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Surveillance of surgical site infection in a teaching hospital in Ghana: a prospective cohort study

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Bediako-Bowan, A ; Owusu, E ; Debrah, S ; Kjerulf, A ; Newman, M J ; Kurtzhals, J A L ; Mølbak, K. / Surveillance of surgical site infection in a teaching hospital in Ghana : a prospective cohort study. I: The Journal of hospital infection. 2020 ; Bind 104, Nr. 3. s. 321-327.

Bibtex

@article{a6a0045418474d61b3cbd3a057140f27,
title = "Surveillance of surgical site infection in a teaching hospital in Ghana: a prospective cohort study",
abstract = "BACKGROUND: Surveillance systems for surgical site infections (SSIs), as a measure of patient safety, help health institutions devise strategies to reduce or prevent them. No surveillance systems exist to monitor SSIs in Ghana.AIM: To establish a system for monitoring trends and detecting outbreaks in order to create awareness of and control SSIs.METHODS: An active 30-day surveillance was undertaken at the general surgical unit of the Korle Bu Teaching Hospital, from July 1st, 2017 to December 31st, 2018 to identify SSI. It involved a daily inpatient surveillance of patients who had had a surgical procedure, followed by post-discharge surveillance by means of a healthcare personnel-based survey and a patient-based telephone survey. We supplied quarterly feedback of results to surgeons.FINDINGS: Among the 3267 patients included, 331 were identified with an SSI, a 10% incidence risk. Patients who acquired an SSI experienced increased morbidity including nine extra days in hospital and an adjusted relative mortality risk of 2.3 (95% confidence interval: 1.3 - 4.1; P=0.006) compared to patients without SSI. Forty-nine per cent (161/331) of SSIs were diagnosed post discharge using the healthcare personnel-based survey. The patient-based telephone survey contributed 12 additional cases. SSI incidence risk decreased from 12.8% to 7.5% during the study period.CONCLUSION: Post-discharge surveillance is feasible using existing healthcare personnel, and the results highlight the high risk and burden of SSIs in Ghana. A surveillance system with feedback for monitoring SSIs may contribute to reducing SSIs; however, firm conclusions regarding the impact need longer observation time.",
keywords = "Adolescent, Adult, Aged, Child, Cohort Studies, Cross Infection/epidemiology, Female, Ghana, Hospitals, Teaching, Humans, Male, Middle Aged, Patient Safety, Population Surveillance, Prospective Studies, Risk Factors, Surgical Wound Infection/epidemiology, Young Adult",
author = "A Bediako-Bowan and E Owusu and S Debrah and A Kjerulf and Newman, {M J} and Kurtzhals, {J A L} and K M{\o}lbak",
note = "Copyright {\textcopyright} 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.",
year = "2020",
month = mar,
doi = "10.1016/j.jhin.2020.01.004",
language = "English",
volume = "104",
pages = "321--327",
journal = "Journal of Hospital Infection",
issn = "0195-6701",
publisher = "W.B./Saunders Co. Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - Surveillance of surgical site infection in a teaching hospital in Ghana

T2 - a prospective cohort study

AU - Bediako-Bowan, A

AU - Owusu, E

AU - Debrah, S

AU - Kjerulf, A

AU - Newman, M J

AU - Kurtzhals, J A L

AU - Mølbak, K

N1 - Copyright © 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

PY - 2020/3

Y1 - 2020/3

N2 - BACKGROUND: Surveillance systems for surgical site infections (SSIs), as a measure of patient safety, help health institutions devise strategies to reduce or prevent them. No surveillance systems exist to monitor SSIs in Ghana.AIM: To establish a system for monitoring trends and detecting outbreaks in order to create awareness of and control SSIs.METHODS: An active 30-day surveillance was undertaken at the general surgical unit of the Korle Bu Teaching Hospital, from July 1st, 2017 to December 31st, 2018 to identify SSI. It involved a daily inpatient surveillance of patients who had had a surgical procedure, followed by post-discharge surveillance by means of a healthcare personnel-based survey and a patient-based telephone survey. We supplied quarterly feedback of results to surgeons.FINDINGS: Among the 3267 patients included, 331 were identified with an SSI, a 10% incidence risk. Patients who acquired an SSI experienced increased morbidity including nine extra days in hospital and an adjusted relative mortality risk of 2.3 (95% confidence interval: 1.3 - 4.1; P=0.006) compared to patients without SSI. Forty-nine per cent (161/331) of SSIs were diagnosed post discharge using the healthcare personnel-based survey. The patient-based telephone survey contributed 12 additional cases. SSI incidence risk decreased from 12.8% to 7.5% during the study period.CONCLUSION: Post-discharge surveillance is feasible using existing healthcare personnel, and the results highlight the high risk and burden of SSIs in Ghana. A surveillance system with feedback for monitoring SSIs may contribute to reducing SSIs; however, firm conclusions regarding the impact need longer observation time.

AB - BACKGROUND: Surveillance systems for surgical site infections (SSIs), as a measure of patient safety, help health institutions devise strategies to reduce or prevent them. No surveillance systems exist to monitor SSIs in Ghana.AIM: To establish a system for monitoring trends and detecting outbreaks in order to create awareness of and control SSIs.METHODS: An active 30-day surveillance was undertaken at the general surgical unit of the Korle Bu Teaching Hospital, from July 1st, 2017 to December 31st, 2018 to identify SSI. It involved a daily inpatient surveillance of patients who had had a surgical procedure, followed by post-discharge surveillance by means of a healthcare personnel-based survey and a patient-based telephone survey. We supplied quarterly feedback of results to surgeons.FINDINGS: Among the 3267 patients included, 331 were identified with an SSI, a 10% incidence risk. Patients who acquired an SSI experienced increased morbidity including nine extra days in hospital and an adjusted relative mortality risk of 2.3 (95% confidence interval: 1.3 - 4.1; P=0.006) compared to patients without SSI. Forty-nine per cent (161/331) of SSIs were diagnosed post discharge using the healthcare personnel-based survey. The patient-based telephone survey contributed 12 additional cases. SSI incidence risk decreased from 12.8% to 7.5% during the study period.CONCLUSION: Post-discharge surveillance is feasible using existing healthcare personnel, and the results highlight the high risk and burden of SSIs in Ghana. A surveillance system with feedback for monitoring SSIs may contribute to reducing SSIs; however, firm conclusions regarding the impact need longer observation time.

KW - Adolescent

KW - Adult

KW - Aged

KW - Child

KW - Cohort Studies

KW - Cross Infection/epidemiology

KW - Female

KW - Ghana

KW - Hospitals, Teaching

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Safety

KW - Population Surveillance

KW - Prospective Studies

KW - Risk Factors

KW - Surgical Wound Infection/epidemiology

KW - Young Adult

U2 - 10.1016/j.jhin.2020.01.004

DO - 10.1016/j.jhin.2020.01.004

M3 - Journal article

C2 - 31931045

VL - 104

SP - 321

EP - 327

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

SN - 0195-6701

IS - 3

ER -

ID: 61990540