Highly Sensitive and Efficient Computer–Assisted System for Routine Surveillance for Surgical Site Infection

Abstract

Surveillance for SSIs using computer-assisted, laboratory-based screening and case confirmation by surgeons is as efficient as and far less time-consuming than the conventional method of chart review. This method permits routine surveillance for SSIs with reliable accuracy.

Methodology of the Norwegian Surveillance System for Healthcare-Associated Infections: The value of a mandatory system, automated data collection, and active postdischarge surveillance

“…Although traditional case-finding by ICPs has been considered the "gold standard" of HAI surveillance, several newer studies show that this is not necessarily the case: computer-aided surveillance may be more time-efficient and superior in case-finding. Many studies have compared traditional surveillance by ICPs with case-finding using surveillance definitions to available data sources such as ICD-9 diagnostic codes and other administrative coding; 78,81,87,89,[177][178][179][180][181] microbiology, laboratory or pharmacy data; [182][183][184][185] or a combination of these 84,137,146,184,[186][187][188][189] . Some have utilized advanced algorithms to detect SSIs and validate these against ICP case-finding.…”

Theory and Practice

“…With further automation, the computer-assisted surveillance system might fare very well, compared with chart review by only a single ICP. Chalfine et al 2 seemed to have significant cooperation from the surgeons involved on this one unit. Their method also relies on appropriate identification of the source of a microbiologic culture sample in order to work.…”

“…The issue of improving the efficiency of case finding is addressed by in this issue of the journal by Chalfine et al 2 These investigators developed a computer-assisted surveillance system to import microbiologic culture data, surgical procedure data, and general demographic information into a database. Records for patients who had undergone a surgical procedure and had a culture positive for a pathogen were reviewed by an ICP.…”

“…To ensure that specimens were appropriately labeled as being from a surgical site, a new ordering form for requesting microbiologic testing was introduced. Chalfine et al 2 report data for a 1-year study period on a gastrointestinal and general surgery ward, comparing the SSIs found by the computer-assisted surveillance system and the SSIs found by traditional surveillance, which involved retrospective record review, with each record reviewed by 2 ICPs. The time spent on surveillance was also compared.…”

“…As Chalfine et al 2 acknowledge, the use of computers to screen microbiology data to assist ICPs in finding SSI cases is not new, 3,4 and neither is sending questionnaires to surgeons to check for SSIs. 5 Nevertheless, these investigators combined the 2 techniques in a fairly unique way to reduce the number of questionnaires sent without sacrificing the sensitivity of surveillance.…”