After HALT 1 Establishment of a surveillance

system for LTCFs in Hungary

Rita SzabóNational Center for Epidemiology, Department of Hospital Epidemiology, Budapest, HungaryEuropean Programme for Intervention Epidemiology Training (EPIET), European Centre for

Disease Prevention and Control (ECDC), Stockholm, Sweden

ARHAI meeting24 November 2011, Warsaw

Ageing – global and national problem

Number of LTCFs – 929 with 64.725 beds

Participation in HALT

• pilot PPS: 4 LTCFs / 281 eligible residents• repeated PPS: 42 LTCFs / 4.895 eligible residents (rate 5%)

BACKGROUND

SWOT ANALYSIS

• strategic planning method

• use S/W/O/T

• identify internal and external factors to

achieve our objectives

STRENGHTS

• strong HALT advisory and scientific board

• simply survey methodology

• usable software

• very motivated national representative

WEAKNESSES

• Institutional level (LTCFs)

- lack of /no infection control knowledge- no infection control practice- a few enthusiastic leader / not motivated leaders - hiding of real situation

• National level

- incomplete registration of long-term care facilities- unexplored area

OPPORTUNITIES

• To design basic and specific training courses (e.g. IC, AB use)

• To develop specific guidelines (e.g. diagnosis, treatment, prevention)

• To share basic care protocols (e.g. device use, hand hygiene)

• To invite the LTCFs to awareness days (e.g. hand hygiene, AB use)

• To set up a national surveillance system specific for LTCFs

THREATS

• No basic diagnostic background (RTG, labor, microbiology)

Roentgenography Laboratory Microbiology

• No isolation possibility (single rooms)

WAYS FORWARD IN 2012(by Department of Hospital Epidemiology)

• Develop a specific guidelines

• Provide trainings

• Establish a specific national surveillance system

SURVEILLANCE OF INFECTIONS AND AB-USE IN LTCFs

AIMS:

• assess type of infections• detect outbreaks and AMRs• follow up trends• identify risk factors and opportunities for prevention and control• define priorities (consider impact of disease)

SURVEILLANCE OF INFECTIONS AND AB-USE IN LTCFs

DATA COLLECTION:• by ourself• use NNSS software

METHODOLOGY:• similar to HALT• patient-based • provide case definitions, data collection and reporting procedures

SURVEILLANCE OF INFECTIONS AND AB-USE IN LTCFs

DATA ANALYISIS:• descriptive (risk factors, infection & AB-use)

INTERPRETATION OF RESULTS:• feedback to all LTCFs yearly

ETHICAL CONSIDERATION:• data – not anonymous, but not identifiable by others

CONCLUSION

HALT is an „awareness” project

Start to improve national surveillance system for LTCFs

IMPROVING THE SAFETY OF RESIDENTS

Thank you for your attention and we are looking forward to the HALT2!

ACKNOWLEDGEMENTS

• voluntary participated long-term care facilities

• EPIET coordinator – Biagio Pedalino MD

• EPIET supervisor – Karolina Böröcz MD