A retrospective evaluation of surgical site infections in a Hong Kong private hospital benchmarking to the National Healthcare Safety Network (NHSN) surveillance risk index

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A retrospective evaluation of surgical site infections in a Hong Kong private hospital benchmarking to the National Healthcare Safety Network (NHSN) surveillance risk index

 

Author: Lau, Sze Sze
Title: A retrospective evaluation of surgical site infections in a Hong Kong private hospital benchmarking to the National Healthcare Safety Network (NHSN) surveillance risk index
Degree: M.Sc.
Year: 2013
Subject: Nosocomial infections -- Prevention.
Health services administration.
Hospital care -- Quality control.
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: vii, 67 leaves : color illustrations ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2761744
URI: http://theses.lib.polyu.edu.hk/handle/200/7801
Abstract: Background: Surgical Site Infections imposes costly, high mortality and morbidity impacts in health institutions. The prevention of SSI becomes highly prioritized in the agenda of health quality assurance policy in healthcare industry. The NHSN national surveillance system in the U.S. is known as the well-established and effective surveillance system for nosocomial infections (including SSI) internationally. Countries have adopted its surveillance protocols and methodologies in order to modify and develop their own national surveillance systems. Since lacking of a central surveillance system, a private hospital in Hong Kong has adopted the NHSN surveillance protocols and methodologies to monitor its SSI rate timely. The aim of this study was to investigate the infection rate and characteristics of SSI in Hospital X benchmarking to the methodologies of the NHSN surveillance system. Methodology: A retrospective study was conducted by retrieving a total of 2011 records of patients underwent seven designated procedures during 2010-2011. The incidences of SSI in the surgeries were detected. Investigation on the additional confounding risk factors and the NHSN's risk parameters was performed. Then the SSI rate of the surgeries between the hospital and NHSN dataset was compared.
Results: The overall SSI rate among seven surgeries of 2011 patients was 1.6%. Majority (94%) of cases were elective and more than 80% were laparoscopic procedures. A total of 32 SSI were detected. Seven of them were self-reported and others were detected by doctors documentation and infection control nurse assessment. Half of the SSI was detected in laparoscopic procedures. The SSI rate (3.8%) in appendix surgery was the highest in all surgeries. The SSI rate of appendix and gallbladder surgeries were both higher than that reported in NHSN dataset. Over 69% of the infected cases were in these two surgeries. Two individual surgeons were found to have particular high SSI rate (8.1% and 3.3%), which contributing one-fourth of all infected cases and all of them were gastrointestinal surgeries of appendix and gallbladder. Conclusion: The overall SSI rate of the hospital was low as 1.6% comparatively with other hospitals in Hong Kong and other countries. Among all surgical procedures large volume of gastrointestinal surgeries, including appendix, gallbladder, colon and rectal surgery, were performed. The large population surgery explained the result of exceptional high SSI rate of the appendix surgery. Moreover, two surgeons had operated on 25% of the infected appendix and gallbladder surgery. Therefore, surgeon was the only risk factor of SSI identified in this study.

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