It has been known for over twenty years that the continuous, systematic collection, analysis and interpretation of data relevant to nosocomial infections and that feedback for doctors and nurses can reduce the frequency of these infections. This kind of internal quality assurance is known as surveillance. Data from one hospital are more valid and more effective when they are compared with those from other hospitals. The frequency of infection at one station or department can only be determined in context with data from other stations and departments. In order to avoid false conclusions, comparisons are only possible when identical methods of data collection with fixed diagnostic definitions are used. Because different stations and departments gauge risks differently and differ in patient composition, these differences are compensated for by a standardisation and stratification process in data calculation and analysis.
In 1996, the NRZ developed a method to enable hospital wards and departments to complete surveillance with a single method that would take the most important influences and risk factors into account and thus make comparisons possible. Participating wards and departments regularly send their data to the NRZ for analysis. Summarised and anonymous data are made available as reference data in an appropriate form.
In order to increase the validity of the data and the effectiveness of the surveillance, KISS concentrates on certain risk areas in hospitals, instead of trying to capture data for an entire hospital. Certain kinds of patients (in NEO-KISS, for example) or certain wards (in ITS-KISS, for example) with high risks of infections are the focus here. KISS consists of multiple components that correspond to their respective risk areas for this reason. Some components have special surveillance methods. The following risk areas are taken into account with their own components:
- Patients on the ICU (ITS-KISS)
- Postoperative patients (OP-KISS)
- Preterm infants on neonatal ICUs (NEO-KISS)
- Postprocedure bone marrow transplant patients (ONKO-KISS)
- Postprocedure ambulant care patients (AMBU-KISS)
- Patients with central vascular catheters, urinary tract catheters, or patients on mechanical ventilation on non-intensive care units (DEVICE-KISS)
- Methicillin-resistant staphylococcus aureus (MRSA-KISS)
Hospitals can choose to participate in one or several components depending on their individual needs. Completion of a course introducing KISS data collection methods and training diagnosis with fixed definitions is required for participation.