Adverse impact of surgical site infections in English hospitals

Coello, R.; Charlett, André; Wilson, Jennie; Ward, V.; Pearson, A.; Borriello, Peter

doi:10.1016/j.jhin.2004.10.019

Cited by 435 publications

(278 citation statements)

References 34 publications

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Section: Evaluación De La Normalización De La Preparación Prequirúrgisupporting

confidence: 92%

“…study (4) highlighted that the third most frequent type is surgical site infection. This finding is consistent with other epidemiological studies in other countries, with detected the alarming problem of surgical site infections and their unwanted repercussions on the increase in morbidity and mortality levels and health care costs (5)(6)(7)(8) .The risk of surgical site infection (SSI) involves multiple factors. Intrinsic (host-related) factors include, for example, malnutrition and protein depletion, extreme ages, severity of baseline diseases like diabetes, cancer, chronic vascular disease, obesity and smoking (9)(10) .…”

supporting

confidence: 90%

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Assessment of protocols for surgical-site preparation in a regional network of hospitals

Peñalver-Mompeán

Saturno-Hernández

Fonseca-Miranda

et al. 2012

Rev. Latino-Am. Enfermagem

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Surgical-site infection is a preventable adverse event. Implementation of good practices for correct surgical-site preparation can contribute to lessen this safety problem. The objective of this study was to describe the presence and quality of protocols on surgical-site preparation in the Murcia (Spain) regional network of public hospitals. The indicator "existence of protocol for surgical-site preparation" was assessed, as well as the formal quality (expected attributes) and contents (compared to current evidence-based recommendations) of existing documents. Seven of the nine hospitals have a protocol for surgical-site preparation. Opportunities to improve have been identified in relation to the protocols' formal quality and contents. Recommendations related to skin asepsis are incomplete and those related to hair removal contradict existing evidence. Most hospitals have protocols for surgical-site preparation; however, there is great room for improvement, in relation to their expected attributes and to the inclusion of evidencebased recommendations. Evaluación de la normalización de la preparación prequirúrgica en una red regional de hospitalesLa infección del sitio quirúrgico es un evento adverso prevenible mediante la implementación de buenas prácticas de preparación prequirúrgica. El objetivo del presente estudio fue describir la existencia y calidad de protocolización de la preparación prequirúrgica en la red regional de hospitales públicos de Murcia (España). Se evaluó el indicador "Existencia de protocolo/norma de preparación prequirúrgica", analizando la calidad formal (atributos) y de contenido (presencia de recomendaciones basadas en evidencia) de los documentos existentes. Siete (de nueve) hospitales acreditaron tener protocolos de preparación prequirúrgica. Existen oportunidades de mejora en la calidad formal y de contenido. Las recomendaciones sobre asepsia son incompletas en la mayoría de los documentos, y las de eliminación del vello contrarias a la evidencia.La preparación prequirúrgica está protocolizada en la mayoría de hospitales, pero la calidad de los protocolos es deficiente, así como la normalización de prácticas basadas en evidencia. study (4) highlighted that the third most frequent type is surgical site infection. This finding is consistent with other epidemiological studies in other countries, with detected the alarming problem of surgical site infections and their unwanted repercussions on the increase in morbidity and mortality levels and health care costs (5)(6)(7)(8) .The risk of surgical site infection (SSI) involves multiple factors. Intrinsic (host-related) factors include, for example, malnutrition and protein depletion, extreme ages, severity of baseline diseases like diabetes, cancer, chronic vascular disease, obesity and smoking (9)(10) .On the other hand, extrinsic factors (related to the surgery and hospital environment) can be the duration of surgical washing, extended hospitalization, shaving, surgery duration, skin antisepsis, prophylactic antibiotics and sterilizati...

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Section: Evaluación De La Normalización De La Preparación Prequirúrgisupporting

confidence: 92%

supporting

confidence: 90%

Assessment of protocols for surgical-site preparation in a regional network of hospitals

Peñalver-Mompeán

Saturno-Hernández

Fonseca-Miranda

et al. 2012

Rev. Latino-Am. Enfermagem

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“…33 Outpatients who develop SSI are not being identified by most SSI surveillance systems in U se. 18 " 24,28,34 Although our surveillance system managed to identify 106 patients who had SSI diagnosed after hospital discharge, of whom 63 were readmitted, we were unable to assess the respective economic burden based on the outcome variables that were addressed in the present study. Perencevich et al 31 reported a significant increase in the use of resources for patients with SSI diagnosed after discharge from the hospital, in terms of emergency room visits, radiology services, readmissions, and home health aide services.…”

Section: Discussionmentioning

confidence: 99%

Economic Burden of Surgical Site Infections at a European University Hospital

Weber

Zwahlen

Reck

et al. 2008

Infect. Control Hosp. Epidemiol.

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OBJECTIVE. To quantify the economic burden of in-hospital surgical site infections (SSIs) at a European university hospital.DESIGN. Matched case-control study nested in a prospective observational cohort study.SETTING. Basel University Hospital in Switzerland, where an average of 28,000 surgical procedures are performed per year.METHODS. All in-hospital occurrences of SSI associated with surgeries performed between January 1, 2000, and December 31, 2001, by the visceral, vascular, and traumatology divisions at Basel University Hospital were prospectively recorded. Each case patient was matched to a control patient by age, procedure code, and National Nosocomial Infection Surveillance System risk index. The case-control pairs were analyzed for differences in cost of hospital care and in provision of specialized care.RESULTS. A total of 6,283 procedures were performed: 187 SSIs were detected in inpatients, 168 of whom were successfully matched with a control patient. For case patients, the mean additional hospital cost was SwF19,638 (95% confidence interval [CI], SwF8,492-SwF30,784); the mean additional postoperative length of hospital stay was 16.8 days (95% CI, 13-20.6 days); and the mean additional in-hospital duration of antibiotic therapy was 7.4 days (95% CI, 5.1-9.6 days). Differences were primarily attributable to organ space SSIs (« = 76).CONCLUSIONS. Ina European university hospital setting, SSIs are costly and constitute a heavy and potentially preventable burden on both patients and healthcare providers. 2008; 29:623-629 Surgical site infections (SSIs) account for 14%-16% of all nosocomial infections in inpatients and are considered the most common form of nosocomial infection among surgical patients. 1 A number of risk factors have been associated with the onset of SSI, and they can be broadly subdivided into patientrelated characteristics (eg, greater age, poor nutritional status, and more numerous and/or more severe combrbid conditions) and surgery-related characteristics (eg, long duration of procedure, high wound classification, and absence of antibiotic prophylaxis). 26 Based on such risk factors, SSI prediction scores have been developed that allow the identification of patients at high risk for developing SSI. 5,7,8 For these high-risk patients, clinicians can implement appropriate prevention strategies and effective measures to diagnose infection and initiate therapy at an early stage. In addition, in the past few years, SSI surveillance systems have been shown to decrease the rates of SSI in various countries. 1 ' 916 In such systems, clinicians share feedback on infection rates with surgical staff and reinforce adherence to Centers for Disease Control and Prevention standards. A nosocomial infection surveillance system was introduced at Basel University Hospital in 1999 to decrease the rate of SSI. Infect Control Hosp EpidemiolNowadays, hospital infections, particularly SSIs-which are potentially preventable complications directly linked to surgery-are considered to reflect the quality of...

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“…For the United Kingdom, Coello et al calculated that SSIs might, depending on the site of infection, increase length of stay from 3.3 to 21 days, causing up to an additional £ 6103 of costs [22] . Further savings are possible if cardiac events and transfusion needs are considered.…”

Section: Cost-effectivenessmentioning

confidence: 99%

Diagnosis, prevention and treatment of accidental and perioperative hypothermia

Brandt¹,

Mühlsteff

Imhoff³

2012

Biomedizinische Technik/Biomedical Engineering

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Accidental hypothermia and its variant, perioperative hypothermia, is a rather common clinical phenomenon in patients. This is surprising because the negative effects on clinical outcomes are well described and effective patient-warming devices are available today. The aim of this paper is to describe the physiologic background of accidental and perioperative hypothermia, the clinical relevance and existing prophylaxis and treatment options. Patient warming techniques will be discussed in detail. Remaining technical and clinical challenges and the need for further research will be addressed. We will present existing guidelines and standards and analyse the impact of accidental and perioperative hypothermia on cost effectiveness.

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Adverse impact of surgical site infections in English hospitals

Cited by 435 publications

References 34 publications

Assessment of protocols for surgical-site preparation in a regional network of hospitals

Assessment of protocols for surgical-site preparation in a regional network of hospitals

Economic Burden of Surgical Site Infections at a European University Hospital

Diagnosis, prevention and treatment of accidental and perioperative hypothermia

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