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An enhanced benchmark for prosthetic joint replacement infection rates
Sue Barnes1, Charles Salemi, Donald Fithian
1Northern California Regional Infection Control, Kaiser Permanente, 1800 Harrison Street, Oakland, CA 94612, USA. sue.barnes@kp.org
American Journal of Infection Control
|December 13, 2006
Summary
Comprehensive postdischarge surveillance in integrated healthcare systems (IHCS) yields higher surgical site infection (SSI) rates than the National Nosocomial Infection Surveillance (NNIS) system. This highlights the importance of including postdischarge monitoring for accurate infection benchmarks.
Area of Science:
- Healthcare epidemiology
- Infection control
- Public health surveillance
Background:
- The National Nosocomial Infection Surveillance (NNIS) system is a historical benchmark for healthcare-associated infections.
- NNIS lacks mandatory postdischarge surveillance, potentially underestimating infection rates.
- Comprehensive postdischarge surveillance can improve the detection efficiency of surgical site infections (SSIs).
Purpose of the Study:
- To compare surgical site infection (SSI) data between a large integrated healthcare system (IHCS) and the National Nosocomial Infection Surveillance (NNIS) system.
- To evaluate the impact of including postdischarge surveillance on SSI rate calculations.
Main Methods:
- Utilized a standard surveillance methodology inclusive of the postdischarge period within an IHCS from 1999 to 2004.
- Compared IHCS and NNIS SSI data for hip and knee procedures.
- Employed stratified and weighted averages for rate calculations.
Main Results:
- IHCS SSI rates were significantly higher than NNIS rates for both hip (1.7% vs. 1.4%, P = .006) and knee (2.1% vs. 1.2%, P = .012) procedures.
- The inclusion of postdischarge surveillance in the IHCS methodology led to the detection of more infections.
- The observed differences underscore the impact of surveillance scope on reported infection rates.
Conclusions:
- Integrated healthcare systems employing comprehensive postdischarge surveillance report higher SSI rates compared to the NNIS database.
- Postdischarge surveillance is crucial for accurate assessment and benchmarking of surgical site infections.
- Findings suggest a need to re-evaluate current surveillance standards to incorporate postdischarge monitoring for a more complete picture of healthcare-associated infections.
