Surveillance of healthcare-associated infection (HAI) is one of the main foundations of good infection control practice. It can be defined as the systematic recording of infections using agreed definitions, with analysis, interpretation and dissemination of the results so that appropriate action can be taken. Surveillance is necessary to monitor trends in infection rates over time, detect outbreaks, provide information for the planning of services and allocation of resources, and to evaluate the impact of any interventions aimed at reducing infection risks.
As well as monitoring MRSA and Clostridium difficile rates Plymouth Hospitals NHS Trust (PHNT) also participates in a National Surgical Site Infection Surveillance Service (SSISS). Although surgical site infections are uncommon it is important to continue to monitor for them in order to improve the quality of care provided.
The SSISS assesses speciality-specific surgical site infections (SSI) on a quarterly basis. Plymouth Hospitals NHS Trust (PHNT) has participated with the national scheme since its conception in 1997. Since this time the service has expanded and the IPCT now follow up the majority of patients undergoing surgery. Members of the team undertake both in-patient and post discharge surveillance using standard case definitions and surveillance methodology.
Patients will either be visited on the ward, where the nurse will collect information relating to the wound, or a letter will be sent to the patient’s home address asking them to complete the questions and return in a pre-paid envelope to the team. Standard case definitions and surveillance methodology are provided to enable comparable rates to be produced.
The information that is collected is passed to the Health Protection Agency (HPA) which is co-coordinating the national programme for monitoring surgical site infection. No information that can be used to identify patients is ever used, such as name, address or postcode. The HPA collects information from 300 NHS and private hospitals in England that are taking part in the national programme. A key objective of the surveillance is to enable hospitals to use data on their rates of SSI to inform and guide the review or change of practice where results indicate these may be necessary to improve the quality of care. Further information on this can be found online at the HPA website www.hpa.org.uk
Patients can find out more about surgical wound in the Guideline on the Prevention and Treatment of Surgical Site Infection published by the National Institute for Health and Clinical Excellence in 2008. This can be found online at www.nice.org.uk
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Post Operative Infection Rates