Infection epidemiology in hospitals; Status of the current surveillance system in Poland following checks made by the State Sanitary Inspectorate (SSI)

An important public health priority at national and EU level is surveillance over infection and alert microorganisms in healthcare and patient safety provision. In Poland legislation measures during 2001-9 were introduced stepwise intended to radically transform the ability of hospitals and healthcare providers in preventing/dealing with infectious disease outbreaks from what had been an outdated system. Requirements included new skin decontamination procedures, new equipment, improved hospital environment, compulsory risk assessment, fully documented internal QC and reporting epidemic outbreaks to the SSI. Since 2009 nationwide checks tested how well these laws were implemented into medical practice through experience gained where the SSI conducted a major assessment on 223 hospitals, (25% national total). Public and private hospitals numbered 182 & 41 respectively and 54% had certified QC in place and thereby more effective infection control. The recommended make-up of staff hospital committees dealing with infection improved effectiveness with a microbiologist (71% cases), however staff generally lacked time through performing normal duties. Liaison staff were vital in supporting risk assessment, registration, education and monitoring however 30% did not have any. The numbers and availability of microbiological testing was deficient to need and various outsourcing options showed no improvement due to insufficient fund allocation. Outdated procedures were also noted for intravenous therapy and total parenteral nutrition leading to increased risk. Sterilisation, disinfection and QC procedures varied considerably between hospitals as well as decontaminating endoscopy equipment. Although there were no cases of serious epidemiological hazards, problem areas were pinpointed which new/amended legislation will target.