Health Services Commissioner Annual Report 2000/2001

infection control issues. The Southern HCN Board has identified, in its Infection
Control Strategic Management Plan 2000-2003, the need for additional financial
resources in order to implement the Plan.
There are comparative, risk adjusted, data on deep sternal wound infection rates
available from five cardiac surgical units, including MMC, as collected and analysed
by the Victorian Infection Control Surveillance Project (VICSP). The most recent
data are for the period August 1998 to May 2000. The statistics for MMC are almost
identical to the aggregate for the five hospitals. There is no significant difference
between the five hospitals.
MMC provided data on cardiac surgery surgical site infections for the period February
1999 to September 2000. These show the number of people having cardiac surgery
by month, the number of infected patients and those who developed deep sternal
wound infections. The data are not risk adjusted. Deep sternal wound infections
appear to be an uncommon event, with 13 cases from almost 600 surgical procedures
(or 2.2%), between February 1999 and September 2000.
Data are collected on in-patients only. Because only in-patient data are collected the
possibility exists, therefore, that discharged cardiac surgical patients may have a
nosocomial infection but not be counted in the statistics. This may lead to undetected
rates of nosocomial infections (excluding deep sternal wound infections) as lengths of
stay decrease. Hospitals performing cardiac surgery, including MMC, should
consider measuring nosocomial infection rates following discharge. Ultimately this is
a resource issue which needs to be addressed.
MMC provided data on levels and groupings of staff, from senior clinicians to ward
cleaners, who had attended in-service/orientation on infection control. The
information provided indicated that nursing staff regularly attended infection control
training and up-dates. However, medical staff were not proportionally represented in
the data. It appears that more needs to be done to ensure that medical staff are
educated in infection control and prevention.
Findings
In response to the first term of reference –
1. Whether the systems in place at Monash Medical Centre (MMC) are adequate
to ensure appropriate monitoring of hospital-acquired infections in the
neonatal special care nursery and cardiac surgical unit;
The monitoring of nosocomial infections is clearly recognised by health care
professionals to be an ongoing challenge. It has been identified as a current priority
area and is receiving extra resources from the DHS. These initiatives are supported
by Government policy, receive DHS support and leadership in the arena of infection
control and prevention. MMC has submitted an infection control plan, to the DHS,
which has resource implications.
The DHS has recently completed a review of all public hospital infection control
Plans and will advise MMC, and all other public hospitals, of their suitability and
acceptability.
Health Services Commissioner Annual Report 2000/2001 17