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SSI surveillance methods

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  • #70681
    Turnbull, Karen P
    Participant

    Author:
    Turnbull, Karen P

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    Hi All,
    We are seeking information on what other regional size (250+ beds) acute hospitals are doing that works well for SSI surveillance. We don’t do CABGs, nor 100 THRs/TKRs in a calendar year, nor participate in the ACHS clinical indicators program for BSI & LUSCS,
    What we have done for many years is a ‘day-5 survey’: anyone who has a surgical wound and is still an inpatient on day 5 (DOS day 0) undergoes chart review against the SSI definitions. Although this has provided valuable data over the years, I suspect times have changed and the validity of someone being here on day 5 (although consistent) might not be sensitive to ever-shorter LOS. One of the obvious catches is if you go home on antibiotics on day 4 or present with infection on/after day 6 – you don’t count. This is a labour intensive spreadsheet based process with manual theatre list entry, (fairly reliable) electronic report for patient matching for day 5 (that is a step up in our world!), and trips to the wards as no electronic medical record.
    We also do an annual telephone follow-up at 30 days of selected 100+ (annual total, not the quarter we do the survey for) procedures (e.g. LUSCS, lap chole, etc.) for a 3-month period.
    Any suggestions, protocols, ideas most welcome
    Thanks
    Karen Turnbull
    Acting Nurse Manager
    Infection Prevention & Control Unit
    Level 2, Launceston General Hospital
    Charles Street 7250

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    #70687
    Wilson, Fiona (TIPCU)
    Participant

    Author:
    Wilson, Fiona (TIPCU)

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    Hi Karen, you may want to have a look at what VICNISS do for SSI. Their program covers all of the public hospitals in Victoria irrespective of size. The procedures chosen by a hospital are dependent on how many are done per annum rather than how many beds there are (and I think the ‘general’ rule is >100 procedures/annum…. although saying that, the health service I worked at did do SSI surveillance on some procedures that had <100/annum).
    Have a look at http://www.vicniss.org.au/

    Regards

    Fiona Wilson I CNC, Infection Control, TIPCU
    Population Health I Department of Health and Human Services
    Post GPO Box 125 Hobart Tas 7001 | Email tipcu@dhhs.tas.gov.au
    Phone (03) 6222 7684 | Fax (03) 6233 0553
    A fair and healthy Tasmania

    Hi All,
    We are seeking information on what other regional size (250+ beds) acute hospitals are doing that works well for SSI surveillance. We don’t do CABGs, nor 100 THRs/TKRs in a calendar year, nor participate in the ACHS clinical indicators program for BSI & LUSCS,
    What we have done for many years is a ‘day-5 survey’: anyone who has a surgical wound and is still an inpatient on day 5 (DOS day 0) undergoes chart review against the SSI definitions. Although this has provided valuable data over the years, I suspect times have changed and the validity of someone being here on day 5 (although consistent) might not be sensitive to ever-shorter LOS. One of the obvious catches is if you go home on antibiotics on day 4 or present with infection on/after day 6 – you don’t count. This is a labour intensive spreadsheet based process with manual theatre list entry, (fairly reliable) electronic report for patient matching for day 5 (that is a step up in our world!), and trips to the wards as no electronic medical record.
    We also do an annual telephone follow-up at 30 days of selected 100+ (annual total, not the quarter we do the survey for) procedures (e.g. LUSCS, lap chole, etc.) for a 3-month period.
    Any suggestions, protocols, ideas most welcome
    Thanks
    Karen Turnbull
    Acting Nurse Manager
    Infection Prevention & Control Unit
    Level 2, Launceston General Hospital
    Charles Street 7250

    ________________________________

    CONFIDENTIALITY NOTICE AND DISCLAIMER
    The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    #70688
    Margaret Evans
    Participant

    Author:
    Margaret Evans

    Position:

    Organisation:

    State:

    Hi Karen
    We do continuous surveillance of SSI for LSCS C/S inpatients but we count any SSI that occur during their hospital stay or if the patient is readmitted as an inpatient up to 30 days.
    We only do telephone post surveillance discharge every 2 years for approx. 300 patients (3 months’ worth of C/S operations).

    For surveillance I use a number of avenues

    * Surgical Site surveillance chart (as attached) this has a carbon copy which come to me on discharge.

    * I review all positive isolates from the labs

    * On ward round / hand over staff always chat to me or leave messages

    * We also use ‘Obstetrix’ data base, & once a month the data analysis person runs a report looking where midwives report infections of any kind and all readmissions.
    Hope this helps
    Kind regards
    Margie

    Margaret Evans IP&C CNC
    Royal Hospital for Women
    Locked Mail Bag 2000
    Randwick 2031
    Phone 02 93826339

    Senior Clinical lectures,
    Sydney university

    Hi All,
    We are seeking information on what other regional size (250+ beds) acute hospitals are doing that works well for SSI surveillance. We don’t do CABGs, nor 100 THRs/TKRs in a calendar year, nor participate in the ACHS clinical indicators program for BSI & LUSCS,
    What we have done for many years is a ‘day-5 survey’: anyone who has a surgical wound and is still an inpatient on day 5 (DOS day 0) undergoes chart review against the SSI definitions. Although this has provided valuable data over the years, I suspect times have changed and the validity of someone being here on day 5 (although consistent) might not be sensitive to ever-shorter LOS. One of the obvious catches is if you go home on antibiotics on day 4 or present with infection on/after day 6 – you don’t count. This is a labour intensive spreadsheet based process with manual theatre list entry, (fairly reliable) electronic report for patient matching for day 5 (that is a step up in our world!), and trips to the wards as no electronic medical record.
    We also do an annual telephone follow-up at 30 days of selected 100+ (annual total, not the quarter we do the survey for) procedures (e.g. LUSCS, lap chole, etc.) for a 3-month period.
    Any suggestions, protocols, ideas most welcome
    Thanks
    Karen Turnbull
    Acting Nurse Manager
    Infection Prevention & Control Unit
    Level 2, Launceston General Hospital
    Charles Street 7250

    ________________________________

    CONFIDENTIALITY NOTICE AND DISCLAIMER
    The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    #70690
    Fiona de Sousa
    Participant

    Author:
    Fiona de Sousa

    Position:

    Organisation:

    State:

    Hi Karen,

    Our facility uses as automated electronic database that has feeds from the ADT, Radiology, Surgery and Laboratory systems in the hospital. This allows us to review potential HAIs easily and then investigate them. The electronic database means that spreadsheets are a thing of the past.

    At present we use it to collect ACHS indicators, SSI, BSI, Dialysis, MRO, Device associated, SAB, C.diff and targeted organism data and assess patients for HAI.

    Happy for you to contact me offline to discuss further.

    Kind regards,

    Fiona De Sousa
    Infection Prevention & Control Coordinator
    Sydney Adventist Hospital
    Fiona.Desousa@sah.org.au
    185 Fox Valley Road, Wahroonga, NSW, 2076

    Hi All,
    We are seeking information on what other regional size (250+ beds) acute hospitals are doing that works well for SSI surveillance. We don’t do CABGs, nor 100 THRs/TKRs in a calendar year, nor participate in the ACHS clinical indicators program for BSI & LUSCS,
    What we have done for many years is a ‘day-5 survey’: anyone who has a surgical wound and is still an inpatient on day 5 (DOS day 0) undergoes chart review against the SSI definitions. Although this has provided valuable data over the years, I suspect times have changed and the validity of someone being here on day 5 (although consistent) might not be sensitive to ever-shorter LOS. One of the obvious catches is if you go home on antibiotics on day 4 or present with infection on/after day 6 – you don’t count. This is a labour intensive spreadsheet based process with manual theatre list entry, (fairly reliable) electronic report for patient matching for day 5 (that is a step up in our world!), and trips to the wards as no electronic medical record.
    We also do an annual telephone follow-up at 30 days of selected 100+ (annual total, not the quarter we do the survey for) procedures (e.g. LUSCS, lap chole, etc.) for a 3-month period.
    Any suggestions, protocols, ideas most welcome
    Thanks
    Karen Turnbull
    Acting Nurse Manager
    Infection Prevention & Control Unit
    Level 2, Launceston General Hospital
    Charles Street 7250

    ________________________________

    CONFIDENTIALITY NOTICE AND DISCLAIMER
    The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

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