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National Healthcare Agreement: PB g-Better health: the rate of Staphylococcus aureus (including MRSA) bacteraemia is no more than 2.0 per 10,000 occupied bed days for acute care public hospitals by 2011–12 in each state and territory, 2013

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termPB g-The rate of Staphylococcus aureus (including MRSA) bacteraemia is no more than 2.0 per 10,000 occupied bed days for acute care public hospitals by 2011–12 in each state and territory, 2013
METeOR identifier:Help on this term498327
Registration status:Help on this termHealth, Superseded 30/04/2014
Description:Help on this termThe rate of Staphylococcus aureus (including methicillin-resistant Staphylococcus aureus (MRSA)) bacteraemia is no more than 2.0 per 10,000 patient days for acute care public hospitals by 2011–12 in each state and territory.
Indicator set:Help on this termNational Healthcare Agreement (2013) Health, Superseded 30/04/2014
Outcome area:Help on this termHospital and Related Care Health, Standard 07/07/2010
National Health Performance Authority (retired), Retired 01/07/2016

Collection and usage attributes

Computation description:Help on this term

Acute care public hospitals are defined as all public hospitals including those hospitals defined as public psychiatric hospitals in the Public hospital establishment national minimum data set. All types of public hospitals are included, both those focusing on acute care, and those focusing on non-acute or sub-acute care, including psychiatric, rehabilitation and palliative care.

Unqualified newborns are included in the indicator. Hospital boarders and posthumous organ procurement are excluded from the indicator.

A patient-episode of Staphylococcus aureus bacteraemia (SAB) is defined as a positive blood culture for Staphylococcus aureus. For surveillance purposes, only the first isolate per patient is counted, unless at least 14 days has passed without a positive blood culture, after which an additional episode is recorded.

A Staphylococcus aureus bacteraemia will be considered to be healthcare-associated if: the first positive blood culture is collected more than 48 hours after hospital admission or less than 48 hours after discharge, OR, if the first positive blood culture is collected 48 hours or less after admission and one or more of the following key clinical criteria was met for the patient-episode of SAB:

  1. SAB is a complication of the presence of an indwelling medical device (e.g. intravascular line, haemodialysis vascular access, CSF shunt, urinary catheter)
  2. SAB occurs within 30 days of a surgical procedure where the SAB is related to the surgical site
  3. An invasive instrumentation or incision related to the SAB was performed within 48 hours
  4. SAB is associated with neutropenia (<1 × 109) contributed to by cytotoxic therapy

Exclusions:

Cases where a known previous positive test has been obtained within the last 14 days are excluded. For example: If a patient has SAB in which 4 sets of blood cultures are positive over the initial 3 days of the patient’s admission only one episode of SAB is recorded. If the same patient had a further set of positive blood cultures on day 6 of the same admission, these would not be counted again, but would be considered part of the initial patient-episode.

Note: If the same patient had a further positive blood culture 20 days after admission (i.e. greater than 14 days after their last positive on day 6), then this would be considered a second patient-episode of SAB.

Denominator: include unqualified newborns, exclude posthumous organ procurement and hospital boarders.

Analysis by state and territory is based on location of the hospital.

Presented as a number per 10,000 patient days.

Coverage: Denominator ÷ Number of patient days for all public hospitals in the state or territory.

Any variation from the specifications by jurisdictions will be footnoted and described in the data quality statement.

Computation:Help on this term

10,000 patient days × (Numerator ÷ Denominator)

Numerator:Help on this term

SAB patient episodes (as defined in the Computation description) associated with acute care public hospitals.

Numerator data elements:Help on this term
Data Element / Data SetData Element
Establishment—organisation identifier (Australian)
Data Source
State/territory infection surveillance data
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetData Element
Person—person identifier
Data Source
State/territory infection surveillance data
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetData Element
Hospital service—care type
Data Source
State/territory infection surveillance data
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetData Element
Episode of admitted patient care—condition onset flag
Data Source
State/territory infection surveillance data
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetData Element
Episode of care—additional diagnosis
Data Source
State/territory infection surveillance data
Guide for use
Data source type: Administrative by-product data
Denominator:Help on this term

Number of patient days for public acute care hospitals under surveillance (i.e. only for hospitals included in the surveillance arrangements).

Denominator data elements:Help on this term
Data Element / Data SetData Element
Establishment—organisation identifier (Australian)
Data Source
State/territory admitted patient data
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetData Element
Episode of admitted patient care—admission date
Data Source
State/territory admitted patient data
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetData Element
Episode of admitted patient care—separation date
Data Source
State/territory admitted patient data
Guide for use
Data source type: Administrative by-product data
Disaggregation:Help on this term

2010–11 (backcast for inclusion of unqualified newborns) and 2011-12—State and territory, by:

  • Methicillin-resistant Staphylococcus aureus (MRSA)/Methicillin-sensitive Staphylococcus aureus (MSSA)

Some disaggregation may result in numbers too small for publication.

Disaggregation data elements:Help on this term
Data Element / Data SetData Element
Establishment—Australian state/territory identifier
Data Source
State/territory infection surveillance data
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetData Element
Methicillin-resistant Staphylococcus aureus (MRSA)/Methicillin-sensitive Staphylococcus aureus (MSSA) indicator
Data Source
State/territory infection surveillance data
Guide for use
Data source type: Administrative by-product data
Comments:Help on this term

Most recent data available for 2013 CRC report: 2011–12

Baseline: 2008–09

The number of SAB patient episodes associated with acute public hospitals under surveillance includes SAB patient episodes associated with all public hospitals, and the number of patient days for public acute care hospitals under surveillance includes the number of patient days for all public hospitals under surveillance.

For some states and territories there is less than 100 per cent coverage of hospitals. This may impact on the reported rate. For those jurisdictions with incomplete coverage of acute care public hospitals (in the numerator), only patient days for those hospitals that contribute data are included (in the denominator). Specifically, if a hospital was not included in the SAB surveillance arrangements for part of the year, then the patient days for that part of the year are excluded. If part of the hospital was not included in the SAB surveillance arrangements (e.g. children’s wards, psychiatric wards), then patient days for that part of the hospital are excluded. Patient days for 'non-acute' hospitals (such as rehabilitation and psychiatric hospitals) are included if the hospital was included in the SAB surveillance arrangements, but not otherwise. However, all these patient days are included in the coverage rate denominator measure of total number of patient days for all public hospitals in the state or territory.

Some states operated a 'signal surveillance' arrangement for smaller hospitals whereby the hospital notifies the appropriate authority if a SAB case is identified, but the hospital is not considered to have formal SAB surveillance as per larger hopsitals. Where this arrangement is in place, these hospitals should be included as part of the indicator. That is, SAB patient episodes and patient days should be included as 'under surveillance'.

Only episodes associated with acute public hospital care in each jurisdiction should be counted. If a case is associated with care provided in another jurisdiction (cross border flows) then it is reported, where known, by the jurisdiction where the care associated with the SAB occurred.

There may be patient episodes of SAB identified by a hospital which did not originate in the identifying hospital (as determined by the definition of a patient episode of SAB), but in another public hospital. If the originating hospital is under surveillance, then the patient episode of SAB should be attributed to the originating hospital and should be included as part of the indicator. If the originating hospital is not under SAB sureillance, then the patient episode is unable to be included in the indicator.

Patient episodes associated with care provided by private hospitals and non-hospital health care are excluded.

Patient days for unqualified newborns are included. Patient days for hospital boarders and posthumous organ procurement are excluded.

Almost all patient episodes of SAB will be diagnosed when the patient is an admitted patient. However, the intention is that patient episodes are reported whether they were associated with admitted patient care or non-admitted patient care in public acute care hospitals.

Where there are significant variation, for example non-coverage of cases diagnosed less than 48 hours after admission, in the data collection arrangements it will affect the calculation of values across states and territories.

Variation in admission practices across jurisdictions will influence the denominator for this indicator, impacting on the comparability of rates.

Jurisdictional manuals should be referred to for full details of definitions used in infection control surveillance.

Representational attributes

Representation class:Help on this termRate
Data type:Help on this termReal
Unit of measure:Help on this termEpisode
Format:Help on this termNN[N]

Data source attributes

Data sources:Help on this term
Data SourceState/territory infection surveillance data
Frequency
Annual
Data custodian

State/territory health authorities



Data SourceState/territory admitted patient data
Frequency
Annual
Data custodian
State/territory health authorities

Accountability attributes

Reporting requirements:Help on this termNational Healthcare Agreement
Organisation responsible for providing data:Help on this termAustralian Institute of Health and Welfare
Further data development / collection required:Help on this term

Specification: Final, the measure meets the intention of the indicator.

Relational attributes

Related metadata references:Help on this term

Supersedes National Healthcare Agreement: PB 06-The rate of Staphylococcus aureus (including MRSA) bacteraemia is no more than 2.0 per 10,000 occupied bed days for acute care public hospitals by 2011–12 in each state and territory, 2012 Health, Superseded 25/06/2013

Has been superseded by National Healthcare Agreement: PB g-Better health: the rate of Staphylococcus aureus (including MRSA) bacteraemia is no more than 2.0 per 10,000 occupied bed days for acute care public hospitals by 2011–12 in each state and territory, 2014 Health, Superseded 14/01/2015

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