Surgical site infections surveillance report

Kate Woodhead RGN DMS explains why surgical site infection surveillance is an important element of practice development. She looks at the latest data and discusses the frameworks for best practice

Surgical site infections (SSIs) continue to cause pain and suffering to patients following surgery, despite the many protocols and policies to reduce them. Regular surveillance reports the data annually.1 SSIs are defined as those which occur up to 30 days after surgery or up to a year if patients have received implants during their surgery. They remain a significant problem for patients and all members of the surgical team. Around one fifth of all hospital associated infections (HCAIs) are SSIs and are associated with substantial mortality and morbidity creating severe demands on hospital resources.

The report under consideration covers the financial year 2022 to 2023, when 183 NHS hospitals in England submitted their data to the surveillance service at the UK Health Security Agency (UKSHA). Orthopaedic surgeries are mandated to report for at least three months of each year and other surgical procedure reports are submitted voluntarily spanning thirteen other surgical specialties. The surgical specialties encompass general surgery, cardiothoracic, neurosurgery, gynaecology, vascular, gastroenterology and orthopaedics. Surveillance is targeted at open surgical procedures, which carry a higher risk of infection than minimally invasive procedures, although laparoscopic procedures are included from some surgical categories. 

Data is collected prospectively on a quarterly basis using a standard methodology. Patients are followed up thirty days after primary surgery and at the annual anniversary for implant surgery. Trusts can then download their confidential report which shows crude and risk-stratified SSI risk, together with the national corresponding benchmark by surgical specialism. It is at this stage that Trusts are identified as being high outliers or low outliers within the data. UKSHA alerts the Trusts of their outlier status and encourages them to explore the reasons. Onsite visits can be arranged to assist with investigation and resolution, including in-depth bespoke analyses and clinical advice. 

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