How do you track post-op infections?

I recently have heard in discussion that patients that have received implants should be tracked for one year. Does anyone know who has mandated this? How do you track your patiens post-operatively?

Started by: Traci Putman (Director, Surgical Services/Director of Nursing) at January 26, 2010 (1:40 pm)

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I see where the CDC regs are but the question I still have is how is anyone really tracking this 1 year out?

Lucinda White (Administrator/Director/Manager/Owner/Exec. Officer) at April 27, 2010 (11:36 am) [last edited on September 14, 2010 (4:32 pm)]

The new CMS requirements specify surgical site infection surveillance must be done, but does not prescribe how it is to be done. There should be a surveillance plan as part of the written Infection Control Program plan. Depending on what procedures you do and the volumes, you may choose to do two or three specific, high volume or high risk procedures- hernia repairs, breast augmentation, laminectomy, etc. Some ASCs call the patient at 30 days to see if they've had a wound problem, some check in with the surgeon's office to see if the patient had a complication. Others send each surgeon a list of the patients having that procedure and ask if any became infected. There is no requirement to follow ALL cases. If the ASC is a very low volume facility, this might be reasonable. If you track specific procedures, you can compare your rates with the National Healthcare Safety Network (NHSN/CDC) rates. You would need to use the NHSN criteria as noted in a previous post.

Marcia Patrick (Other) at May 4, 2010 (11:42 am)

JC NPSG #7 requires monitoring of infections for the first 30 days post-op and for one year for inplantables. "Infection rates are measured for the first 30 days following procedures and for the first year following implantables"
They don't give any suggestions how to do it. The expectation is that you create a process and follow through.

Judy H. (Administrator/Director/Manager/Owner/Exec. Officer) at May 11, 2010 (7:55 am)

At the begining of each month I take the monthly list of patients from the prior month and send it with a form to be filled out if a patient presents with an SSI. I ask for the symptoms and treatment and look at the OR record for any common denominators. I don't have a system for keeping track of the patients w/implants but do know that they are to be followed for one year. We are a Physician owned facility with the office practice in the same building so it is easy for me keep up with getting returns on the reports....lucky me!

Joan S. (OR Manager/Supervisor) at May 11, 2010 (8:30 am)

Our ICP sends out a list to each physician monthly to track infections 30 days post-op. For implants, she sends out a list of each patient that received implants on a quarterly basis one year out. The surgery date is on the list. The surgeon is asked to report infections for one year for implants, complete the form, and return it.

John H. (Administrator/Director/Manager/Owner/Executive Officer) at May 18, 2010 (11:13 am)

Because a PO infection is defined as any infection occuring up to 1 month after surgical procedure, we wait the entire month that follows to send out the complication list to surgeons, so to capture procedures completed at the end of any month. This is frustrating because reports are delayed. I've asked surgeons to verbally report any infection to me as soon as they discover it. A medicare consultant we hired told us that we needed to tract infection reports x 1 yr for implants and we have created a way to run a report off of the clinical log to send monthly reports to surgeons 1 year later. Any non compliance of physicians in getting reports back in a timely basis and/or withholding information are reported/peer reviewed and go into re-credentialling files.

Margaret Lebo (OR Manager/Supervisor) at May 18, 2010 (2:07 pm)

Not a response - but wonder if anyone knows if IOL's are considered implants?

Jeanette Rasmussen (Administrator/Director/Manager/Owner/Exec. Officer) at May 25, 2010 (4:16 pm)

Obviously, when you put a something foreign into the body it is an implant, Duh!

Joe C

Joseph C. (Administrator/Director/Manager/Owner/Exec. Officer) at June 10, 2010 (9:58 am) [last edited on June 10, 2010 (10:00 am)]

Can someone point me to a resource that defines "implant", please? It may sound like a silly question, but none of the references I have read give me any distinctions to use for the 1 year follow-up tracking. What is considered an implant, and where is the regulation, please? Thanks.

Karen Prejean

Karen P. (Other) at August 4, 2010 (11:50 am)

Joe C, yes you would think it is a duh until you deal with insurance companies who swear that a cadaveric tissue graft is not an "implant" even though it is foreign to the patient in whom it is implanted and supports structures at the operative site. However, that would definitely be something that I will track for a year. And, it is a lot easier when the physicians are in the office downstairs so that I can find them (or they come find me) when there is a problem.

Marcia Van Alstine (Administrator/Director/Manager/Owner/Exec. Officer) at August 31, 2010 (1:51 pm)

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