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. 2024 Dec 23;13(1):155.
doi: 10.1186/s13756-024-01505-2.

Automated surveillance for surgical site infections (SSI) in hospitals and surveillance networks-expert perspectives for implementation

Luisa A Denkel  1   2 , Isabelle Arnaud  3 , Manon Brekelmans  4   5 , Mireia Puig-Asensio  6   7   8 , Hoger Amin  9 , Sophie Gubbels  9 , Pernille Iversen  10 , Mohamed Abbas  11   12 , Elisabeth Presterl  13 , Pascal Astagneau  3   14 , Stephanie van Rooden  4 ; PRAISE SSI working group
Collaborators, Affiliations

Automated surveillance for surgical site infections (SSI) in hospitals and surveillance networks-expert perspectives for implementation

Luisa A Denkel et al. Antimicrob Resist Infect Control. .

Abstract

Background: This work aims at providing practical recommendations for implementing automated surveillance (AS) of surgical site infections (SSI) in hospitals and surveillance networks. It also provides an overview of the steps, choices, and obstacles that need to be taken into consideration when implementing such surveillance. Hands-on experience with existing automated surveillance systems of SSI (AS SSI systems) in Denmark, France, the Netherlands and Spain is described regarding trend monitoring, benchmarking, quality control, and research for surveillance purposes.

Methods: Between April and October 2023, specific aspects/options of various surveillance purposes for AS SSI were identified during regular meetings of the SSI working group in the PRAISE (Providing a Roadmap for Automated Infection Surveillance in Europe) network. Expert discussions provided the basis for this perspective article.

Results: Decisions for implementation of AS SSI systems highly depend on the purpose of the surveillance. AS SSI systems presented here differ according to study population, setting, central or local implementation; the level of automation, design, and the data sources used. However, similarities were found for the rationales of automation, design principles and obstacles that were identified. There was consensus among all the experts that shortcomings in interoperability of databases, limited time, a want of commitment on the part of stakeholders, and a shortage of resources for information technology (IT) specialists represent the main obstacles for implementing AS SSI. To overcome obstacles, various solutions were reported, including training in the development of AS systems and the interpretation of AS SSI results, early consultation of end-users, and regular exchanges between management levels, IT departments, infection prevention and control (IPC) teams, and clinicians.

Conclusion: Clarity on the intended application (e.g. purpose of surveillance) and information on the availability of electronic and structured data are crucial first steps necessary for guiding decisions on the design of AS systems. Adequate resources for IT specialists and regular communication between management, IT departments, IPC teams, and clinicians were identified as essential for successful implementation. This perspective article may be helpful for a wider implementation of more homogeneous AS SSI systems in Europe.

Keywords: Automated surveillance; Barriers; Experiences; Expert recommendations; Surgical site infection.

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Conflict of interest statement

Declarations. Consent for publication: Not applicable. Competing interests: SJS Aghdassi (member of the PRAISE SSI working group) and Maaike van Mourik (member of the PRAIS SSI working group) serve as Associate Editors for the Journal Antimicrobial Resistance & Infection Control and are co-editors of the thematic series “Automation in the practice of infection prevention and control: From automated surveillance of healthcare-associated infections to automated cluster detection and beyond” to which the manuscript was submitted. LA Denkel serves as an Associate Editor for the Journal Antimicrobial Resistance & Infection Control.

Figures

Fig. 1
Fig. 1
Overview of decisions to be made during development and implementation AS SSI systems. Visualization of algorithms adapted from [37]
See this image and copyright information in PMC

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