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BACKGROUND
Post cesarean section (CS) surgical site infections (SSI) surveillance may be challenging
due to short postoperative hospital stays and time and resource intensive post discharge
surveillance methods. At our obstetrical/gynecological facility, which is housed within
a large pediatric hospital, surveillance was limited to inpatient readmissions and
patients who presented to an urgent care center. Our purpose was to expand CS SSI
surveillance to include outpatient clinics in our system by creating and implementing
the use of a custom surveillance tool in October 2018.
METHODS
Reports of patients who underwent CS within the past 30?days were generated from the
electronic data warehouse. Of these, patients who presented to our outpatient clinics
and were prescribed antibiotics were considered. After chart review, two infectious
diseases physicians further refined the list of antibiotics based on local prescribing
patterns for wound infections. Patients queried through this tool received an additional
full medical chart review by an infection preventionist to determine the possibility
of SSI following CS.
RESULTS
After two months of implementation, 4 of 8 (50%) of CS SSI were identified through
the use of this surveillance method. Compared to the previous year, enhanced surveillance
resulted in a 1.7 fold increase in the CS SSI rate.
CONCLUSIONS
CS SSI surveillance using antibiotic prescription data in the outpatient setting is
an efficient method to enhance traditional SSI surveillance. In our facility, implementation
of this tool has improved the identification of CS SSI. Accurate case identification
will aid in identifying trends and guide targeted interventions.
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Copyright
© 2019 Published by Elsevier Inc.
