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

Published online by Cambridge University Press:  21 June 2016

Annie Chalfine*
Affiliation:
Infection Control Unit, Paris, France
Daniel Cauet
Affiliation:
Saint Joseph Hospital, the Information System in Public Health Department, EpiConcept, Paris, France
Wei Chi Lin
Affiliation:
Infection Control Unit, Paris, France
Jacqueline Gonot
Affiliation:
Infection Control Unit, Paris, France
Nadine Calvo-Verjat
Affiliation:
Gastrointestinal Surgery Department, Paris, France
François-Emile Dazza
Affiliation:
Gastrointestinal Surgery Department, Paris, France
Olivier Billuart
Affiliation:
Computer System and Medical Information Department, Paris, France
Marie Dominique Kitzis
Affiliation:
Microbiology Laboratory, Paris, France
Jean Pierre Blériot
Affiliation:
Hospital Information System, Health Ministry, Paris, France
Marie Laure Pibarot
Affiliation:
Clinical Risk Management Department, Assistance Publique–Hôpitaux de Paris, Paris, France
Jean Carlet
Affiliation:
Infection Control Committee, Paris, France
*
Infection Control Unit, Saint–Joseph Hospital, 185 rue Raymond Losserand, 75614 Paris CEDEX, France, (achalfine@hopital-saint-joseph.org)

Abstract

Objectives.

Surveillance of surgical site infections (SSIs) is effective in reducing the rates of these complications, but it is extremely time-consuming and, consequently, underused. We determined the sensitivity and specificity of a computer-assisted surveillance system, compared with a conventional method involving review of medical records, and the time saved with the computer-assisted system.

Method.

A prospective study was conducted from January 1 to December 31, 2001. With the computer-assisted method, screening for SSIs relied on identification in the laboratory database of positive results of microbiological tests of surgical-site specimens; confirmation was obtained via computer-generated questionnaires completed by the surgeon in charge of the patient. In the conventional method, SSIs were identified by exhaustive chart review. The time spent on surveillance was recorded for both methods.

Setting.

A 25-bed gastrointestinal surgery unit in a tertiary care hospital.

Patients.

A total of 766 consecutive patients who underwent gastrointestinal surgery.

Results.

The sensitivity of the computer-assisted method was 84.3% (95% confidence interval, 0.66-0.94); the specificity was 99.9%. For the 807 surgical procedures in the study, 197 had an SSI identified by culture of a surgical-site specimen. After elimination of 63 duplicate cultures with positive results, 134 questionnaires were sent to the surgeons, who confirmed 27 SSIs. The conventional method identified 32 SSIs. The computer-assisted method required 60% less time than the conventional method (90 hours vs 223 hours).

Conclusion.

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.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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