Study: Surveillance May Miss Many Outpatient Surgical Site Infections

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The results of a new study show that surgical site infection (SSI) surveillance systems may omit numerous outpatient surgeries with an expected increased likelihood of an adverse event.

As the study, which was published in the Society for Healthcare Epidemiology of America (SHEA) journal Infection Control & Hospital Epidemiology, notes, surveillance was based on Veterans Affairs Surgical Quality Improvement Program (VASQIP) eligibility criteria, which is defined by clinician determination of invasiveness.

Data for the study came from 31 Veterans Affairs (VA) organizations —  20 freestanding ambulatory surgery centers and 11 inpatient facilities — reports Infectious Disease News. Researchers conducted a retrospective study examining outpatient surgeries performed at these facilities between October 2011 and September 2015.

Researcher Dr. Katherine Linsenmeyer of the VA Boston Healthcare System told Infectious Disease News that the researchers' analysis indicated that more than half of the adverse events identified occurred in low-risk surgeries that did not meet criteria for review under the current VASQIP surveillance processes. These include nearly all skin and soft tissue procedures and nearly half of urologic procedures.

She told the publication, "Our study demonstrates the need to re-evaluate surveillance, particularly for SSIs, in this outpatient setting and to re-think how we classify 'low'- and 'high'-risk procedures — infections are a risk following any invasive procedure and it is important that we think about ways to implement effective inpatient prevention programs in outpatient settings."

This is yet another study raising concerns about effective SSI identification. Duke researchers recently determined that inconsistent methods for calculating SSI rates of some procedures are contributing to underestimates of the rates.