Healthcare-associated infection Severity Assessment Code (SAC) examples 2024-25

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: https://www.hqsc.govt.nz/our-work/system-safety/healing-learning-and-improving-from-harm-policy/

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

SAC 1: Severe - Death or harm causing severe loss of function and/or requiring lifesaving intervention

• not related to natural course of illness or treatment
• differs from immediate expected outcome of care
• can be physical, psychological, cultural or spiritual

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: Major - Harm causing major loss of function and/or requiring significant intervention

• not related to natural course of illness or treatment
• differs from immediate expected outcome of care
• can be physical, psychological, cultural or spiritual

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
• healthcare-associated pneumonia requiring ventilation.

SAC 3: Moderate - Harm causing short-term loss of function and/or requiring minimal additional intervention

• not related to natural course of illness or treatment
• differs from immediate expected outcome of care
• can be physical, psychological, cultural or spiritual

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 Minor - Requires little or no intervention

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
• healthcare-associated norovirus, respiratory infection
• healthcare-associated infection with a drug-resistant organism.