Surgical infection prevention measures reduce postoperative infections when used together, but not singly
A new study finds that compliance with several infection-prevention measures from the Surgical Care Improvement Project (SCIP) predicts a decreased likelihood of postoperative infections. The SCIP, a national effort to reduce the rate of surgical complications, has developed 20 quality measures, including 9 (6 of which focus on postoperative infection prevention) that are publically reported on the Hospital Compare Web site of the Centers for Medicare & Medicaid Services (http://www.hospitalcompare.hhs.gov). Reporting to Hospital Compare is voluntary, but failure to do so results in a decrease in Medicare or Medicaid payments.
The researchers found that patients who received proper treatment that included at least two SCIP infection-prevention measures every time indicated (S-INF compliant) had a significant 15 percent reduced probability of postsurgical infection. Patients whose treatment complied with the original three SCIP infection-related measures (S-INF-Core) involving proper use and timing of antibiotics also had a 16 percent reduction in risk of postoperative infection, but this finding narrowly missed statistical significance.
In contrast, no individual SCIP infection-related measure was individually associated with reduced risk of postoperative infection. The data were from a retrospective study of 405,720 patients discharged between the beginning of July 2006 and the end of March 2008 from 398 hospitals who filed Hospital Compare reports. Among these patients, there were 3,996 documented postoperative infections. The researchers analyzed the rates of infection for discharged patients who did or did not adhere to the S-INF and S-INF-Core composite measures and the six individual SCIP measures. The study was funded in part by the Agency for Healthcare Research and Quality (T32 HS00059).
More details are in "Adherence to Surgical Care Improvement Project measures and the association with postoperative infections," by Jonah J. Stulberg, M.D., Ph.D., M.P.H., Conor P. Delaney, M.D., Ph.D., Duncan V. Neuhauser, Ph.D., and others in the June 2010 Journal of the American Medical Association 303(24), p. 2479-2485.
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