Healthcare associated infections (HAI) are a major public health concern and a significant cause of morbidity and mortality globally. The European Centre for Disease Prevention and Control (ECDC) estimates that 3.2 million patients develop a HAI every year in Europe. In 2011, it was estimated that one in twenty Scottish inpatients had an infection associated with healthcare delivered in a Scottish hospital. The inpatient cost of HAI originating in Scottish acute care hospitals was estimated to be £137 million a year with an additional 318 172 bed days required in order to care for patients with HAI; the equivalent of a large teaching hospital occupied for one year. A significant proportion of HAI are considered to be avoidable and prevention of these infections provides an opportunity to improve patient outcome and reduce unnecessary costs within healthcare systems.
A robust and current evidence base that is specific to Scottish hospital settings is necessary to inform the development of local and national strategies to reduce HAI and contain antimicrobial resistance (AMR). National point prevalence surveys (PPS) are undertaken every five years in Scotland in order to take stock of the current epidemiological situation and to review local and national policy. The Scottish Government tasked Health Protection Scotland (HPS) with coordinating a third Scottish National PPS of HAI and Antimicrobial Prescribing and advised the NHS boards of the requirement to participate. The survey took place in Autumn 2016.
The results from this third PPS of HAI and antimicrobial prescribing will provide an opportunity to review the current epidemiology of HAI and antimicrobial prescribing and, for the first time, describe infection prevention and control (IPC) and antimicrobial stewardship structures and processes in Scottish hospitals. The intelligence will inform the development of key priority areas and recommendations for the prevention and control of HAI, surveillance of HAI and quality improvement interventions for antimicrobial stewardship. This will assist the Scottish Government in the further development of national policy to reduce HAI, improve antimicrobial prescribing and contain AMR in Scotland.
Aim and Objectives
The objectives of the 2016 prevalence survey were to:
- Measure the specific types and overall prevalence of HAI
- Measure the overall prevalence of antimicrobial prescribing and types of antimicrobials prescribed, as well as compliance with Scottish Antimicrobial Prescribing Group (SAPG) hospital-based empirical prescribing and surgical prophylaxis prescribing indicators
- Describe the organisation of IPC and antimicrobial stewardship programmes
- Identify priority areas for future interventions to prevent and control HAI, for antimicrobial stewardship quality improvement strategies and for future targeted incidence surveillance of HAI in Scotland
- Contribute to the ECDC prevalence survey and inform the European strategy to reduce HAI and antimicrobial resistance.
Third National Prevalence Survey - 2016
First National Prevalence Survey - 2006