An Evaluation of Surgical Site Infection Surveillance Methods for Colon Surgery and Hysterectomy in Colorado Hospitals

2014 ◽  
Vol 36 (3) ◽  
pp. 353-355 ◽  
Author(s):  
Sara M. Reese ◽  
Bryan C. Knepper ◽  
Connie S. Price ◽  
Heather L. Young
Keyword(s):  
Surgical Site Infection ◽  
Online Survey ◽  
Colon Surgery ◽  
Infect Control Hosp ◽  
Healthcare Personnel ◽  
Site Infection ◽  
Laboratory Values ◽  
Infection Surveillance ◽  
Infection Preventionists

Surgical site infection (SSI) surveillance techniques for colon surgery and hysterectomy among Colorado infection preventionists were characterized through an online survey. Considerable variation was found in SSI surveillance practices, specifically varying use of triggers for SSI review, including laboratory values, healthcare personnel communication, and postoperative visits.Infect Control Hosp Epidemiol 2014;00(0): 1–3

Impact of Surveillance Technique on Reported Rates of Surgical Site Infection

2015 ◽  
Vol 36 (5) ◽  
pp. 594-596 ◽  
Author(s):  
Heather Young ◽  
Sara M. Reese ◽  
Bryan Knepper ◽  
Connie S. Price
Keyword(s):  
Surgical Site Infection ◽  
Online Survey ◽  
Infect Control Hosp ◽  
Site Infection ◽  
Infection Preventionists

Surgical site infection (SSI) surveillance methods vary among infection preventionists. An online survey regarding SSI surveillance technique was administered to infection preventionists and linked to superficial and complex colon SSI rates. Higher superficial but not complex SSI rates were reported when more SSI surveillance techniques were used (P <.0001).Infect Control Hosp Epidemiol 2015;00(0): 1–3

scholarly journals Variable Case Detection and Many Unreported Cases of Surgical-Site Infection Following Colon Surgery and Abdominal Hysterectomy in a Statewide Validation

2017 ◽  
Vol 38 (9) ◽  
pp. 1091-1097 ◽  
Author(s):  
Michael S. Calderwood ◽  
Susan S. Huang ◽  
Vicki Keller ◽  
Christina B. Bruce ◽  
N. Neely Kazerouni ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Chart Review ◽  
External Validation ◽  
Colon Surgery ◽  
Abdominal Hysterectomy ◽  
Site Infection ◽  
California Department ◽  
Added Benefit ◽  
Infection Preventionists ◽  
Traditional Surveillance

OBJECTIVETo assess hospital surgical-site infection (SSI) identification and reporting following colon surgery and abdominal hysterectomy via a statewide external validationMETHODSInfection preventionists (IPs) from the California Department of Public Health (CDPH) performed on-site SSI validation for surgical procedures performed in hospitals that voluntarily participated. Validation involved chart review of SSI cases previously reported by hospitals plus review of patient records flagged for review by claims codes suggestive of SSI. We assessed the sensitivity of traditional surveillance and the added benefit of claims-based surveillance. We also evaluated the positive predictive value of claims-based surveillance (ie, workload efficiency).RESULTSUpon validation review, CDPH IPs identified 239 SSIs following colon surgery at 42 hospitals and 76 SSIs following abdominal hysterectomy at 34 hospitals. For colon surgery, traditional surveillance had a sensitivity of 50% (47% for deep incisional or organ/space [DI/OS] SSI), compared to 84% (88% for DI/OS SSI) for claims-based surveillance. For abdominal hysterectomy, traditional surveillance had a sensitivity of 68% (67% for DI/OS SSI) compared to 74% (78% for DI/OS SSI) for claims-based surveillance. Claims-based surveillance was also efficient, with 1 SSI identified for every 2 patients flagged for review who had undergone abdominal hysterectomy and for every 2.6 patients flagged for review who had undergone colon surgery. Overall, CDPH identified previously unreported SSIs in 74% of validation hospitals performing colon surgery and 35% of validation hospitals performing abdominal hysterectomy.CONCLUSIONSClaims-based surveillance is a standardized approach that hospitals can use to augment traditional surveillance methods and health departments can use for external validation.Infect Control Hosp Epidemiol 2017;38:1091–1097

scholarly journals Standardized Infection Ratio for Surgical Site Infection after Colon Surgery: Discord in Models Measuring Healthcare Quality

2016 ◽  
Vol 37 (11) ◽  
pp. 1378-1382
Author(s):  
Raymond Chinn ◽  
Jason M. Lempp ◽  
Susan S. Huang ◽  
Rekha Murthy ◽  
Francesca J. Torriani ◽  
...  
Keyword(s):  
Pilot Study ◽  
Surgical Site Infection ◽  
Healthcare Quality ◽  
Colon Surgery ◽  
Hospital Quality ◽  
Infect Control Hosp ◽  
Site Infection ◽  
Cross Sectional ◽  
Public Report ◽  
The Government

The government publishes 3 different public report surgical site infection (SSI) metrics, all called standardized infection ratios (SIRs), that impact perceived hospital quality. We conducted a non-random cross-sectional observational pilot study of 20 California hospitals that voluntarily submitted colon surgery and SSI data. Discordant SIR values, leading to contradictory conclusions, occurred in 35% of these hospitals.Infect Control Hosp Epidemiol2016;1–5

scholarly journals Surgical Site Infection Surveillance Following Ambulatory Surgery

2014 ◽  
Vol 36 (2) ◽  
pp. 225-228 ◽  
Author(s):  
Chanu Rhee ◽  
Susan S. Huang ◽  
Sandra I. Berríos-Torres ◽  
Rebecca Kaganov ◽  
Christina Bruce ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Chart Review ◽  
Ambulatory Surgery ◽  
Medical Chart ◽  
Infect Control Hosp ◽  
Site Infection ◽  
Medical Chart Review ◽  
Infection Surveillance

We assessed 4045 ambulatory surgery patients for surgical site infection (SSI) using claims-based triggers for medical chart review. Of 98 patients flagged by codes suggestive of SSI, 35 had confirmed SSIs. SSI rates ranged from 0 to 3.2% for common procedures. Claims may be useful for SSI surveillance following ambulatory surgery.Infect Control Hosp Epidemiol 2014;00(0):1–4

Postdischarge Surgical Site Infection Surveillance Practices in Washington Acute Care Hospitals

2012 ◽  
Vol 33 (1) ◽  
pp. 87-89 ◽  
Author(s):  
Roxie Zarate ◽  
David Birnbaum
Keyword(s):  
Surgical Site Infection ◽  
Acute Care ◽  
Surgical Site Infections ◽  
Acute Care Hospitals ◽  
Public Reporting ◽  
Infect Control Hosp ◽  
Site Infection ◽  
Infection Surveillance

Little is known about postdischarge surveillance practices currently in place among American hospitals. This survey describes practices used by acute care hospitals covered by Washington State's legislated mandate for public reporting of surgical site infections. While the vast majority of facilities use multiple techniques, wide variation in practices was discovered.Infect Control Hosp Epidemiol 2012;33(1):8

USE OF AN ELECTRONIC DATA WAREHOUSE TO ENHANCE CARDIAC SURGICAL SITE SURVEILLANCE AT A LARGE CANADIAN CENTRE

2008 ◽  
Vol 31 (4) ◽  
pp. 21 ◽  
Author(s):  
G W Rose ◽  
V R Roth ◽  
K N Suh ◽  
M Taljaard ◽  
C Van Walraven ◽  
...  
Keyword(s):  
Infection Control ◽  
Surgical Site Infection ◽  
Data Warehouse ◽  
Stepwise Logistic Regression ◽  
Site Infection ◽  
Electronic Data ◽  
Trigger Mechanism ◽  
Trigger Tool ◽  
Infection Surveillance ◽  
Trigger Mechanisms

Background/Purpose: Surgical site infection surveillance to determineincidence is a key infection control activity. Case detection is labour-intensive, therefore most infection control programs use manual or simple electronic mechanisms to “trigger” chart review. However, such “trigger” mechanisms are also labour-intensive, and often of poor specificity. Our objective is to develop a complex trigger mechanism using data from an electronic data warehouse, to improve specificity of surveillance of surgical site infection compared to current trigger mechanisms. Methods: We will derive an electronic trigger tool for cardiac surgical site infection surveillance using a nested case-control design, among a cohort of all patients undergoing coronary artery bypass grafting, cardiac valve repairor replacement, or heart transplant at the University of Ottawa Heart Institute, from July 1 2004 to June 30 2007. We will perform a systematic literature review to identify potential trigger factors to include in the model, then construct the trigger tool by backwards stepwise logistic regression. The best-fit model will be used to calculate the probability of surgical site infection. We will select the threshold probability to use in surveillance by visual inspection of receiver-operator-characteristic curves. The accuracy of this electronic trigger mechanism will be compared to pre-existing manual and simple electronic mechanisms using relative true positive ratios and relative false positive ratios. Results/Conclusions: We have selected 200 cases of surgical site infection and 541 controls from among 3744 procedures performed during the study period. As of the date ofthis abstract we are still undertaking the systematic review.

scholarly journals Cerebrospinal Fluid Shunt-Associated Surgical Site Infection With Three- Versus Twelve-Month Follow-Up in Canadian Hospitals

2020 ◽  
Vol 41 (S1) ◽  
pp. s157-s157
Author(s):  
Kelly Baekyung Choi ◽  
John Conly ◽  
Blanda Chow ◽  
Joanne Embree ◽  
Bonita Lee ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Age Distribution ◽  
Patient Characteristics ◽  
Csf Shunt ◽  
Surveillance Program ◽  
Site Infection ◽  
Infection Surveillance ◽  
Surgical Manipulation ◽  
National Systems

Background: Surgical site infection (SSI) after cerebrospinal fluids (CSF) shunt surgery is thought to be acquired intraoperatively. Biomaterial-associated infection can present up to 1 year after surgery, but many national systems have shortened follow-up to 90 days. We compared 3- versus 12-month follow-up periods to determine the nature of case ascertainment in the 2 periods. Methods: Participants of any age with placement of an internal CSF shunt or revision surgical manipulation of an existing internal shunt identified in the Canadian Nosocomial Infection Surveillance Program (CNISP) participating hospitals between 2006 and 2018 were eligible. We excluded patients with external shunting devices or culture-positive CSF at the time of surgery. Patients were followed for 12 months after surgery for the primary outcome of a CSF infection with a positive CSF culture by review of laboratory and health records. Patients were categorized as adult (aged ≥18 years) or pediatric (aged < 18 years). The infection rate was expressed as the number of CSF shunt-associated infections divided by the number of shunt surgeries per 100 procedures. Results: In total, 325 patients (53% female) met inclusion criteria in 14 hospitals from 7 provinces were identified. Overall, 46.1% of surgeries were shunt revisions and 90.3% of shunts were ventriculoperitoneal. For pediatric patients, the median age was 0.7 years (IQR, 0.2–7.0). For adult patients, the median age was 47.9 years (IQR, 29.6–64.6). The SSI rates per 100 procedures were 3.69 for adults and 3.65 for pediatrics. The overall SSI rates per 100 procedures at 3 and 12 months were 2.74 (n = 265) and 3.48 (n = 323), respectively. By 3 months (90 days), 82% of infection cases were identified (Fig. 1). The median time from procedure to SSI detection was 30 days (IQR, 10–65). No difference was found in the microbiology of the shunt infections at 3- and 12-month follow-ups. The most common pathogens were coagulase-negative Staphylococcus (43.6 %), followed by S. aureus (24.8 %) and Propionibacterium spp (6.5 %). No differences in age distribution, gender, surgery type (new or revision), shunt type, or infecting organisms were observed when 3- and 12-month periods were compared. Conclusions: CSF-SSI surveillance for 3 versus 12 months would capture 82.0% (95% CI, 77.5–86.0) of cases, with no significant differences in the patient characteristics, surgery types, or pathogens. A 3-month follow-up can reduce resources and allow for more timely reporting of infection rates.Funding: NoneDisclosures: None

Developing a Surgical Site Infection Surveillance System Based on Hospital Unstructured Clinical Notes and Text Mining

2020 ◽  
Vol 21 (8) ◽  
pp. 716-721 ◽  
Author(s):  
Marta Luisa Ciofi Degli Atti ◽  
Fabrizio Pecoraro ◽  
Simone Piga ◽  
Daniela Luzi ◽  
Massimiliano Raponi
Keyword(s):  
Text Mining ◽  
Surgical Site Infection ◽  
Surveillance System ◽  
Site Infection ◽  
Clinical Notes ◽  
Infection Surveillance

scholarly journals Risk factors for surgical site infection in colon surgery in our population

2018 ◽  
Vol 75 (4) ◽  
pp. 229
Author(s):  
Santiago Olguín Joseau ◽  
Natalia Paola Bollati ◽  
Santiago Reimondez ◽  
Franco Signorini ◽  
Alejandro Mario Rossini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Odds Ratio ◽  
Colon Surgery ◽  
Site Infection ◽  
Quimioterapia Neoadyuvante ◽  
Factores De Riesgo

<p>Introducción: La infección de sitio quirúrgico (ISQ) es la infección intrahospitalaria más frecuente en los pacientes quirúrgicos con una incidencia entre 5-30%. Objetivos: Identificar los factores de riesgo para ISQ en cirugía colónica en nuestra población. Los objetivos secundarios son determinar la incidencia y tipo de ISQ, así como la incidencia de dehiscencia de anastomosis (DA). Materiales y métodos: Estudio de casos-controles de pacientes intervenidos de colectomía entre 2010-2014 en el Hospital Privado Universitario de Córdoba y Hospital Raúl Ferreyra. Se incluyeron las intervenciones convencionales y laparoscópicas, con seguimiento de 30 días, pacientes entre 20 y 85 años y con ASA I-III. Se excluyeron las cirugías de urgencia y las resecciones recto-anales. Se definió ISQ a aquella que ocurre dentro de 30 días. Resultados: Se incluyeron 238 pacientes. Se diagnosticó ISQ en 27,7% (n=66) de los pacientes de los cuales 12,2% fue superficial, 4,6% profunda y 10,9% de órgano/espacio. El análisis multivariado demostró que la ISQ se asocia con sexo masculino (odds ratio [OR] 3,15; IC95%:1,43-6,92; p=0,004), quimioterapia neoadyuvante (OR 6,72; IC95%:1,48-30,93; p=0,01), conversión (OR 3,32; IC95%:1,13-9,77; p=0,02), reintervención dentro de 30 días postquirúrgicos (OR 12,34; IC95%:2,65-57,37, p=0,001) y DA (OR 12,83; IC95%:2,97- 55,5; p=0,001). La DA presenta una incidencia del 9,6%, de los cuales el 91% presentó ISQ y todas fueron de órgano/espacio. Conclusión: Sexo masculino, quimioterapia neoadyuvante, conversión, reintervención dentro de 30 días postquirúrgicos y DA son factores de riesgo para ISQ en nuestra población. Estos resultados deben ser considerados para implementar medidas preventivas para ISQ.</p>

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