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S11.KL1 QUALITY MANAGEMENT FOR SEPTIC SURGERY



Abstract

At the Orthopedic Hospital Vienna Speising 7.857 surgeries were performed in 2008.

2.211 of these surgeries required implants. The number of performed Total Hip Arthroplasties (THA) was 836.

All of these surgeries were elective. Approximately 0,5% of the patients who underwent a surgery at our institution had a postoperative infection, 0,8% were admitted because of an already existing infection, which required treatment at our department.

In order to achieve a basis for international compatibility and to meet the legal postulations the Orthopedic Hospital Vienna Speising actively participates in ANISS (Austrian Nosocomial Infection Surveillance System)/HELICS (Hospital in Europe Link for Infection Control through Surveillance).

In 2008 a survey on incidences for Total Hip Arthroplasties was started. So the possibility of specific measures is given when interventions should be necessary.

The stuff unit for Hospital Hygiene gathers data from clinical records and conducts an evaluation by means of a standardised (equivalent surgeries) and stratified (differentiation of the patients after ASA-score- American Society of Anaesthesiologists, duration of the surgery, etc) procedure. Three times a week the stuff unit for Hospital Hygiene visits the wards and collect selected indicator-surgeries, which are entered in a specific program for registering infections. By finding noticeable problems, a detailed analysis is continued with the examination of microbiologic, histological and radiologic data as well as questions to the surgeon or attending staff and ward rounds for inspecting for instance changes of dressing.

The infectdiagnoses, based upon CDC (Center of Desease Control) definitions for nosocomial infections, are encrypted and sent to the control center quarterly. In turn our hospital receives an analysis and feedback once a year. A biannual exchange of experiences on behalf of the active members including an interpretation of the data allows to settle discrepancies and dubieties in evaluation.

This data on surveillance allows a detailed analysis of information gathered in recent years as well as a discussion with authorities.

As a result specific consequences could already been deducted like written guidelines for surgical management, recommendations for antibiotic treatment, preoperative shaving of the surgical area as well as preoperative screening for staphylococcus in Total Hip Arthroplasties.

Correspondence should be addressed to Vienna Medical Academy, Alser Strasse 4, A-1090 Vienna, Austria. Phone: +43 1 4051383 0, Fax: +43 1 4078274, Email: ebjis2009@medacad.org