Tjallie van der Kooi

prevention activities. CRBSI rates were successfully reduced by introducing a bundle of best practices regarding CVC insertion and care, especially in settings with relatively high rates. Hand hygiene improvement has also proven to be effective although not all studies demonstrate an effect. Given the published HH levels in Dutch hospitals there is room for improvement. One of the limitations of voluntary surveillance is the variable pool of participating hospitals which complicates straightforward interpretation of results when assessing national HAI trends. The reduced HAI rates has led some Dutch hospitals to cease participation with the national surveillance programme which jeopardizes representativity of the data and benchmarking possibilities. Currently automated surveillance is increasingly adopted but not all HAI, such as CRBSI, can as yet be monitored this way. Other outcomes, such as hospital‐onset microbiologically‐confirmed, i.e. easily retrievable, bloodstream infections (HOB) are nowadays investigated for relevance as well. Despite the achieved reductions, surveillance of HAI remains important as both unforeseen and foreseen developments can affect HAI rates and require optimization of practices to prevent HAI. 270 Summary

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