scholarly journals Impact of method and duration of post discharge surveillance on detection of surgical site infections

2011 ◽  
Vol 5 (S6) ◽  
Author(s):  
M Koek ◽  
J Wille ◽  
A Voss ◽  
B van Benthem ◽  
M Isken
Keyword(s):  
Surgical Site Infections ◽  
Post Discharge

scholarly journals Incidence study of surgical site infections in a large University Hospital in Rome, first results

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
D Vallone ◽  
M Di Pumpo ◽  
A Gentili ◽  
A Tamburrano ◽  
F Berloco ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Incidence Rate ◽  
Health Management ◽  
Surgical Site Infections ◽  
University Hospital ◽  
Surveillance Systems ◽  
Hospital Infections ◽  
Post Discharge ◽  
Average Hospital ◽  
Hospital Units

Abstract Background Surgical Site Infections (SSI) represent about a quarter of healthcare associated infections (HAI), increase the risk of mortality and hospital stay and extend healthcare costs. The aim of this work is to evaluate the incidence of SSI in patients undergoing surgical procedures of Hospital Units in the Fondazione Policlinico A. Gemelli IRCCS (FPG). Methods This descriptive observational monocentric study has a 30-months duration: the first phase was conducted between July 2018 and March 2019. Patients undergoing abdominal surgery procedures were enrolled. Active infection surveillance was performed, according to the ECDC, during the hospital stay and the surgical outpatient visits. We also performed a post-discharge surveillance (PDS) at 30 days (or 90 days if an implant has been inserted), through a telephone interview, made by a medical doctor resident in Public Health. Results During the first phase were enrolled 431 procedures in 2 Hospital Units, about emergency and hepatobiliary surgery. There were 53 cases of surgical site infection (SSI) highlighted in these procedures. Therefore, SSI’s were reported in 12.09% of the procedures. In particular, in 6.28% of cases, SSIs were diagnosed during the hospital stay. The results of this study showed statistically significant differences (p < 0.005) in incidence rate of emergency (10,70%) and hepatobiliary tract (13,17%) procedures. The average hospital stay was significant higher (p < 0.001) in patients who developed an SSI (17.27 days) than in patients without SSI (4.89 days). Conclusions These preliminary results show that the incidence rate of SSI for gastrointestinal procedures is similar to other European Countries (9.6%). The Hospital Health Management of FPG take care to the surveillance of hospital infections and monitor the correct application of the procedures, in line with the standards defined by Joint Commission International for guarantee high level in patients’ care. Key messages Performing a survey to measure the incidence of surgical site infections for surgery procedures is very important to define it and to improve surveillance systems of hospital infections in FPG. Active surveillance of surgical site infections may allow to enhance appropriate preventive measures.

scholarly journals Surveillance of post-caesarean surgical site infections in a hospital with limited resources, Cambodia

2013 ◽  
Vol 7 (08) ◽  
pp. 579-585 ◽  
Author(s):  
Sok Srun ◽  
Yin Sinath ◽  
An Thoun Seng ◽  
Meas Chea ◽  
Mony Borin ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Surgical Site Infections ◽  
Limited Resources ◽  
Post Discharge ◽  
Staphylococcus Lugdunensis ◽  
Oral Amoxicillin ◽  
Post Operative Period ◽  
Health Care Associated Infections ◽  
Length Of Hospitalization ◽  
Discharge Length

Introduction: In Cambodia, we implemented a pilot surveillance of superficial surgical site infections (SSSI) following caesarean deliveries (CD) in a provincial hospital, to estimate their incidence, describe their clinical management, and determine their causative pathogens. Methodology: Between October 2010 and February 2011, all women admitted for CD were included in the surveillance. Their clinical condition was monitored for a post-operative period of 30 days, including two assessments performed by surgeons. Cases were clinically diagnosed by surgeons, with bacterial cultures performed. Results: Of the 222 patients admitted for CD, 176 (79.3%) were monitored for 30 days. Of these, 11 were diagnosed with a SSSI, giving an incidence rate of 6.25% (95% CI 3.2-10.9). Four of the cases (36.4%) were detected after hospital discharge.  Length of hospitalization was significantly longer for the SSSI cases. All 222 patients were prescribed antibiotics.  Ampicillin was administered intravenously to 98.6% of them, with subsequent oral amoxicillin given to 82.9%. Three of six pus samples collected were positive on culture: two with Staphylococcus aureus and one with Staphylococcus lugdunensis. One S.aureus was methicillin resistant (MRSA). The other was clindamycin and erythromycin resistant. Conclusion: Surveillance of health-care associated infections in a setting with limited resources is challenging but feasible. Effective post-discharge surveillance was essential for the estimation of the incidence rate of SSSI following caesarean deliveries.   This surveillance led to a peer-review of medical practices.

scholarly journals Multidrug-resistant surgical site infections in a humanitarian surgery project

2016 ◽  
Vol 144 (16) ◽  
pp. 3520-3526 ◽  
Author(s):  
R. A. MURPHY ◽  
O. OKOLI ◽  
I. ESSIEN ◽  
C. TEICHER ◽  
G. ELDER ◽  
...  
Keyword(s):  
Surgical Site Infections ◽  
Median Number ◽  
Multidrug Resistant ◽  
Sub Saharan Africa ◽  
Post Discharge ◽  
Port Harcourt ◽  
Sensitivity Report ◽  
Late Generation ◽  
Sub Saharan

SUMMARYThe epidemiology of surgical site infections (SSIs) in surgical programmes in sub-Saharan Africa is inadequately described. We reviewed deep and organ-space SSIs occurring within a trauma project that had a high-quality microbiology partnership and active follow-up. Included patients underwent orthopaedic surgery in Teme Hospital (Port Harcourt, Nigeria) for trauma and subsequently developed a SSI requiring debridement and microbiological sampling. Data were collected from structured chart reviews and programmatic databases for 103 patients with suspected SSI [79% male, median age 30 years, interquartile range (IQR) 24–37]. SSIs were commonly detected post-discharge with 58% presenting >28 days after surgery. The most common pathogens were: Staphylococcus aureus (34%), Pseudomonas aeruginosa (16%) and Enterobacter cloacae (11%). Thirty-three (32%) of infections were caused by a multidrug-resistant (MDR) pathogen, including 15 patients with methicillin-resistant S. aureus. Antibiotics were initiated empirically for 43% of patients and after culture and sensitivity report in 32%. The median number of additional surgeries performed in patients with SSI was 5 (IQR 2–6), one patient died (1%), and amputation was performed or recommended in three patients. Our findings suggest the need for active long-term monitoring of SSIs, particularly those associated with MDR organisms, resulting in increased costs for readmission surgery and treatment with late-generation antibiotics.

P17.70 Post-Discharge Surveillance of Surgical Site Infections in Polish Hospitals

2006 ◽  
Vol 64 ◽  
pp. S103
Author(s):  
P. Heczko ◽  
J. Wojkowska-Mach ◽  
A. Rozanska ◽  
M. Bulanda
Keyword(s):  
Surgical Site Infections ◽  
Post Discharge

scholarly journals Epidemiologic Characteristics of Orthopedic Surgical Site Infections and Under-reporting Estimation of Registries Using Capture-recapture Analysis

2020 ◽  
Author(s):  
Niloufar Taherpour ◽  
Yadollah Mehrabi ◽  
Arash Seifi ◽  
Babak Eshrati ◽  
Seyed Saeed Hashemi Nazari
Keyword(s):  
National Level ◽  
Surgical Site Infections ◽  
Infection Prevention And Control ◽  
Post Discharge ◽  
Cross Sectional ◽  
Mortality And Morbidity ◽  
Capture Recapture ◽  
One Year ◽  
And Control ◽  
Epidemiologic Characteristics

Abstract Background Surgical Site Infections (SSIs) are among the leading causes of the postoperative complications. This study aimed at investigating the epidemiologic characteristics of orthopedic SSIs and estimating the under-reporting of registries using the capture-recapture method. Methods This study, which was a registry-based, cross-sectional one, was conducted in six educational hospitals in Tehran during a one-year period, from March, 2017 to March, 2018. The data were collected from two hospital registries (National Nosocomial Infection Surveillance System (NNIS) and health information management database (HIM)). First, all orthopedic SSIs registered in these sources were used to perform capture-recapture (N = 503). Second, 202 samples were randomly selected to assess patients` characteristics. Results Totally, 76.24% of SSIs were detected post-discharge. Staphylococcus.aureus (11.38%) was the most frequently detected bacterium in orthopedic SSIs. The median time between the detection of a SSI and the discharge was 17 days. The results of a study done on 503 SSIs showed that the coverage of NNIS and HIM was 59.95% and 65.17%, respectively. After capture-recapture estimation, it was found that about 221 of orthopedic SSIs were not detected by two sources among six hospitals and the real number of SSIs were estimated to be 623 ± 36.58 (95% CI, 552–695) and under-reporting percentage was 63.32%. Conclusions To recognize the trends of SSIs mortality and morbidity in national level, it is significant to have access to a registry with minimum underestimated data. Therefore, according to the weak coverage of NNIS and HIM among Iranian hospitals, a plan for promoting the national Infection prevention and control (IPC) programs and providing updated protocols is recommended.

scholarly journals Post-discharge surveillance of surgical site infections in teaching hospitals in Brazil

2020 ◽  
Vol 54 ◽  
Author(s):  
Amandha Fernandes Pagamisse ◽  
Judith Tanner ◽  
Vanessa De Brito Poveda
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
National Registry ◽  
Teaching Hospitals ◽  
Site Infection ◽  
Online Questionnaire ◽  
Post Discharge ◽  
Cross Sectional ◽  
Active Search ◽  
Hospital Infection Control

Abstract Objective: Understanding the reality of surgical site infections post-discharge surveillance in Brazilian teaching hospitals. Method: A cross-sectional study conducted by sending an online questionnaire to nurses from the Hospital Infection Control Committee of Brazilian teaching hospitals registered in the National Registry of Health Establishments. Results: Of the 193 teaching hospitals in Brazil, eight declined to take part as they did not conduct post-discharge surveillance and 36 did not respond. Twenty five of the remaining 149 hospitals provided detailed responses and 96% of responding institutions performed surgical site infection surveillance during hospitalization; active search (29.3%) was the main method, while 84% reported performing post-discharge surveillance mainly by telephone (42.8%). Both surveillance actions have nurses as the main responsible professionals. Conclusion: Nurses play a prominent role in surgical site infection identification/screening actions, and active search during hospitalization allied with post-discharge surveillance by telephone were the preferred methods.

scholarly journals The Association Between Preterm Premature Rupture of Membranes and Surgical Site Infection Following Cesarean Section

2016 ◽  
Author(s):  
Mehmet Çınar ◽  
Hakan Timur ◽  
Ali İrfan Güzel ◽  
Aytekin Tokmak ◽  
Burak Ersak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cesarean Section ◽  
Clinical Characteristics ◽  
Positive Culture ◽  
Surgical Site Infections ◽  
Study Group ◽  
Obese Women ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Post Discharge

<p><strong>OBJECTIVE:</strong> To evaluate clinical characteristics of surgical-site infections (SSIs) following cesarean section (CS) and to identify infection rates and risk factors associated with SSIs following cesarean section. <br /><strong>STUDY DESIGN:</strong> A total of 197 patients who underwent cesarean and complicated with SSIs was evaluated during hospital stay or within 30 days following cesarean section by readmission to the hospital or by post discharge survey. The clinical characteristics, subsequent microbiological culture results and management were recorded. <br /><strong>RESULTS:</strong> There were 34 (17.25%) patients complicated with preeclampsia and 26 (13.17%) gestational diabetes mellitus (GDM) in the study group. Preterm rupture of membranes (PROM) rate was 17.31% and mean rupture period were 6.61 hours. In the study population, 66 patients had positive culture results. The most isolated microorganism was S. Aureus (n=13, 19.7%). Preeclampsia, GDM and PROM rates were statically significant high in patients with positive culture results (p&lt;0.05). There were 31 patients complicated with PROM in the study group. The rates of positive culture results were significantly increased by PROM (mean 45%, p&lt;0.05).<br /><strong>CONCLUSION:  </strong>Independent risk factors for post-cesarean SSIs are younger age, obesity, diabetes, hypertension, premature rupture of membranes. Information regarding higher rates of SSIs should be provided to obese women undergoing cesarean delivery, especially when diabetes and hypertension coexists.</p>

Use of health databases to deal with underreporting of surgical site infections due to suboptimal post-discharge follow-up

2020 ◽  
Vol 104 (2) ◽  
pp. 239-242
Author(s):  
C. Gagliotti ◽  
R. Buttazzi ◽  
A. Ricciardi ◽  
E. Ricchizzi ◽  
G. Lanciotti ◽  
...  
Keyword(s):  
Surgical Site Infections ◽  
Post Discharge

scholarly journals 1234. Mental Models of Surgical Site Infection Prevention Among Surgical Technicians and Nurses

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S444-S445
Author(s):  
Aurora E Pop-Vicas ◽  
Amanda Young ◽  
Mary-Jo Knobloch ◽  
Nasia Safdar
Keyword(s):  
Behavior Change ◽  
Focus Groups ◽  
Mental Models ◽  
Wound Care ◽  
Care Center ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Post Discharge ◽  
Sterile Technique ◽  
Increased Risk

Abstract Background Surgical site infections (SSI) are common and costly. Institutions have implemented complex prevention bundles to reduce SSI, but adherence remains challenging. Understanding clinicians’ mental models related to SSI prevention can help develop strategies to improve adherence. Methods We conducted focus groups with surgical clinicians at a tertiary care center. We used constructs from behavior change theories to analyze responses and identify relevant themes for SSI prevention. Results We had 19 participants (10 nurses, 9 surgical technicians) in 4 focus groups. We found the following SSI prevention challenges: (1) emphasis on rapid patient turnover, which impairs ability to complete all required infection control tasks; (2) OR crowding and traffic, with increased risk to sterile technique breaks; (3) poor compliance with OR attire, including wearing scrubs outside of the hospital; (4) inadequate OR cleaning between cases; (5) lack of emphasis on post-discharge wound care instructions. The following beliefs were commonly expressed: (1) belief that some SSI are inevitable, due to increased complexity and duration of surgical procedures in a referral center; (2) perceived lack of knowledge and training on OR sterile technique among medical and nursing students; (3) perceived incorrect techniques for applying skin preps among surgical residents, and, occasionally, attendings; (4) fear and hesitancy to bring up OR irregularities if individual involved is perceived as having a “difficult personality,” irrespective of social hierarchy; (5) feeling overwhelmed by too many requirements for SSI prevention, which frequently change; (6) belief that some policies originate from outside influences and are not relevant to frontline clinicians; (7) frustration to receiving SSI performance feedback that is not individualized and lacks actionable items; (8) feeling “blamed” for having SSI without knowing “how to fix it”; (9) belief that training rigor and dedication to patient care have decreased over time, and are lax among younger generations. Representative quotes categorized according to behavior change constructs are shown in Table 1. Conclusion Addressing clinicians’ perceptions of SSI prevention may help improve adherence to the process and reduce SSI incidence. Disclosures All authors: No reported disclosures.

scholarly journals Development of a single, practical measure of surgical site infection (SSI) for patient report or observer completion

2017 ◽  
Vol 18 (4) ◽  
pp. 170-179 ◽  
Author(s):  
Rhiannon C Macefield ◽  
Barnaby C Reeves ◽  
Thomas K Milne ◽  
Alexandra Nicholson ◽  
Natalie S Blencowe ◽  
...  
Keyword(s):  
Hospital Discharge ◽  
Phase 1 ◽  
Surgical Site Infections ◽  
Structured Interviews ◽  
Post Discharge ◽  
Single Measure ◽  
Patient Morbidity ◽  
Reliable Assessment ◽  
Three Phase ◽  
Measurement Tools

Background: Surgical site infections (SSIs) are the third most common hospital-associated infection and can lead to significant patient morbidity and healthcare costs. Identification of SSIs is key to surveillance and research but reliable assessment is challenging, particularly after hospital discharge when most SSIs present. Existing SSI measurement tools have limitations and their suitability for post-discharge surveillance is uncertain. Aims: This study aimed to develop a single measure to identify SSI after hospital discharge, suitable for patient or observer completion. Methods: A three-phase mixed methods study was undertaken: Phase 1, an analysis of existing tools and semi-structured interviews with patients and professionals to establish the content of the measure; Phase 2, development of questionnaire items suitable for patients and professionals; Phase 3, pre-testing the single measure to assess acceptability and understanding to both stakeholder groups. Interviews and pre-testing took place over 12 months in 2014–2015 with patients and professionals from five specialties recruited from two UK hospital Trusts. Findings: Analyses of existing tools and interviews identified 19 important domains for assessing SSIs. Domains were developed into provisional questionnaire items. Pre-testing and iterative revision resulted in a final version with 16 items that were understood and easily completed by patients and observers (healthcare professionals). Conclusion: A single patient and observer measure for post-discharge SSI assessment has been developed. Further testing of the validity, reliability and accuracy of the measure is underway.

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