses involved in bedside patient care. Students are not included. A ‘registered nurse’ is a nurse who has graduated from a college’s nursing program or from a school of nursing and has passed a national licensing exam to obtain a nursing license. Also include ‘agency nurses’, ‘bank nurses’, ‘interim nurses’ or other registered nurses who are not permanently employed for that position in the hospital.
Total number of nursing assistant hours in ICU over 7 day period | Total number of hours of real presence of nursing assistants during a period of 7 days, including hours of presence during the night (presence of 1 full-time nursing assistant 24/7=168 hours). Only include nursing assistants involved in bedside patient care. Students are not included. A ‘nursing assistant’ is also referred to as ‘nurses’ aide’, ‘healthcare assistant’, ‘nursing auxiliary’, ‘auxiliary nurse’, ‘patient care assistant’ or similar terms. Also include nursing assistants who are not permanently employed for that position in the hospital.
Total number of patient-days over the same 7 day period | Total number of patient-days (all patients) over the same 7 days used for the number of (registered/assistant) nurse hours. Short interruptions are not taken into account. Partial days count as one patient day.
Antimicrobial stewardship: Review antimicrobial therapy within 72 hours (chart review) | Verify, for 30 (minimum 20) consecutive patients with antimicrobial therapy whether the therapy was evaluated within 72 hours after the start of the antimicrobial and has been documented in the patient file. Only consider first empiric or documented antimicrobial therapies that were started in the current ICU. Only systemic antimicrobial therapy (IV, IM, SC, oral) started since more than 72 hours are eligible for evaluation. Number of observations (denominator) = Total number of audited antimicrobial therapies that were started more than 3 days ago; Number compliant (numerator) = Number of antimicrobial therapies that were started more than 3 days ago and were re-assessed within 72 hours after start of the antimicrobial.
Intubation: Endotracheal cuff pressure controlled and/or corrected at least twice a day (chart review) | Numerator=Number of intubation days (days of patients with intubation) during which the endotracheal cuff pressure was verified and maintained between 20 and 30 cm H2O (and documented in the patient file) at least twice per day; Denominator=Total number of observed intubation days. Source: medical or nurse patient file, prospective review of 30 patient-days with intubation. One patient with intubation is included only once a day, but the same patient can be included for several consecutive days.
Intubation: Oral decontamination using oral antiseptics at least twice a day (chart review) | Numerator=Number of intubation days (days of patients with intubation) during which oral decontamination with oral antiseptics has been performed (and documented in the patient file) at least twice per day; Denominator=Total number of observed intubation days. Source: medical or nurse patient file, prospective review of 30 patient-days with intubation. One patient with intubation is included only once a day, but the same patient can be included for several consecutive days.
Intubation: Position of the patient not supine (direct observation) | Numerator=Number of days of patients with intubation during which the patient’s position was not supine (= was either prone or recumbent); Denominator=Total number of observed intubation days. Source: Direct observation of the position of the patient with intubation (in bed), up to 30 patient observations. One patient with intubation is included only once a day, but the same patient can be included for several consecutive days. Observations should as much as possible be perform at the same time during the day (e.g. at 16:00 in the afternoon). Patients in strict supine (dorsal decubitus) position for specific indications (e.g. certain trauma patients) should be excluded.
CVC: Catheter site dressing is not damp, loose or visibly soiled (direct observation) | Numerator = Number of days of patients with a central vascular catheter during which the dressing of the CVC was not loose, damp or visibly soiled; Denominator = Total number of observed CVC days. Source: Direct observation of 30 patients with at least one CVC in place, up to 30 patient observations. One patient with one or several CVCs is included only once a day, but the same patient can be included for several consecutive days. Observations should as much as possible be perform at the same time during the day (e.g. at 16:00 in the afternoon). For patients with several CVCs in place, all CVC dressings need to be ok (not loose, damp nor visibly soiled).
Comments/ observations | Free text field.

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