Assessment of the Nosocomial Infection Notification System of Hospitals in the South-East of France

Assessment of the Nosocomial Infection Notification System in Hospitals in the South-East of France

Background: In France, the notification of severe unusual nosocomial infections (NI) by health care settings (HCS) has been mandatory since 2001. The aims are to detect NI threats or emerging situations, to alert the authorities and to identify potential failures of practice. The first step is to alert the infection control team (ICT) (an internal procedure) which validates the signal and implements immediate corrective measures. The second step is official notification of local health authorities (DDASS, exercising a function of control) and the regional NI control coordinating centre (CCLIN, exercising an expert function), using a standardized form. A non exhaustive list of notification criteria was defined nationally. Based on the evidence since the system came into operation, 2/3^rds of hospitals never made any NIN.

Objective: 1) To assess the nosocomial infection notification (NIN) system in HCS in the southeast of France, 2) to identify reasons why health care workers (HCW) still do not comply with NIN, and 3) to take advantage of the development of the NIN system via Internet to optimize the NIN official form and circuit.

Methods: A self-evaluation survey was conducted by sending a two page questionnaire to the ICT of 943 HCS in December 2008. Data on NIN organization in the HCS and on the perception of the NIN system and the NIN form by HCW were collected.

Results: A total of 470 HCS (49.8%) participated (Table). The NIN system is well organized but functions inefficiently (almost half of HCS never made any NIN since 2001). In spite of reluctance to notify NI events (28.7%), the NIN led to an improvement in health care practices (45.3%). The intervention of the CCLIN seems on the whole justified (81.0%) and appropriate (75.2%), especially for methodological support (60.6%). The NIN form is well adapted to its purpose (95.6%) but some items are difficult to fill in (14.1% for NIN criteria and 17.6% for other information).

Conclusions: The results underline the importance of the organization of an operational internal alert procedure to optimize the effectiveness of the NIN. In the future, the computerization of medical records and the use of Internet for data input and management coordination should simplify the system.