[Peterson, Allison]

Hi Heather

The Healthcare Infection Surveillance Western Australian (HISWA) program adopted these NHSN/CDC definitions in 2013 – so they are not new.
We welcomed the change at the time and our data showed that 91% of hip SSIs and 70% of knee SSIs were detected within 30 days of the initial procedure and 100% of hip SSIs and 92% of knee SSIs were detected within 4 months.

Kind regards
Allison
Allison Peterson HISWA / Healthcare Associated Infection Unit | Communicable Disease Control Directorate
Department of Health
Grace Vaughan House, 227 Stubbs Tce, SHENTON PARK WA 6008
* +61 8 9388 4808 | 7 +61 8 9388 4888
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Dear Colleagues

The CDC changed the definition of a hospital acquired surgical site infection of a joint replacement from 1 year to 90 days.
Have all hospitals adopted this new protocol?
I would also be interested to know what brought about this change, and is this generally considered a positive change.

Kind regards

Heather

Heather Warfield
Infection Prevention & Control
Surgical site surveillance
Canberra Hospital
building 10, level 4

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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

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