Orthopaedic surgical site infection surveillance in NHS England: national audit of current practice
- PMID: 28148657
- DOI: 10.1302/0301-620X.99B2.BJJ-2016-0420.R1
Orthopaedic surgical site infection surveillance in NHS England: national audit of current practice
Abstract
Aims: The importance of accurate identification and reporting of surgical site infection (SSI) is well recognised but poorly defined. Public Health England (PHE) mandated collection of orthopaedic SSI data in 2004. Data submission is required in one of four categories (hip prosthesis, knee prosthesis, repair of neck of femur, reduction of long bone fracture) for one quarter per year. Trusts are encouraged to carry out post-discharge surveillance but this is not mandatory. Recent papers in the orthopaedic literature have highlighted the importance of SSI surveillance and the heterogeneity of surveillance methods. However, details of current orthopaedic SSI surveillance practice has not been described or quantified.
Patients and methods: All 147 NHS trusts in England were audited using a structured questionnaire. Data was collected in the following categories: data collection; data submission to PHE; definitions used; resource constraints; post-discharge surveillance and SSI rates in the four PHE categories. The response rate was 87.7%.
Results: Variation in practice was clear in all categories in terms of methods and timings of data collection and data submission. There was little agreement on SSI definitions. At least six different definitions were used, some trusts using more than one definition. Post-discharge surveillance was carried out by 62% of respondents but there was again variation in both the methods and staff used. More than half of the respondents felt that SSI surveillance in their unit was limited by resource constraints. SSI rates ranged from 0% to 10%.
Conclusion: This paper quantifies the heterogeneity of SSI surveillance in England. It highlights the importance of adequate resourcing and the unreliability of relying on voluntary data collection and submission. Conformity of definitions and methods are recommended to enable meaningful SSI data to be collated. Cite this article: Bone Joint J 2017;99-B:171-4.
Keywords: Arthroplasty; Infection; NHS; Surgical site surveillance.
©2017 The British Editorial Society of Bone & Joint Surgery.
Similar articles
-
A benchmark too far: findings from a national survey of surgical site infection surveillance.J Hosp Infect. 2013 Feb;83(2):87-91. doi: 10.1016/j.jhin.2012.11.010. Epub 2013 Jan 15. J Hosp Infect. 2013. PMID: 23332352
-
Mapping national surveillance of surgical site infections in England: needs and priorities.J Hosp Infect. 2018 Dec;100(4):378-385. doi: 10.1016/j.jhin.2018.06.006. Epub 2018 Jun 12. J Hosp Infect. 2018. PMID: 29906490
-
Challenges in reporting surgical site infections to the national surgical site infection surveillance and suggestions for improvement.Ann R Coll Surg Engl. 2015 Sep;97(6):460-5. doi: 10.1308/rcsann.2015.0027. Ann R Coll Surg Engl. 2015. PMID: 26320763 Free PMC article.
-
[Surgical site infection surveillance].Nihon Geka Gakkai Zasshi. 2004 Nov;105(11):720-5. Nihon Geka Gakkai Zasshi. 2004. PMID: 15565904 Review. Japanese.
-
Surgical site infection surveillance.J Hosp Infect. 2000 Jul;45(3):173-84. doi: 10.1053/jhin.2000.0736. J Hosp Infect. 2000. PMID: 10896795 Review.
Cited by
-
Factors Influencing Postoperative Inpatient Rehabilitation Requirement After Surgical Intervention for Isolated Hip Fracture: A Multicenter Study.Orthop Surg. 2025 Jan;17(1):252-259. doi: 10.1111/os.14290. Epub 2024 Nov 15. Orthop Surg. 2025. PMID: 39545453 Free PMC article.
-
Association between Allogeneic Blood Transfusion and Wound Infection after Total Hip or Knee Arthroplasty: A Retrospective Case-Control Study.J Bone Jt Infect. 2019 Apr 20;4(2):99-105. doi: 10.7150/jbji.30636. eCollection 2019. J Bone Jt Infect. 2019. PMID: 31192107 Free PMC article.
-
The biofilm eradication activity of acetic acid in the management of periprosthetic joint infection.Bone Joint Res. 2018 Sep 15;7(8):517-523. doi: 10.1302/2046-3758.78.BJR-2018-0045.R1. eCollection 2018 Aug. Bone Joint Res. 2018. PMID: 30258571 Free PMC article.
-
Getting it right first time: national survey of surgical site infection 2019.Ann R Coll Surg Engl. 2023 Jul;105(6):513-522. doi: 10.1308/rcsann.2022.0083. Epub 2022 Oct 20. Ann R Coll Surg Engl. 2023. PMID: 36263893 Free PMC article.
-
The effect of triclosan-coated sutures on the rate of surgical site infection after hip and knee arthroplasty: a double-blind randomized controlled trial of 2546 patients.Bone Joint J. 2018 Mar 1;100-B(3):296-302. doi: 10.1302/0301-620X.100B3.BJJ-2017-0247.R1. Bone Joint J. 2018. PMID: 29589500 Free PMC article. Clinical Trial.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources