Healthcare-associated infection Severity Assessment Code (SAC) examples 2022–23

This list is for guidance only. All events should be rated on actual outcome for the consumer.

See also the Always Report and Review list 2021–22 and the Severity Assessment Code (SAC) rating and triage tool for adverse event reporting. All documents are available here: www.hqsc.govt.nz/our-work/system-safety/adverse-events/national-adverse-events-reporting-policy.

Abbreviations: HDU = high-dependency unit; ICU = intensive care unit

SAC 1 - Death or permanent severe loss of function

Healthcare-associated infection resulting in sepsis-related* death or permanent disability.

For example:

• sepsis-related death
• amputation of limb following surgical site infection
• blindness following eye procedure infection.

* Sepsis definition = refer to organisational sepsis definitions

SAC 2 - Permanent major or temporary severe loss of function

Healthcare-associated infection leading to ICU/HDU/1:1 care, or unplanned transfer to another hospital for higher acuity care

OR

other major complication of healthcare-associated infection.

For example:

• sepsis leading to organ failure and/or requiring vasopressor support
• a surgical procedure to remove infected prosthetic material with subsequent reimplantation, eg, prosthetic joints, ventriculo- peritoneal (VP) shunts, vascular grafts
• pacemaker-related endocarditis
• hospital-acquired pneumonia requiring ventilation.

SAC 3 - Permanent moderate or temporary major loss of function

Healthcare-associated infection that requires surgical or other significant intervention or readmission for management of healthcare-associated infection not requiring ICU/HDU/1:1 care.

For example:

• central or peripheral venous catheter bloodstream infection
• prosthetic joint infection resulting in prolonged IV antibiotics
• readmission for surgical or non-surgical management of healthcare-associated infection (not ICU/HDU/1:1 care)
• urosepsis following urinary tract manipulation, eg, after transrectal ultrasound (TRUS) biopsy or catheterisation.

SAC 4 - Requiring increased level of care

Healthcare-associated infection requiring additional non-surgical management only (eg, antimicrobial therapy) and resulting in minimal harm.

For example:

• device-related healthcare-associated infection, eg, peripheral intravenous catheter exit site infection
• hospital-acquired norovirus, respiratory infection
• hospital-acquired infection with a drug-resistant organism.