Multicentred surgical site infection surveillance using partitioning analysis
康宏 藤原 · Institutional Repositories DataBase (IRDB) · 2013
Background] Surgical site infection (SSI) is an ongoing major public health problem throughout the world that increases healthcare costs.Utilizing a methodology that can help clinicians to continuously collect data about SSIs, analyze it and implement the feedback back into routine hospital practice has been identified as a top national priority in Japan.[Aim] The purpose of this study was to conduct an intervention study through Operations Research using partitioning at multiple facilities, and to reduce the incidence and consequences of SSI.[Methods] The Setouchi SSI Surveillance Group, which consists of 7 institutes, started SSI surveillance in 2006.Until May of 2008, there were four surveillance periods (A to D).Three thousand eightynine patients underwent gastrointestinal surgery and were followed up for 30 days after their operations.Twenty six factors that have been reported to be related to SSI were evaluated for all patients.The top 3 factors from each surveillance period were determined and then actual practice improvements were planned for each subsequent period.[Findings] The total SSI occurrence was 6.9% for Period A, 6.3% for Period B, 6.4% for Period C and 3.9% for Period D. Comparing Periods A and D, there was a statistical significance in the decrease of SSI occurrence (p=0.012).[Conclusion] Using the results and partitioning analysis of active SSI surveillance to contribute to action plans for improving clinical practice was effective in significantly reducing SSIs.