National Healthcare Agreement: PB g-Better health: the rate of Staphylococcus aureus (including MRSA) bacteraemia is no more than 2.0 per 10,000 occupied bed days for acute care public hospitals by 2011–12 in each state and territory, 2014

Acute care public hospitals are defined as all public hospitals including those hospitals defined as public psychiatric hospitals in the Public Hospital Establishment National Minimum Data Set. All types of public hospitals are included, both those focusing on acute care, and those focusing on non-acute or sub-acute care, including psychiatric, rehabilitation and palliative care.

Unqualified newborns are included in the indicator. Hospital boarders and posthumous organ procurement are excluded from the indicator.

A patient-episode of Staphylococcus aureus bacteraemia (SAB) is defined as a positive blood culture for Staphylococcus aureus. For surveillance purposes, only the first isolate per patient is counted, unless at least 14 days has passed without a positive blood culture, after which an additional episode is recorded.

A SAB will be considered to be healthcare-associated if: the first positive blood culture is collected more than 48 hours after hospital admission or less than 48 hours after discharge, OR, if the first positive blood culture is collected 48 hours or less after admission and one or more of the following key clinical criteria was met for the patient-episode of SAB:

1. SAB is a complication of the presence of an indwelling medical device (e.g. intravascular line, haemodialysis vascular access, cerebrospinal fluid (CSF) shunt, urinary catheter)
2. SAB occurs within 30 days of a surgical procedure where the SAB is related to the surgical site
3. An invasive instrumentation or incision related to the SAB was performed within 48 hours
4. SAB is associated with neutropenia (<1 × 10⁹) contributed to by cytotoxic therapy

Exclusions:

Cases where a known previous positive test has been obtained within the last 14 days are excluded. For example: If a patient has SAB in which 4 sets of blood cultures are positive over the initial 3 days of the patient’s admission only one episode of SAB is recorded. If the same patient had a further set of positive blood cultures on day 6 of the same admission, these would not be counted again, but would be considered part of the initial patient-episode.

Note: If the same patient had a further positive blood culture 20 days after admission (i.e. greater than 14 days after their last positive on day 6), then this would be considered a second patient-episode of SAB.

Denominator: include unqualified newborns, exclude posthumous organ procurement and hospital boarders.

See Establishment—number of patient days, total N[N(7)] for the definition of patient days. Also included in the denominator are patient days for unqualified newborns, which are not covered in the linked definition. Patient days for unqualified newborns must be reported in addition to patient days as defined in the link.

Analysis by state and territory is based on location of the hospital.

Presented as a number per 10,000 patient days.

Coverage: Denominator ÷ Number of patient days for all public hospitals in the state or territory.

Any variation from the specifications by jurisdictions will be footnoted and described in the data quality statement.