ACHS CI for SSI

[Michael Wishart]

Hi all

Another question on something different at a new employer. This one may just be me not being up to date, though.

For the purposes of ACHS Infection Control Clinical Indicators 1.1-1.4 (hip and knee prostheses) how many facilities report bilateral prosthesis procedures as TWO procedures in their denominator (not a single procedure). ACHS have confirmed to us this is what they expect, which surprised me a bit.

Since there is a single CMBS / ICD-10 code for bilateral procedures such as these, I have only ever known reporting these as one procedure, and I wondered whether other ICP’s are familiar with this ACHS requirement. Might be worth checking with whoever collates your denominator for these indicators if you are unsure.

I have to then wonder about coronary artery bypass graft procedures…. does anyone report these by the number of grafts performed, or only as one procedure regardless of the number of grafts? We didn’t specifically ask ACHS about this, but looking at the interpretation of ‘procedure’ for hip and knee prostheses, I have to wonder. Ie

“Multiple procedures on an individual patient should be counted separately (eg hip
prosthesis and knee prosthesis);”

Looking at the way the indicators are worded, note:

“1.1 Total number of hip prothesis procedures performed”

And

“1.5 Total number of coronary artery bypass graft procedures
performed,”

Thanks for any thoughts (including letting me know I am way behind the times here!).

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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[Fiona de Sousa]

Hi Michael,

I will have to confirm that our THR and TKR denominators are counted as
two when a bilateral procedure is done (I have always assumed they are).
In relation to CABG I can confirm that I only count one surgery
regardless of the number of grafts performed.

Kind regards,

Fiona De Sousa

Infection Prevention & Control Coordinator

Sydney Adventist Hospital

Fiona.Desousa@sah.org.au

185 Fox Valley Road, Wahroonga, NSW, 2076

________________________________

Behalf Of Michael Wishart

Hi all

Another question on something different at a new employer. This one may
just be me not being up to date, though.

For the purposes of ACHS Infection Control Clinical Indicators 1.1-1.4
(hip and knee prostheses) how many facilities report bilateral
prosthesis procedures as TWO procedures in their denominator (not a
single procedure). ACHS have confirmed to us this is what they expect,
which surprised me a bit.

Since there is a single CMBS / ICD-10 code for bilateral procedures such
as these, I have only ever known reporting these as one procedure, and I
wondered whether other ICP’s are familiar with this ACHS requirement.
Might be worth checking with whoever collates your denominator for these
indicators if you are unsure.

I have to then wonder about coronary artery bypass graft procedures….
does anyone report these by the number of grafts performed, or only as
one procedure regardless of the number of grafts? We didn’t specifically
ask ACHS about this, but looking at the interpretation of ‘procedure’
for hip and knee prostheses, I have to wonder. Ie

“Multiple procedures on an individual patient should be counted
separately (eg hip

prosthesis and knee prosthesis);”

Looking at the way the indicators are worded, note:

“1.1 Total number of hip prothesis procedures performed”

And

“1.5 Total number of coronary artery bypass graft procedures

performed,”

Thanks for any thoughts (including letting me know I am way behind the
times here!).

Cheers

Michael

Michael Wishart

CNC Infection Control

Holy Spirit Northside Private Hospital

627 Rode Road, Chermside, Qld 4032

t: (07) 3326 3068 | f: (07) 3326 3523

e: Michael.Wishart@hsn.org.au

w:www.holyspiritnorthside.org.au

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[Brett, Judy]

Michael

The Victorian Healthcare Associated Infection Surveillance (VICNISS) counts bilateral hip (and knee) prosthesis operations as two procedures. This is consistent with CDC NHSN.

In regards to coronary artery bypass graft procedures (chest and donor site) this is counted as one procedure however each infection is reported separately. Thus it is possible for one patient to have as many as four or more infections for the one procedure however this is certainly taken into consideration when analysing the data if a high infection rate is reported.

Regards
Judy

Judy Brett
Infection Control Consultant
VICNISS Coordinating Centre
10 Wreckyn Street
North Melbourne Vic 3051
Tel: 03 93423905
Fax: 03 9342 2633
email: judy.brett@mh.org.au

From: ACIPC Infexion Connexion [mailto:AICALIST@AICALIST.ORG.AU] On Behalf Of Michael Wishart
Sent: Friday, 13 July, 2012 3:08 PM
To: AICALIST@AICALIST.ORG.AU
Subject: [ACIPC_Infexion_Connexion] ACHS CI for SSI

Hi all

Another question on something different at a new employer. This one may just be me not being up to date, though.

For the purposes of ACHS Infection Control Clinical Indicators 1.1-1.4 (hip and knee prostheses) how many facilities report bilateral prosthesis procedures as TWO procedures in their denominator (not a single procedure). ACHS have confirmed to us this is what they expect, which surprised me a bit.

Since there is a single CMBS / ICD-10 code for bilateral procedures such as these, I have only ever known reporting these as one procedure, and I wondered whether other ICPs are familiar with this ACHS requirement. Might be worth checking with whoever collates your denominator for these indicators if you are unsure.

I have to then wonder about coronary artery bypass graft procedures. does anyone report these by the number of grafts performed, or only as one procedure regardless of the number of grafts? We didnt specifically ask ACHS about this, but looking at the interpretation of procedure for hip and knee prostheses, I have to wonder. Ie

Multiple procedures on an individual patient should be counted separately (eg hip
prosthesis and knee prosthesis);

Looking at the way the indicators are worded, note:

1.1 Total number of hip prothesis procedures performed

And

1.5 Total number of coronary artery bypass graft procedures
performed,

Thanks for any thoughts (including letting me know I am way behind the times here!).

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
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[Peterson, Allison]

Hi Michael
HISWA aligns with CDC / NHSN SSI definitions and count bilateral
procedures for hip and knee arthroplasty as two separate procedures.
I have attached the link – see page 9-13.
http://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf
Kind regards
Allison
Allison Peterson, RN
Healthcare Associated Infection Surveillance WA
Healthcare Associated Infection Unit (HAIU)
Communicable Disease Control Directorate
Department of Health, WA

________________________________

Behalf Of Michael Wishart

Hi all

Another question on something different at a new employer. This one may
just be me not being up to date, though.

For the purposes of ACHS Infection Control Clinical Indicators 1.1-1.4
(hip and knee prostheses) how many facilities report bilateral
prosthesis procedures as TWO procedures in their denominator (not a
single procedure). ACHS have confirmed to us this is what they expect,
which surprised me a bit.

Since there is a single CMBS / ICD-10 code for bilateral procedures such
as these, I have only ever known reporting these as one procedure, and I
wondered whether other ICP’s are familiar with this ACHS requirement.
Might be worth checking with whoever collates your denominator for these
indicators if you are unsure.

I have to then wonder about coronary artery bypass graft procedures….
does anyone report these by the number of grafts performed, or only as
one procedure regardless of the number of grafts? We didn’t specifically
ask ACHS about this, but looking at the interpretation of ‘procedure’
for hip and knee prostheses, I have to wonder. Ie

“Multiple procedures on an individual patient should be counted
separately (eg hip

prosthesis and knee prosthesis);”

Looking at the way the indicators are worded, note:

“1.1 Total number of hip prothesis procedures performed”

And

“1.5 Total number of coronary artery bypass graft procedures

performed,”

Thanks for any thoughts (including letting me know I am way behind the
times here!).

Cheers

Michael

Michael Wishart

CNC Infection Control

Holy Spirit Northside Private Hospital

627 Rode Road, Chermside, Qld 4032

t: (07) 3326 3068 | f: (07) 3326 3523

e: Michael.Wishart@hsn.org.au

w:www.holyspiritnorthside.org.au

Please consider the environment before printing this email

WARNING : This email contains information, which is CONFIDENTIAL, and
that maybe subject to LEGAL PRIVILEGE. This e-mail and any attachments
to it (the “Communication”) is confidential and is for the use only of
the intended recipient, and may not duplicated or used by any other
party without the express consent of the sender. The Communication may
contain copyright material of St Vincent’s Health & Aged Care(“SVHAC”),
or any of its related entities or of third parties. If you are not the
intended recipient of the Communication, please notify the sender
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[Michele.Cullen@HEALTH.VIC.GOV.AU Subject: Re: ACHS CI for SSI In-Reply-To:]

Dear Michael
The reason for two procedures for Hips and Knees (if both performed on the
one day is that they are two procedures – two incision sites and should be
two separate set-ups for OR.
Multiple numbers of coronary grafts are performed through the one incision
hence should be one procedure.
I think …………..

Regards

(Embedded (Embedded image moved to file: pic00015.jpg)
image moved
to file:
pic05631.jpg)

Michele Cullen
Infection Control Consultant | Communicable Disease Prevention and
Control | Public Health
Department of Health | 50 Lonsadale Street, Melbourne, Victoria,
3000
p. 03 9096 5094 | f. 1300 651 170
e. michele.cullen@health.vic.gov.au

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|Michael Wishart |
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|ACIPC Infexion Connexion |
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Hi all

Another question on something different at a new employer. This one may
just be me not being up to date, though.

For the purposes of ACHS Infection Control Clinical Indicators 1.1-1.4 (hip
and knee prostheses) how many facilities report bilateral prosthesis
procedures as TWO procedures in their denominator (not a single procedure).
ACHS have confirmed to us this is what they expect, which surprised me a
bit.

Since there is a single CMBS / ICD-10 code for bilateral procedures such as
these, I have only ever known reporting these as one procedure, and I
wondered whether other ICPs are familiar with this ACHS requirement. Might
be worth checking with whoever collates your denominator for these
indicators if you are unsure.

I have to then wonder about coronary artery bypass graft procedures. does
anyone report these by the number of grafts performed, or only as one
procedure regardless of the number of grafts? We didnt specifically ask
ACHS about this, but looking at the interpretation of procedure for hip
and knee prostheses, I have to wonder. Ie

Multiple procedures on an individual patient should be counted separately
(eg hip
prosthesis and knee prosthesis);

Looking at the way the indicators are worded, note:

1.1 Total number of hip prothesis procedures performed

And

1.5 Total number of coronary artery bypass graft procedures
performed,

Thanks for any thoughts (including letting me know I am way behind the
times here!).

Cheers
Michael

Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this email
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without the express consent of the sender. The Communication may contain
copyright material of St Vincent’s Health & Aged Care(“SVHAC”), or any of
its related entities or of third parties. If you are not the intended
recipient of the Communication, please notify the sender immediately by
return e-mail, delete the Communication, and do not read, copy, print,
retransmit, store or act in reliance on the Communication. Any views
expressed in the Communication are those of the individual sender only,
unless expressly stated to be those of SVHAC. SVHAC does not guarantee the
integrity of the Communication, or that it is free from errors, viruses or
interference. Thank-you.

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