Table 1.

HAI Network’s BSI Surveillance system attributes, indicators and data collection method, India, 2022

Attribute and operational definition	Indicator	Data collection method
Simplicity: Simplicity of workflow and ease of implementation	1. Ease of collecting data (staff required and time spent in surveillance activities each day on average) 2. Proportion of surveillance staff who report applying BSI case definition as easy or very easy 3. Proportion of surveillance staff who replied online reporting as easy or very easy 4. Average amount of time spent by surveyed staff in reporting one BSI case in the portal 4. Number of levels of reporting in the system	Onsite observations Survey of Surveillance staff and Data entry operator (DEO)
Stability: System’s reliability, availability, and sustainability	1. Proportional of surveillance staff trained in BSI surveillance protocols 2. Proportion of sites where denominator data is collected everyday including holidays 3. Proportion of sites with a full-time (24 h) microbiology laboratory 4. Proportion of sites with Laboratory Information System (LIS) 5. Proportion of sites where surveillance staff have access to all positive cultures 6. Proportion of sites who review every positive culture at month-end to capture missing cases 7. Availably of the system since its inception in 2017 8. Proportion of sites with funding support	Survey of surveillance staff and DEO Review of network data Review of site-visit records
Acceptability: Willingness of individuals and institutions to participate in the BSI surveillance network	Number of hospitals participating in surveillance	Review of HAI network database Review of quarterly reports
Representativeness: System’s ability to accurately describe BSIs over time	Proportion of febrile episodes (in patients admitted in surveillance ICUs) where a blood culture is collected	Review of patient case files during on-site visits
Data quality: Completeness and validity of the captured data	1. Data validity: Proportion of CRF with case definition applied correctly 2. Data completeness: Proportion of CRF with 100% mandatory fields filled	Record review of CRF during site visits Review of site-visit records
Timeliness: System’s ability to detect BSI cases and outbreaks in timely fashion	1. Proportional of febrile episodes (in patients admitted in surveillance ICUs) where a blood culture is collected within 24 h of the febrile episode 2. Proportion of sites reporting BSI data within 10 days of the reporting month 3. Proportion of quarterly reports submitted by the network within one month of the reporting quarter 4. Proportion of ICU physicians who received monthly feedback on their ICU’s BSI rate 5. Proportion of BSI outbreaks detected and controlled while still ongoing	Review of ICU patient case files Review of HAI network database Review of quarterly reports Survey of physicians Interview of site representatives
Sensitivity: System’s ability to detect BSI cases and outbreaks correctly	1. Proportion of BSI cases reported among all BSI cases detected 2. Proportion of quarterly BSI trend reports submitted in last five years (2017–2021) 3. Number of early warning signals generated in the last one year (Jan-Dec 2021) and last one month (Dec 2021)	Review of patient case files and laboratory records during site visits Review of network database
Positive Predictive Value: Probability that a detected BSI case is true case of BSI	1. Proportion of true BSI cases among all BSI cases reported 2. Method for confirming true cases	Review of CRF during site visits
Usefulness: Usefulness of the system in achieving its objectives of monitoring BSI trends and using system data to reduce HAI in participating hospitals	1. Monitor network-based BSI trends over time 2. Number of BSI outbreaks detected using surveillance data 3. Proportion of sites using data to improve IPC practices at their ICUs	Review of network database Survey of physicians