SMHS Prevention and Management of Healthcare Associated Infections (HAIs)

Infections people get while being cared for in a healthcare facility are known as healthcare-associated infections (HAI). 

About healthcare associated infections (HAIs)

An older female patient laying in a bed and being reviewed by two nursesThe most common types of infection acquired in hospitals are:

  • urinary tract infection (UTI)
  • pneumonia (lung infection)
  • wound infection
  • bloodstream infection.

For a patient, a HAI can result in:

  • illness
  • an extended stay in hospital
  • a slower recovery
  • increased stress
  • lower morale.

HAIs are costly to patients, hospitals and the community. While they can occur in any healthcare setting, effective infection prevention and control can significantly reduce the infection rate. Patients, visitors and staff all play a role in reducing HAIs.

Read consumer information about healthcare associated infections (Healthy WA).

Staphylococcus aureus bloodstream infections (SABSI)

A common HAI is Staphylococcus aureus (S. aureus), also known as ‘Golden Staph’. It is a type of bacteria often found on the skin of healthy people and is relatively harmless unless it causes infection. In hospitals, transmission is most commonly via the hands of healthcare workers.

Most cases can be treated by antibiotics; however, there are more serious antibiotic-resistant strains. It is estimated that contracting a healthcare-associated S. aureus bloodstream infection, whilst in hospital, can be life-threatening or cause serious harm in 20 to 35 per cent of cases.

Measuring HAIs

Healthcare-associated Staphylococcus aureus (S. aureus) bloodstream infections are measured as a rate of infection using the number of beds occupied by patients each day (occupied bed days). For an infection to qualify as healthcare associated there must be no evidence it was present or developing at the time of hospital admission. Both the antibiotic-treatable and the more serious antibiotic-resistant strains of S. aureus are included in the rates.

The definition of healthcare-associated S. aureus was developed by the Australian Commission on Safety and Quality in Health Care. Read more detail information about how HAIs are measured (external site).

Benchmark rates

The nationally agreed benchmark set under the National Healthcare Agreement (NHA) is no more than 2.0 cases of healthcare-associated S. aureus bloodstream infection per 10,000 days of patient care for public hospitals in each state and territory.

WA Health has a lower benchmark of less than or equal to 1.0 healthcare-associated S. aureus bloodstream infection per 10,000 bed days.

To minimise the risk of patients getting a preventable infection, each SMHS hospital has a surveillance program which assists them to closely monitor infection rates and evaluate the effectiveness of the strategies used to prevent and control these HAIs. Surveillance data is reported throughout all levels of the health service to support good decision-making in the prevention of HAIs. When a SMHS hospital’s HAI rate does not meet the agreed benchmark a review is undertaken and an action plan is developed to address the issue/s.  For example, FSH has implemented a number of strategies to address their raised Healthcare-associated Staphylococcus aureus bloodstream infection rate.

See how we measure up
p>The table below shows the rate of Staphylococcus aureus bloodstream infections (SABSI) for the reported time period expressed as the number of cases of SABSI per 10,000 occupied bed days for the following SMHS hospitals:
  • FHHS – Fremantle Hospital and Health Service
  • FSH – Fiona Stanley Hospital
  • RkPG – Rockingham Peel Group
  • PHC – Peel Health Campus.

Coloured lines and numbers are used to display compliance.  When comparing data it is important to exercise caution, as hospital activity varies between sites.

Table: Healthcare-associated Staphylococcus aureus bloodstream infection rate per 10,000 bed days in SMHS hospitals, Annual for 2014/15, 2015/16 and 2016/17

Fremantle Hospital and Health Service,  Rockingham Peel Group and Peel Health Campus were all below the WA Health target rate for 2015/16 for healthcare-associated Staphylococcus aureus (S. aureus) bloodstream infection. Fiona Stanley Hospital healthcare-associated Staphylococcus aureus (S. aureus) bloodstream infection increased to 1.18 in 2016/17. This rate is comparable to other tertiary hospital sites in WA.

What do these figures show?
  • Healthcare-associated Staphylococcus aureus (S. aureus) bloodstream infection rates at Fremantle Hospital and Health Service increased from 0.13 in 2015/16 to 0.24 in 2016/17, and the rate remains well below the WA Health target rate.
  • Healthcare-associated Staphylococcus aureus (S. aureus) bloodstream infection rates at Fiona Stanley Hospital reduced between 2014/15 and 2015/16 from 1.43 to 1.08, and increased to 1.18 in 2016/17. This rate is comparable to other tertiary hospital sites in WA.
  • Rockingham Peel Group and Peel Health Campus both continue to maintain a rate well below the WA Health target rate for 2016/17 for healthcare-associated Staphylococcus aureus (S. aureus) bloodstream infection.
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South Metropolitan Health Service