Surveillance Provinciale des Infections Nosocomiales (SPIN) Program: Implementation of a mandatory surveillance program for central line-associated bloodstream infections

BackgroundIn 2003, the Surveillance Provinciale des Infections Nosocomiales (SPIN) program was launched to gather data on incidence rates of central line–associated bloodstream infections (CLABSIs) in intensive care units (ICUs) in the Province of Quebec. To improve the generalizability of SPIN benchmarks, in 2007 participation in SPIN became mandatory for all ICUs with ≥10 beds.ObjectiveTo describe the implementation process, surveillance methods, and overall results of the SPIN program between 2003 and 2009.MethodsSPIN surveillance methods are based on the National Healthcare Safety Network. Participation is open to all Quebec ICUs and as of January 2007 is mandatory for all units with ≥10 beds. Data include CLABSI incidence rates for 2003-2009 and the epidemiology of CLABSI cases.ResultsMandatory participation in the SPIN program increased the number of ICUs by 100% (from 30 to 60 units). For 2003-2009, the overall CLABSI incidence rates were 1.67 CLABSIs/1,000 catheter-days for adult ICUs, 2.24 CLABSIs/1,000 catheter-days for pediatric ICUs, and 4.40 CLABSIs/1,000 catheter-days for neonatal ICUs. The patients with CLABSI were predominately female (60%), mean patient age was 44 ± 32 years, and 64% of the patients had a regular central venous line in place.ConclusionThe implementation of mandatory participation was essential to increase the generalizability of SPIN CLABSI incidence rates, which also improved the quality of these data for use as provincial benchmarks.