370. Improved accuracy of caesarean section surgical site infection surveillance utilizing post-discharge email
Session: Poster Abstract Session: HAI: Surgical Site Infections
Thursday, October 8, 2015
Room: Poster Hall
  • SSI poster IDweek_v1 CL.pdf (265.0 kB)
  • Background:

    Post-discharge surveillance for surgical site infections (SSI) is critical for procedures with short hospital stays. We describe SSI rates for Caesarean sections (C/S) with six years of surveillance data using conventional and innovative approaches to post-discharge surveillance. 


    At an acute care hospital in Vancouver, Canada, C/S SSI surveillance was routinely performed from April 1, 2009 to March 31, 2015. A 30 day post-discharge component was implemented starting April 1, 2012. In the first year of post-discharge surveillance, patient self-reported infections via traditional mail surveys; in the second year, an Infection Control Practitioner (ICP) initiated phone calls to patients (in addition to mail surveys); in the third year, electronic follow-up via email was initiated. We examined SSI rates, response rates and time spent by an ICP engaging with patients for responses. Chi-squared tests were applied to comparisons of the three years with and without post-discharge surveillance. 


    In the first three years, 1939 C/S and in the final three years, 1947 C/S were performed, respectively. The SSI rate in the first three years was 0.36 per 100 procedures (6 superficial and 1 deep).  In the final three years, the SSI rate was 1.39 per 100 procedures (19 superficial, 1 deep, 7 organ space). Significantly more infections were captured (p < 0.001) and a significantly higher number of organ space and deep incisional infections were identified (p = 0.020) with post-discharge surveillance. Response rates improved significantly, from 20% to 46% with mail and phone calls. Response rates with email were 73% email (p < 0.001). Time spent by ICP engaging with patients for responses for post-discharge surveillance varied from 24.9 hours in 2012/13 (711 C/S) to 40.5 hours in 2013/14 (654 C/S) to 35.7 hours in 2014/15 (582 C/S) with the corresponding response rates of 20%, 46% and 73%.


    Post-discharge surveillance for patients who undergo C/S detected significantly more SSI, including deep incisional and organ space infections. Email follow-up was an efficient and effective method of post-discharge surveillance and should be included routinely in a SSI surveillance program for procedures associated with short hospital lengths of stay.

    Elisa Lloyd-Smith, PhD1, Christopher F. Lowe, MD, FRCPC1, Mary Mcnaughton, RN2, Marc G. Romney, MD, FRCPC, DTM&H3 and Victor Leung, MD, FRCPC4, (1)Infection Prevention and Control, Providence Health Care, Vancouver, BC, Canada, (2)Providence Health Care, Vancouver, BC, Canada, (3)Pathology and Laboratory Medicine, Providence Health Care, Vancouver, BC, Canada, (4)Pathology and Laboratory Medicine, Infectious Diseases, Providence Health Care, Vancouver, BC, Canada


    E. Lloyd-Smith, None

    C. F. Lowe, None

    M. Mcnaughton, None

    M. G. Romney, None

    V. Leung, None

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