Session: Infection Prevention Surveillance and Data Collection in the ASC

Editor's Note

Only 26 states require the reporting of surgical site infections (SSIs) to either the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) or the state, Lisa Berus, MSN, MEd, RN, CAIP, CNAMB, CASSPT, senior director at SCA Health, explained in this two-part breakout session.

The other speakers—Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC, CCTP, director of nursing programs at the American Nurses Association, and Abigail Carlson, MD, a medical officer of the CDC Division of Healthcare Quality Promotion—came together to present Project Firstline: a collaborative of diverse healthcare and public health partners that provides innovative and accessible infection control training for frontline healthcare workers. They discussed the important of the NHSN’s Outpatient Procedure Component (OPC), a tool designed to track and monitor SSIs in ambulatory surgery centers (ASCs) and provide surveillance protocols and guidance. OPC-SSI is aligned with hospital surveillance, so the guidelines and reporting are similar. However, for most ASCs, enrollment is voluntary.

Berus posed the question: Why track and report SSIs? The purpose of surveillance is to determine baseline rates, assess effectiveness of processes, identify where to concentrate efforts lie, and determine the need for further education, she explained. There are numerous factors that can impact the risk of SSIs, including hand hygiene, aseptic technique, point of care testing, personal protective equipment, the environment, sterilization, safe medication practices, and other infections.

Berus identified three types of SSI and their common characteristics:

• Superficial Incisional SSI
  • Follow for 30 days
  • Infection occurs within 30 days after operative procedure
  • Involves only skin and subcutaneous tissue of the incision
• Deep Incisional SSI
  • Follow for 30 days, some for 90 days
  • Infection occurs within 30 or 90 days after the operative procedure
  • Involves deep soft tissue of the incision (eg, fascial and muscle layers)
• Organ/Space SSI
  • Follow all for 30 days, some for 90 days
  • Infection occurs within 30 or 90 days after the operative procedure
  • Infection involves any part of the body deeper than the fascial/muscle layers that is opened or manipulated during the procedure.

After identifying an SSI, organize a detailed medical review, lay out the patient and case information, and identify the sterilization records. “Follow the case until the SSI is resolved,” Berus said. “We can all work together to prevent SSI and make sure they don’t happen.”

OR Manager covered this ASC surveillance program in the October issue. For more information, read the article here.