APH 1999, 57, 233-242:

Surveillance van postoperatieve wondinfecties na ontslag uit het ziekenhuis: resultaten uit het Nederlandse netwerk.

ELPE Geubbels, R. de Haas, AJ. Mintjes-de Groot, JMJ. van den Berg, and AS. de Boer

Keywords: postdischarge surveillance, surgical wound infection, multi-centre

In June 1996 a network for surveillance of nosocomial infections in the Netherlands was set up as the PREZIES project One of the goals was to collect comparable information about prevention of surgical site infections (SSI) and related factors on national and hospital level. Comparing their information to the national reference information, hospitals obtain feedback to support their strategies of infection prevention. To guarantee the comparability of the information it is necessary to standardise both the method of in-hospital surveillance and the method of post discharge surveillance.

Of all hospitals that had sent in data until June 1997, 21 conducted post-discharge surveillance (PDS). These hospitals were compared to hospitals that only conducted in-hospital surveillance to estimate the effectiveness of PDS. For various operation groups and procedures the proportion of infections found post discharge and the corresponding infection percentages were assessed, and the influence was determined of the type of infection (superficial/deep) and the a priori chance of the patient of acquiring an SSI (expressed as the NNIS-index on the effectiveness of PDS.

This study demonstrated the importance of PDS on the complete registration of SSI, especially for superficial infections (depending on the type of procedure) and for procedures that are associated with a short postoperative stay.

As a result of these findings two standard methods for PDS were introduced in the PREZIES project in June 1998: surveillance by a registration card in the outpatient chart which should be completed by the surgeon, and outpatient chart review by the hygienist.