Surgical Site Infection Prevention
A Surgical Site Infection (SSI) occurs at the site of a surgical incision. Germs can get into the incision area, and cause an infection. It can develop within 30 days of an operation, or sometimes even up to one year if an implant (such as a knee or hip joint implant) is used. Infections can be minor, or occasionally they can increase complications that result in a longer length of stay in the hospital, or an increased readmission rate for patients. Post-operative SSIs are the most common health care-associated infections in surgical patients.
The NHS has a number of practices in place to help prevent surgical site infections, including administering antibiotics to patients at a certain time before their surgery. This indicator measures whether those antibiotics were administered with 60 or 120 minutes before surgery, depending on the method and type of antibiotic. What is not reported in this indicator is the number of patients who received the antibiotic or the actual number of post-operative infections. At the NHS, fully 95% of all patients receiving hip and knee joint replacement surgery received antibiotics in March and not one patient has been readmitted to hospital with a post-op infection. These stats tell us we need to improve our process for administering antibiotics in a timely way and work has begun on tightening up this protocol.
Prophylactic Antibiotic Use Prior to Total Joint Replacement Surgery:
| Site | Percentage of Patients with Antibiotic Administration within the Appropriate Time* Prior to Surgery | Percentage of Patients with Antibiotic Administration Prior to Surgery | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Mar 09 |
Apr-Jun 09 | Jul-Sep 09 | Oct-Dec 2009 | Jan-Mar 2010 | Apr-Jun 2010 | Mar 09 |
Apr-Jun 09 | Jul-Sep 09 | Oct-Dec 2009 | Jan-Mar 2010 | Apr-Jun 2010 | |
| Douglas Memorial | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| Niagara-on-the-Lake | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| Port Colborne General | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| Greater Niagara General | 11.4% | 20.4% | 69.9% | 84.8% | 92.7% | 90.4% | 91.4% | 88.0% | 90.3% | 95.7% | 98.2% | 96.5% |
| St. Catharines General | 83.3% | 82.3% | 83.8% | 83.6% | 93.8% | 91.5% | 95.8% | 95.2% | 91.9% | 96.1% | 99.2% | 100% |
| Welland | 41.2% | 26.7% | 46.3% | 68.8% | 72.3% | 90.2% | 97.1% | 89.5% | 87.8% | 94.8% | 96.0% | 92.2% |
*Appropriate Time for prophylactic antibiotic administration is within 60 minutes prior to surgical incision (Except for cases where vacomycin was administered; it must be given within 120 minutes of surgery start time).
** N/A - do not perform total joint replacement surgery
All hospitals that perform hip and/or knee joint replacement surgery must publicly report the SSI-Prevention indicator data. These Ontario hospitals are posting their quarterly SSI-Prevention percentages for their facility, using the following formula:
% of Patients with Antibiotic Administration within the Appropriate Time Prior to Surgery |
= |
# of Hip/Knee joint replacement surgeries who received usual antibiotics within 60 min of skin incision |
+ | # of Hip/Knee joint replacement surgeries who received vancomycin within 120 min of skin incision |
x 100% |
|---|---|---|---|---|---|
Total number of patients during the reporting period who had a primary knee/hip joint replacement surgical procedure |
|||||
Timely Administration of Prophylactic Antibiotic
Prior to Total Joint Replacement Surgery
