Surveillance of healthcare-associated infections

A healthcare-associated infection is an infection that

occurs during treatment or care provided in a healthcare or social welfare unit, or
is associated with procedures carried out in these units.

Approximately 100,000 treatment-related infections occur in Finland each year, one half of them in hospitals and the other half in long-term care.

Healthcare-associated infections

Finnish Hospital Infection Programme SIRO

Healthcare-associated infections are monitored nationally in Finland as part of the Finnish Hospital Infection Programme (SIRO), which has been operating since 1999.

The SIRO programme currently involves all Finnish university hospitals and some other hospitals. The programme monitors healthcare-associated infections with significance for public health.

The SIRO programme helps hospitals prevent healthcare-associated infections. It improves the monitoring of infections and collects data on their occurrence in participating hospitals. The hospitals participating in the programme can compare their prevalence figures with those of other hospitals.

In the SIRO programme, hospitals are represented by persons from different professional groups who are responsible for infection control in practice: infection control nurses, communicable disease control physicians, clinical microbiologists, hospital microbiologists and surgeons.

Objectives of the programme

prevention of healthcare-associated infections
development of surveillance and feedback associated with it
common definitions and surveillance methods
prevalence figures for hospital use
common prevention guidelines and recommendations
investigations of hospital outbreaks
training and courses
research.

Infections to be monitored and studies

1. Nosocomial bloodstream infections

from September 1998
includes all hospital wards
laboratory based case-finding by infection control nurses
rate per ward and specialisation
patient groups and predisposing factors, including central venous catheters
causative pathogens and their susceptibility to antimicrobials

2. Surgical site infections

from January 1999: coronary surgery, hip and knee prosthesis, and upper femur fractures
from January 2003: caesarean section, breast surgery, appendectomy and hysterectomy
from 2008: laminectomy and spinal fusion surgery
rate by procedure and risk category
causative pathogens and their antimicrobial resistance

3. Prevalence studies

cross-sectional study on the prevalence of healthcare-associated infections at a given moment in a sample of Finnish hospitals
in 2005, all somatic specialities except paediatrics (30 hospitals)
in 2008–2009, repeated studies in all neonatal intensive care and control units (24 units)
in 2011, a European prevalence study (59 hospitals)
in 2016, a European prevalence study (50 hospitals)
in 2017, a European prevalence study at long-term care facilities (175 operating units)

4. Clostridium difficile infections

from September 2008
all hospital wards
laboratory based case-finding by infection control nurses
overall incidence, nosocomial incidence and prevalence at admission
severe cases and outbreaks

5. Resource survey, or a survey on prevention

A survey on methods used to monitor and control healthcare-associated infections in acute hospitals and the number of infection control experts
annually since 2018
previous surveys in 2000, 2008 and 2015