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Sixteen Years' Surveillance of Surgical Sites in an Irish Acute-Care Hospital

Published online by Cambridge University Press:  02 January 2015

Eilish Creamer ,
Robert J. Cunney ,
Hilary Humphreys  and
Edmond G. Smyth
Eilish Creamer*
Affiliation:
Department of Infection Control and Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
Robert J. Cunney
Affiliation:
Department of Infection Control and Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
Hilary Humphreys
Affiliation:
Department of Infection Control and Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
Edmond G. Smyth
Affiliation:
Department of Infection Control and Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
*
Department of Public Health, Eastern Regional Health Authority, Dr. Steevens' Hospital, Dublin 8, Ireland
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Abstract

Objective:

To report a program of continuous surveillance of surgical-site infections (SSIs) using basic surveillance methods.

Design:

Analysis of routine prospective surveillance data.

Setting:

Two hospitals in Ireland (300 and 350 beds) that merged and moved to a new 650-bed hospital in 1987.

Patients:

59,335 surgical sites of postoperative patients.

Interventions:

Surgical sites were surveyed by one infection control nurse and SSI rates were produced for selected operations and surgical services. The program was conducted in general accordance with the 1999 HICPAC guidelines, but differed in surveillance strategy. Operations were limited to two to three risk classifications, assigned by the infection control nurse.

Results:

The overall SSI rate was 4.5%, with 2.4% in clean surgery. Apart from increases in the 3rd, 4th, 13th, and 14th years, rates remained relatively stable during the 16 years. Few significant decreases in SSI rates in surgical services or specific operations were shown, apart from the following: vascular surgery, 8.1% to 5% between the first 8 years and the last 8 years; general surgery services, 9% to 5%, and gynecology, 15.8% to 1.7%, both in the first year compared with in subsequent years; and gastric operations, 21% to 4.3% between the first year and the second year. Organ/space infection was identified in 0.5% of 17,804 operations, including 0.4% meningitis after neurosurgical procedures, 3% graft infections after vascular bypass operations, and 0.2% intra-abdominal infections after abdominal surgery.

Conclusions:

With the use of basic principles of surveillance and modest resources, procedure-specific SSI rates were produced, with little significant change during the 16 years. Despite limitations in case-finding, risk stratification, feedback, and surveillance methods, the overall SSI rates were comparable with other published data.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 1 , January 2002 , pp. 36 - 40
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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