Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-26T16:54:08.456Z Has data issue: false hasContentIssue false
  • English
  • Français

Validation of Surgical Site Infection Surveillance in The Netherlands

Published online by Cambridge University Press:  02 January 2015

J. Manniën ,
A. E. van der Zeeuw ,
J. C. Wille  and
S. van den Hof
J. Manniën*
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
A. E. van der Zeeuw
Affiliation:
Dutch Institute for Healthcare Improvement, Utrecht, The Netherlands
J. C. Wille
Affiliation:
Dutch Institute for Healthcare Improvement, Utrecht, The Netherlands
S. van den Hof
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
*
National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The, Netherlands ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives.

To describe how continuous validation of data on surgical site infection (SSI) is being performed in the Dutch National Nosocomial Infection Surveillance System (Preventie Ziekenhuisinfecties door Surveillance [PREZIES]), to assess the quality and accuracy of the PREZIES data, and to present the corresponding outcomes of the assessment.

Design.

Mandatory, 1-day on-site validation visit to participating hospitals every 3 years. The process of surveillance, including the quality of the method of data collection, is validated by means of a structured interview. The use of SSI criteria is validated by review of medical records, with the judgment of the validation team as the criterion standard.

Setting.

Hospitals participating in PREZIES.

Results.

During 1999-2004, the validation team visited 40 hospitals and reviewed 859 medical charts. There was no deviation between reports of SSI by infection control professionals and findings by the PREZIES validation team at 30 hospitals and 1 deviation in each of 10 hospitals; the positive predictive value was 0.97, and the negative predictive value was 0.99. The validation team often gave advice to the hospital, aimed at perfecting the process of surveillance. On 2 occasions, data were removed from the PREZIES database after the validation visit revealed deviations from the SSI surveillance protocol that could have resulted in nonrepresentative SSI rate data.

Conclusions.

PREZIES is confident that the assembled Dutch SSI surveillance data are reliable and robust and are sufficiently accurate to be used as a reference for interhospital comparison. PREZIES will continue performing on-site validation visits, to improve the process of surveillance and ensure the reliability of the surveillance data.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 1 , January 2007 , pp. 36 - 41
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Kirkland, KB, Briggs, JP, Trivette, SL, Wilkinson, WE, Sexton, DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999;20:725–730.CrossRefGoogle ScholarPubMed
2. Perencevich, EN, Sands, KE, Cosgrove, SE, Guadagnoli, E, Meara, E, Platt, R. Health and economic impact of surgical site infections diagnosed after hospital discharge. Emerg Infect Dis 2003;9:196–203.CrossRefGoogle ScholarPubMed
3. Wenzel, RP. The economics of nosocomial infections. J Hosp Infect 1995;31:79–87.CrossRefGoogle ScholarPubMed
4. Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182–205.CrossRefGoogle ScholarPubMed
5. Bruce, J, Russell, EM, Mollison, J, Krukowski, ZH. The quality of measurement of surgical wound infection as the basis for monitoring: a systematic review. J Hosp Infect 2001;49:99–108.CrossRefGoogle ScholarPubMed
6. Wenzel, RP, Osterman, CA, Townsend, TR, et al. Development of a statewide program for surveillance and reporting of hospital-acquired infections. 7 Infect Dis 1979;140:741–746.CrossRefGoogle ScholarPubMed
7. Gastmeier, P, Kampf, G, Hauer, T, et al. Experience with two validation methods in a prevalence survey on nosocomial infections. Infect Control Hosp Epidemiol 1998;19:668–673.CrossRefGoogle Scholar
8. Larson, E, Horan, T, Cooper, B, Kotilainen, HR, Landry, S, Terry, B. Study of the definition of nosocomial infections (SDNI). Research Committee of the Association for Practitioners in Infection Control. Am J Infect Control 1991;19:259–267.CrossRefGoogle ScholarPubMed
9. McCoubrey, J, Reilly, J, Mullings, A, Pollock, KG, Johnston, F Validation of surgical site infection surveillance data in Scotland. J Hosp Infect 2005;61:194–200.CrossRefGoogle ScholarPubMed
10. Broderick, A, Mori, M, Nettleman, MD, Streed, SA, Wenzel, RP. Nosocomial infections: validation of surveillance and computer modeling to identify patients at risk. Am J Epidemiol 1990;131:734–742.CrossRefGoogle ScholarPubMed
11. Cardo, DM, Falk, PS, Mayhall, CG. Validation of surgical wound surveillance. Infect Control Hosp Epidemiol 1993;14:211–215.CrossRefGoogle ScholarPubMed
12. Ehrenkranz, NJ, Shultz, JM, Richter, EL. Recorded criteria as a “gold standard” for sensitivity and specificity estimates of surveillance of nosocomial infection: a novel method to measure job performance. Infect Control Hosp Epidemiol 1995;16:697–702.CrossRefGoogle ScholarPubMed
13. Emori, TG, Edwards, JR, Culver, DH, et al. Accuracy of reporting nosocomial infections in intensive-care-unit patients to the National Nosocomial Infections Surveillance system: a pilot study. Infect Control Hosp Epidemiol 1998;19:308–316.CrossRefGoogle Scholar
14. Geubbels, EL, Mintjes-de Groot, AJ, van den Berg, JM, de Boer, AS. An operating surveillance system of surgical-site infections in The Netherlands: results of the PREZIES national surveillance network. Preventie van Ziekenhuisinfecties door Surveillance. Infect Control Hosp Epidemiol 2000;21:311–318.CrossRefGoogle Scholar
15. Horan, TC, Gaynes, RP. Surveillance of nosocomial infections. Mayhall, CG, ed. Hospital Epidemiology and Infection Control. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2004:1659–1702.Google Scholar
16. Mannien, J, Wille, JC, Snoeren, RL, van den Hof, S. Impact of postdischarge surveillance on surgical site infection rates for several surgical procedures: results from the nosocomial surveillance network in The Netherlands. Infect Control Hosp Epidemiol 2006;27:809–816.CrossRefGoogle Scholar
17. de Haas, R, de Boer, AS, Mintjes-de Groot, AJ, Geubbels, ELPE, Voss, A, van den Berg, JMJ. Surgical Site Infections: Validation of the National Surveillance [in Dutch]. Bilthoven, The Netherlands: National Institute for Public Health and the Environment; Utrecht, The Netherlands: The Dutch Institute for Healthcare Improvement; 1998.Google Scholar
18. Fleiss, JL. A simplification of the classic large sample standard error of a function of multinomial proportions. Am Stat 1982;36:377–378.Google Scholar
19. Manniën, J, van den Hof, S, Wille, JC. Internal validation within the PREZIES network [in Dutch]. Tijdschrift Voor Hygiëne en Infectie Preventie 2004;5:118–119.Google Scholar