Ch 14 Monitoring for surgical infection

Question 1

Surveillance

Answer 1

ongoing, systematic collection, analysis, interpretation and dissemination of data regarding a health-related event….

a structured approach to collection of specific data (e.g., surgical site infection incidence), along with a plan to use that information.

ongoing vs reactive vs intermittent

attempts must be made to systematically collect data that are as complete and unbiased as possible.

Data can only have an impact if they are properly analyzed.

Question 2

Goals of Surveillance

Answer 2

For SSI, goal = determination of overall or procedure-specific rates or evaluation factors associated with surgical site infection.

Determination of endemic disease rates > allows for objective assessment of current practices, raises awareness, identifies areas for potential improvement, and facilitates identification of outbreaks.

Procedure-specific data

Risk factor evaluation

Question 3

What factors need to be considered when creating a surveillance program? (6)

Answer 3

Patient population
The hospital
Personnel (infection control practitioner)
Current infrastructure
Risk aversion
Clear objectives

Question 4

What are the three forms of surveillance systems?

Answer 4

Passive - Using data already in the records

Active - highest quality data, usually performed in the face of an outbreak

Syndromic - analysing certain clinical signs - lack of specificity

Question 5

What are the basic requirements for passive surveillance? 5

Answer 5

• Standard SSI definition
• Clear reporting
• Searchable record system
• Complete medical record database
• Retrievable culture results

data about bacterial species and their susceptibility patterns can be useful in selection of empiric therapy

> > With this type of surveillance, treating a dog with a postoperative wound infection could use those data

Question 6

Limitations of passive surveillance

Answer 6

Post-discharge surveillance can be problematic

Question 7

surveillance program consists of five main elements:

Answer 7

1. A written plan > objectives and components
2. Consistency over time: be maintained over time so that meaningful comparisons can be made
3. Appropriate personnel resources and mandates
4. Review the program: annually
5. Available resources and experts should be used whenever possible.

Question 8

if a specific surgeon is noted to have a high surgical site infection rate, the infection control practitioner should investigate

Answer 8

reporting surgical site infection rates back to surgeons (or comparing between surgeons) can be part of an effective surgical site infection prevention program by driving an increased awareness of the issue and leading surgeons to evaluate potential weaknesses or improvements in their practices.

Question 9

surgical site infection outbreak investigation

Answer 9

identify increased and then confirm SSI rate is higher than normal
communicate problem
identify procedure/factor/pathogen incvolved
Identify reason
develop/coommunicate plan
provide ongoing monitoring