A road map for the implementation of statistical control charts for the monitoring and prevention of hospital infections

Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. Healthcare-related infections are infections that arise in a patient during the course of care in a hospital or other care facility, which were not present or incubating at the time of admission. Among the member states of the European Union, Italy is one of the countries that is most affected by the circulation of multi-resistant microorganisms, attributable to an improper use of antibiotics and a lack of effective measures to prevent the transmission of infections. In most Italian hospitalization facilities, clinical and organizational procedures have already been implemented regarding the prevention of HAIs, however no systematic surveillance of processes with statistical control tools has yet been introduced. The purpose of the research is to outline which kind of control chart can be used in the healthcare sector and for which type of parameters (clinical and environmental one). This article analyzes the literature by analyzing the application of control charts in the healthcare sector. The limits of applicability of such kind of tools are then highlighted. According to the authors, the use of monitoring tools such as control charts would allow a significant reduction of the HAIs. The surveillance implemented through the use of control charts, in the context of infection prevention, could create the basis for activating immediate preventive actions (eg. example in case of epidemics) and directs health policies. Finally, surveillance should generate data that can be used in some way to improve the quality of care. The choice of the most effective chart to use is often essential to avoid overestimating or underestimating the control variable under consideration. Finally, this paper defines a possible road map for the implementation of control charts in monitoring hospital infections in a middle size Italian hospital.