Surgical Site Infection (SSI) Prevention

A surgical Site Infection 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.

How do patients get a surgical site infection?
There are various factors that could put a patient at risk of an SSI. For example, patients that have poor circulation, certain medical conditions, or shave themselves before surgery (this causes little nicks and cuts in the skin where germs can enter) have an increased risk of infection.

To try to reduce the number of surgical site infections, Safer Healthcare Now! and the Institute for Healthcare Improvement (IHI) have shared with hospitals a set of best practices in the form of “SSI bundles”. These “bundles” are a collection of best practices (for example, administration of prophylactic antibiotics, clipping and not shaving of body hair, etc.) that, when used together, can reduce the chances of a patient contracting a surgical site infection.

Our hospital is committed to keeping our patients as safe as possible from infection, and we have incorporated a number of best practices to reduce our surgical site infections.

What is being publicly reported with the SSI prevention percentages?
The SSI prevention percentage refers only to the use of antibiotics that help prevent surgical site infections from occurring in hip and knee joint replacement surgeries - that is, the percentage of hip/knee replacement surgical patients that received prophylactic antibiotic within the appropriate time prior to surgery during the reporting period of March 1 - March 31, 2009. Hospitals are not measuring actual surgical site infections.

The public reporting of this indicator will reveal the percent of all eligible patients who get antibiotics at the right time, just before a “first time” joint replacement surgery. If a patient has had a revision or “re-do”, this will not be included in the data.

Why are hospitals only reporting on hip and knee joint replacement surgeries for the SSI prevention percentage?
Reporting on joint replacement surgeries is a good place to start. Hip and knee joint replacements are common surgeries in a hospital. Studies have shown that antibiotic prophylaxis administration just before a joint replacement is a good way to reduce the chance of infection.