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. 2020 Jan;25(2):1900321.
doi: 10.2807/1560-7917.ES.2020.25.2.1900321.

Electronically assisted surveillance systems of healthcare-associated infections: a systematic review

H Roel A Streefkerk  1   2 , Roel Paj Verkooijen  3 , Wichor M Bramer  4 , Henri A Verbrugh  1
Affiliations

Electronically assisted surveillance systems of healthcare-associated infections: a systematic review

H Roel A Streefkerk et al. Euro Surveill. 2020 Jan.

Abstract

BackgroundSurveillance of healthcare-associated infections (HAI) is the basis of each infection control programme and, in case of acute care hospitals, should ideally include all hospital wards, medical specialties as well as all types of HAI. Traditional surveillance is labour intensive and electronically assisted surveillance systems (EASS) hold the promise to increase efficiency.ObjectivesTo give insight in the performance characteristics of different approaches to EASS and the quality of the studies designed to evaluate them.MethodsIn this systematic review, online databases were searched and studies that compared an EASS with a traditional surveillance method were included. Two different indicators were extracted from each study, one regarding the quality of design (including reporting efficiency) and one based on the performance (e.g. specificity and sensitivity) of the EASS presented.ResultsA total of 78 studies were included. The majority of EASS (n = 72) consisted of an algorithm-based selection step followed by confirmatory assessment. The algorithms used different sets of variables. Only a minority (n = 7) of EASS were hospital-wide and designed to detect all types of HAI. Sensitivity of EASS was generally high (> 0.8), but specificity varied (0.37-1). Less than 20% (n = 14) of the studies presented data on the efficiency gains achieved.ConclusionsElectronically assisted surveillance of HAI has yet to reach a mature stage and to be used routinely in healthcare settings. We recommend that future studies on the development and implementation of EASS of HAI focus on thorough validation, reproducibility, standardised datasets and detailed information on efficiency.

Keywords: Point prevalence survey; computer-assisted; electronic; healthcare-associated infections; surveillance.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
A flowchart of the inclusion process of studies used in the systematic review (adjusted from the PRISMA 2009 flowchart)
Figure 2
Figure 2
Published studies on electronically assisted surveillance of healthcare-associated infections by year of publication and by region of the world (n = 78)
Figure 3
Figure 3
Sensitivity of electronically assisted surveillance systems by category of algorithm used and by type of healthcare-associated infection (n = 78)
Figure 4
Figure 4
Distribution of overall quality score of studies on electronically assisted surveillance systems vs the overall performance score of the electronically assisted surveillance system reported in these studies (n = 78)
See this image and copyright information in PMC

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