Internet and electronic resourcesTuesday, April 13, 2010, 12:30 - 13:30
Experiences with a new computer-based system for automated monitoring and surveillance of healthcare-acquired infections in intensive careW. Koller*, A. Blacky, H. Mandl, K.P. Adlassnig (Vienna, AT)
Objectives: To compare infection alerts and healthcare-acquired infection (HCAI) surveillance results generated by the computer-based system MONI/Surveillance-ICU with the ones generated in parallel by trained infection control staff. MONI/Surveillance-ICU is a new release of an already established knowledge-based expert system used for monitoring of HCAIs in the intensive care units at the Vienna General Hospital.
Method: Direct comparison of surveillance results generated automatically by MONI with the ones generated in parallel by trained surveillance staff and attending clinical specialists who reviewed patient charts and used other on-site information.
Results: In 50 admissions covering 382 patient days, both systems gave identical results in 40 cases (33 without and 7 with infection). In 6 cases MONI detected HCAIs (2 LRT and 4 CVK-related) which had been missed by the attending clinical specialists. In 4 admissions MONI missed HCAIs (3 LRT and 1 CVK-related) which had been reported by human experts. Though MONI in all those cases reported general indicators for infection, specific information on the actual infection site (e.g., radiology and/or microbiology lab reports indicative for LRT-infection) had not been imported into the surveillance database of MONI and was therefore not available for the automated inference process, which on its own was impeccable. MONI made gradual emergence and fading of HCAIs visible during a patient stay.
Conclusion: MONI/Surveillance-ICU proved to be reliable, quick and even better than human observers in sensing and surveilling HCAI in intensive care, provided all relevant information held in the ICU patient data management system and microbiology lab IT was correctly matched and imported into the MONI database. In our present setting, MONI serves excellently its intended purpose of “infection radar” in intensive care. For a fully-automated surveillance reporting system not all relevant criteria are accessible yet and improvements are planned especially in the IT interfaces to radiology and microbiology