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SSI Surveillance Definitions and Examples

SSI Surveillance Definitions and Examples. OVERVIEW OF KEY POINTS FROM THE WORKSHOP, “HOW TO REPORT AND APPLY THE NHSN SSI DEFINITION”. Resources. Updated website www.cdc.gov/nhsn/ Training, Protocols, Forms, Support Materials, Analysis Resources, FAQs

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SSI Surveillance Definitions and Examples

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  1. SSI Surveillance Definitions and Examples OVERVIEW OF KEY POINTS FROM THE WORKSHOP, “HOW TO REPORT AND APPLY THE NHSN SSI DEFINITION”

  2. Resources • Updated website www.cdc.gov/nhsn/ • Training, Protocols, Forms, Support Materials, Analysis Resources, FAQs • Forms: Monthly Reporting Plan, Surgical Site Infection, Denominator for Procedure

  3. Primary Closure Definition: Update 4/2013 Primary closure is defined as closure of all tissue levels during the original surgery, regardless of the presence of wires, wick drains, or other devices or objects extruding through the incision. This category includes surgeries where the skin is closed by some means, including incisions that are described as being “loosely closed” at the skin level. Thus, if any portion of the incision is closed at the skin level, by any manner, a designation of primary closure should be assigned to the surgery

  4. Important Note Chapter 9: Reporting Instructions in the Denominator Data Section and Table of Instructions • Provide guidance for how to report in a variety of situations

  5. New in 2013 • Surveillance of implants for 1 year no longer required • Deep incisional or organ space SSI for either 30 days or 90 days depending on protocol • Implant definition was too broad limiting its usefulness, causing confusion

  6. SSI Definitions

  7. SIP/ SIS • Donor sites - Example CBGB, secondary incision in the leg • Question? What if they both get infected? - Reported as 2 SSIs 

  8. DIP/DIS • 30 or 90 days depending on table 3 (pictured left) • Involves fascial and muscle layers • Superficial infection that eventually spreads deeper would be reported as a Deep Infection • If an incisional infection develops into an organ space infection it is considered a deep incisional SSI; complication of the incision

  9. Organ Space • Any part of the body excluding the incision, fascia, or muscle layers that is opened or manipulated during the operative procedure and meets the remaining criteria. • Specific sites of infection must be used to differentiate organ/space SSI and their criteria must also be met.

  10. Special Instruction If more than one procedure, report the operation performed closes to infection date Example: Patient underwent a COLO of 2/12/13. Three days later, he went back to surgery to repair a leaking anastomosis (OTH). He developed an intraabdominal abscess on 2/28/13. This SSI is attributed to the second procedure (OTH), not the COLO. If more than one procedure done through a single incision. Attempt to determine the procedure that is thought to be associated with the infection. If can’t be attributed to the specific one use Table 5.

  11. Thank you.

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