&lt;p&gt;The Impacts of Deep Surgical Site Infections on Readmissions, Length of Stay, and Costs: A Matched Case–Control Study Conducted in an Academic Hospital in the Netherlands&lt;/p&gt;

Purba, Abdul Khairul Rizki; Luz, Christian F.; Wulandari, Riyanti Retno; Gun, Ieneke van der; Dik, Jan-Willem H.; Friedrich, Alex; Postma, Maarten J.

doi:10.2147/idr.s264068

Cited by 4 publications

(4 citation statements)

References 51 publications

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“…3 suggest that infectious complications could be driving readmissions. This is consistent with existing literature that reveals how SSI can lead to increased readmission rates, making it a potential target to improve quality measures [18,19]. Dirtier wound class was significantly associated with surgical site infections and sepsis, which may explain why wound class was significantly prognostic of readmission in this study.…”

Section: Discussionsupporting

confidence: 92%

“…Dirtier wound class was significantly associated with surgical site infections and sepsis, which may explain why wound class was significantly prognostic of readmission in this study. In a case control study, prophylactic antibiotics was found to be protective of deep SSI during initial surgical admission [ 18 ]. Optimization of antibiotic use or source control among “non-clean” surgeries should be investigated further to examine its effect on readmission rate.…”

Section: Discussionmentioning

confidence: 99%

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Centers for Disease Control (CDC) Wound Classification is Prognostic of 30‐Day Readmission Following Surgery

et al. 2023

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Background The goal of this study was to investigate factors associated with 30-day readmission in a multivariate model, including the CDC wound classes “clean,” “clean/contaminated,” “contaminated,” and “dirty/infected.” Methods The 2017–2020 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for all patients undergoing total hip replacement, coronary artery bypass grafting, Ivor Lewis esophagectomy, pancreaticoduodenectomy, distal pancreatectomy, pneumonectomy, and colectomies. ACS-defined wound classes were concordant with CDC definitions. Multivariate linear mixed regression was used to determine risk factors for readmission while adjusting for type of surgery as a random intercept. Results 477,964 cases were identified, with 38,734 (8.1%) patients having experienced readmission within 30 days of surgery. There were 181,243 (37.9%) cases classified as wound class “clean”, 215,729 (45.1%) cases classified as “clean/contaminated”, 40,684 cases (8.5%) classified as “contaminated”, and 40,308 (8.4%) cases classified as “dirty/infected”. In the multivariate generalized mixed linear model adjusting for type of surgery, sex, body mass index, race, American Society of Anesthesiologists class, presence of comorbidity, length of stay, urgency of surgery, and discharge destination, “clean/contaminated” (p < .001), “contaminated” (p < .001), and “dirty/infected” (p < .001) wound classes (when compared to “clean”) were significantly associated with 30-day readmission. Organ/space surgical site infection and sepsis were among the most common reasons for readmission in all wound classes. Conclusions Wound classification was strongly prognostic for readmission in multivariable models, suggesting that it may serve as a marker of readmissions. Surgical procedures that are “non-clean” are at significantly greater risk for 30-day readmission. Readmissions may be due to infectious complications; optimizing antibiotic use or source control to prevent readmission are areas of future study.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Centers for Disease Control (CDC) Wound Classification is Prognostic of 30‐Day Readmission Following Surgery

et al. 2023

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“…Surgical site infections are the most common and complex healthcare-associated infections. Surgical site infections could lead to patient mortality and increased cost of care (Bhangu et al, 2018 ; Purba et al, 2020 ; Silvestri et al, 2018 ). Although surgical site infections have declined in the past decade, their rate in China is still problematic, especially during operations.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitude, and practice of surgical site infection prevention among operating room nurses in southwest China

Feng,

Sae-Sia,

Kitrungrote

2022

Belitung Nurs J

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Background: Surgical site infection has become a problem in the operating room, and the nurses’ knowledge, attitude, and practice could impact the incidence of the infection. Unfortunately, there is a dearth of studies on this issue in China. Therefore, determining nurses’ knowledge, attitude, and practice of surgical site infection prevention is necessary. Objectives: This study aimed to examine the knowledge, attitude, and practice of surgical site infection prevention and their relationships, as well as to identify differences in knowledge, attitude, and practice of surgical site infection prevention according to nurses’ demographic characteristics. Methods: A sample of 999 operating room nurses participated in 49 tertiary hospitals and 75 secondary hospitals in Guizhou Province, Southwest China. Data were collected using validated questionnaires through a Chinese survey website. Data were analyzed using descriptive statistics, One-Way Analysis of Variance, and Pearson product-moment correlation. Results: The knowledge of surgical site infection prevention was at a low level, the attitude was positive, and the practice was at a high level. Approximately 39% of the nurses passed knowledge scores of ≥ 70%, 60% gave a positive attitude score of ≥ 80%, and 76% achieved a practice score of ≥ 80%. The nurses’ attitude was positively related to knowledge (p < .01), and practice (p < .01), respectively. However, knowledge and practice did not significantly relate. The age group of 30-39 years old had significant higher knowledge than other age groups. The nurses with working experience of 6-15 years had significant higher knowledge scores than other groups. In addition, the nurses with one time of training frequency had significant lower attitude and practice scores than those with six to ten times of training frequency. Conclusion: Approximately 60% of operating room nurses still had inadequate knowledge regarding surgical site infection prevention, but they had a positive attitude and high level of practice. The findings of this study might serve as an input for nurse administrators or policymakers to provide updated knowledge or guideline, closed supervision, and in-service training on surgical site infection prevention for operating room nurses.

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“…Our results were also consistent with previous study which found that deep surgical site infections were associated with re-hospitalization, prolonged LoS and increased costs. 29 Furthermore, hospital re-admission is common in survivors of critical illnesses and increases stress on the patients and their caregivers. According to a previous systematic review and meta-analysis study, re-admission rates after critical illness were 16.9% (95%CI: 13.3-21.2%) within 30 days.…”

Section: A Comparative Effectiveness Study In Health Care Management ...mentioning

confidence: 99%

A Comparative Effectiveness Study in Health Care Management of Neurosurgery Patients by Bangkok International Hospital Case Manager Nurse

Yongprawat¹,

Suwalapha²,

Jarrat³

et al. 2023

bkkmedj

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To compare effective health care management practices, with a focus on three dimensions consisting of internal process, utilization management (UM) and financial management (FM) between patients who received clinical coordination interventions by case management (CM) nurse and usual standard of care of neurosurgery patients at Bangkok International Hospital (BIH). MATERIALS AND METHODS:This study is a retrospective chart review. This research collected data from neurosurgical patients, namely confirmed cases by neurosurgeons. They have undergone brain surgery procedures and have been admitted to BIH during a period of 3 years from 1st January 2019 -30th June 2022. We compared the outcome variables between two groups (The control group received usual care and the post-intervention group received clinical coordination by CM nurse) to assess the effectiveness of health care management. This consisted of the internal process, UM and FM. These data were analyzed using statistics with descriptive statistics and the independent t-test. RESULTS: Of a total of 372 neurosurgical cases, 235 cases (63.2%) met the inclusion criteria. More than half of cases were male (58.3%). The mean age was 60.6 ± 16.6 years. Most of them 181 (77.0%) were admitted to the neuro ward. The diagnosis included Stroke 100 (42.5%), Brain Tumor 86 (36.6%) and Traumatic Brain Injury (TBI) 27 (11.5%), respectively. The post-intervention group presented obviously higher compliance rates of 87.2% with a patient/family care team meeting and 79.2% discharge planning, respectively. The post-intervention group had lower costs (0.1%) of Risk Management than the control group (0.4%). Meanwhile, the control group had lower cost of bad debts expenses per year than the post-intervention group. That may have been an effect of some patients in the post-intervention group not having an insurance coverage of 100% of medical costs and could not afford the care. The comparison of the LoS in the control group showed significant differences, and less than those in the post-intervention group (p < 0.05). CONCLUSION: These results indicate that CM nurses can decrease risk management costs. Although, this study does have limitations. We have seen a positive trend towards using our CM model as this can assist in the improvement of quality in health care management through an effective care team meeting and discharge planning for our neurosurgical patients and their family. However, future studies should control confounding variables and more study is needed into other factors that may affect clinical outcomes.Keywords: health care management, case manager nurse, outcome of neurosurgical patients P atients with neurological disorders such as, Brain Tumor, Stroke, Cerebral Aneurysm and TBI may require brain surgery for full recovery. These are high-risk diseases and need specific care related to complex illnesses. There were also various factors associated with their outcomes. Therefore, these patients focused on the immediate assessment and management of neurological proble...

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<p>The Impacts of Deep Surgical Site Infections on Readmissions, Length of Stay, and Costs: A Matched Case–Control Study Conducted in an Academic Hospital in the Netherlands</p>

Cited by 4 publications

References 51 publications

Centers for Disease Control (CDC) Wound Classification is Prognostic of 30‐Day Readmission Following Surgery

Centers for Disease Control (CDC) Wound Classification is Prognostic of 30‐Day Readmission Following Surgery

Knowledge, attitude, and practice of surgical site infection prevention among operating room nurses in southwest China

A Comparative Effectiveness Study in Health Care Management of Neurosurgery Patients by Bangkok International Hospital Case Manager Nurse

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