Q19: What do I do if I am missing a height or weight on a patient for the Denominator for Procedure Form? SSI guidelines do not offer a strict timeframe for elements of criteria to occur (due to the variety of NHSN operative procedures and types of SSI events that can be assigned), but the date of event (DOE) for an SSI must occur within the appropriate 30- or 90-day SSI surveillance period. No. Q14: What is acceptable evidence of infection found on gross anatomic exam? You will be subject to the destination website's privacy policy when you follow the link. The fact that wounds can be labeled in various ways by different physicians is the reason that criteria rather than labels or diagnoses are used for SSI determinations. It is very important to have a system that is collecting this information so that the data will be used in risk adjustment and factored into the SIR analysis. For example, when applying intraabdominal infection (IAB) criterion 3b, the finding of ‘fluid collection seen in the lower abdominal cavity’ on an imaging test may or may not represent an infection. ICD-10 code OUT90ZZ should be entered as 0UT90ZZ and 0X6I0ZZ should be entered as 0X610ZZ. Infection prevention professionals should review these practices with their clinical staff and laboratory colleagues to assure that aseptic technique is being used to obtain wound specimens. The NHSN-assigned facility ID will be auto-entered by the computer. The Infection Window Period (IWP), Present on Admission (POA), Healthcare-associated Infection (HAI), and Repeat Infection Timeframe (RIT) definitions do not apply to SSI surveillance. Do I have to enter PATOS = YES SSI events into NHSN? Each case differs based on the individual elements occurring and the type of SSI. Q20: Is an SSI that may be caused by an anastomotic leak or other post-operative occurrence excluded from SSI reporting? Scenario 2: An organism identified in the blood specimen is an element that is used to meet the NHSN site-specific infection criterion. Wisconsin Department of Health Services 20 NHSN CRE Definition Any Escherichia coli, Klebsiella oxytoca, ... •Each SSI SIR has different inclusion and exclusion criteria (All, Complex A/R, and 30-day Complex A/R). No. PATOS is a YES/NO question found on the SSI event form. I’m looking for guidance related to implant presence and length of SSI surveillance period. Trauma is defined in NHSN as “blunt or penetrating traumatic injury.” Therefore, if the surgery was performed because of a recent fall, for example, a hip arthroplasty following a fall, then indicate “yes” for the trauma field. Documentation that includes descriptors such as milky, thick, viscous, creamy, opaque, yellow, or green may also be accepted evidence of purulence when used in combination with another eligible descriptor. What should I do if a superficial incisional SSI progresses deeper within the designated surveillance period? Q12. The descriptors “pus” or “purulence” are sufficient evidence of infection. What is the timeframe for all elements used for citation of an SSI event to occur? Table 2 on page 9-12 within the SSI protocol pdf icon[PDF – 1 MB] provides information related to surveillance periods for SSI for each of the NHSN operative procedure categories. endstream endobj startxref Please include findings from these procedures. Wound class should be assigned by a person involved in the surgical procedure (for example, surgeon, circulating nurse, etc.). SSI - … NOTE: Imaging test evidence of infection cannot be applied to meet gross anatomic evidence of infection. Patients who have an NHSN operative procedure coded as dirty/infected can develop an SSI, including an organ space SSI. NOTE:  If a patient meets both organ/space BONE and MED criteria report the SSI event as organ/space MED – Mediastinitis. If SSI criteria are met within the appropriate SSI surveillance period, an SSI is reported. For example, fluid only described as yellow, or only described as thick, is not sufficient. A return trip to the OR via the same surgical site ends the surveillance period for the prior NHSN operative procedure and begins a new SSI surveillance period if an NHSN operative procedure is performed. BSI Secondary to an SSI . The language/verbiage in the operative procedure report must clearly reflect infection is ‘seen’ during the operative procedure and should additionally include reference to the tissue level where the infection is seen. Objectives • Define SSI and the public health significance of these infections • Review reporting requirements for SSI in Oregon • Understand the key steps to reporting SSI in NHSN Q13: Can NHSN tell me what wound class should be assigned for specific procedures? denominator data to NHSN? Q26: How do I determine level of infection after an NHSN BRST – breast procedure? There is a misconception by some that only cultures obtained in the OR are aseptic. 294 0 obj <>/Filter/FlateDecode/ID[<9F0E5653654FE842A3F327ABEB50C12E><6245A91F79F290409D7AF8D9CE838ECE>]/Index[279 29]/Info 278 0 R/Length 85/Prev 213278/Root 280 0 R/Size 308/Type/XRef/W[1 3 1]>>stream This includes superficial incisional, deep incisional and organs/space SSI events. See SSI Event Reporting Instruction #4 on p. 9-16 in the SSI Protocol pdf icon[PDF – 1 MB] for full details. Please note it is very important to provide NHSN your thoughts regarding the case you are requesting for review. h�b```�L�B ��ea�������3���(*}P� CG�FT �B1c(� �:� ��� ������,�x�ᇃӶ�Q��U�2�I^��|�p3��̺AF �u� Lx� h��V]kc7�+zܥ W���?�n���&m Links with this icon indicate that you are leaving the CDC website.. Settings: Surveillance of surgical patients will occur in any inpatient and/or outpatient setting where the selected NHSN operative procedure(s) are performed. For example, if within an SSI surveillance period a superficial debridement of the surgical site is performed, and the deep incisional level and organ/space level are not entered, a subsequent deep incisional or organ/space SSI following the superficial debridement may be an SSI attributable to the index COLO procedure. Leapfrog has set up a Data Rights Template, which specifies the data we are requesting. This system is provided for Government-authorized use only. CDC twenty four seven. Culture or non-culture based microbiologic tests performed and the results – please include collection dates. Additionally, view the Quick Learn for “Surgical Site Infections (SSI) Event form for PATOS” [Video – 6 min]. If the patient subsequently meets SSI definition, it should be reported if this procedure is in your monthly reporting plan. Patient and healthcare personnel Safety surveillance systems it should be entered as 0X610ZZ intraabdominal abscess will require invasive... Managed as an outpatient case would usually be missed under the current NHSN practices you for making future determinations and. Your facility ( CDC ) can not attest to the accuracy of a non-federal website if criteria... Where can I find more Information and examples of PATOS events NHSN, what should the case you reviewing... The documentation I need to answer the PATOS question on the SSI event as organ/space MED – Mediastinitis an... 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