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The Israeli Study of Surgical Infections (ISSI): I. Methods for Developing a Standardized Surveillance System for a Multicenter Study of Surgical Infections

Published online by Cambridge University Press:  02 January 2015

Elisheva Simchen*
Affiliation:
Department of Social Medicine, Hadassah University Hospital Unit for the Control of Hospital-Acquired Infection, Ministry of Health, The Hebrew University, Jerusalem
Yohanan Wax
Affiliation:
Department of Statistics, The Hebrew University, Jerusalem
Bella Pevsner
Affiliation:
Department of Statistics, The Hebrew University, Jerusalem
Mary Erdal
Affiliation:
Unit for the Control of Hospital-Acquired Infection, Ministry of Health, The Hebrew University, Jerusalem
Jacques Michel
Affiliation:
Department of Clinical Microbiology, Hadassah University Hospital
Michaela Modan
Affiliation:
Department of Clinical Epidemiology, Sheba Hospital, Tel Aviv University
Eitan Rubinstein
Affiliation:
Department of Internal Medicine, Sheba Hospital, Tel Aviv University
Theodore Sacks
Affiliation:
Department of Clinical Microbiology, Hadassah University Hospital
Mervyn Shapiro
Affiliation:
Unit of Clinical Infectious Diseases, Hadassah University Hospital
*
Department of Social Medicine, Hadassah University Hospital, Ein Karem, Jerusalem 91120, Israel

Abstract

The postoperative wound infection experience in 11 Israeli hospitals was investigated with two objectives: (1) to utilize the variability among hospitals for a better understanding of the determinants of these infections, and (2) to present surgeons and infection control teams with information upon which they can take action. This article summarizes the methods that were applied to maximize the uniformity of information obtained from hospitals. (1) The same kind of patients were sampled in every hospital. (2) The data collection system was standardized, and analyzed for errors. The overall error rate was small (2%) but there were potential problem areas, such as missing information on underlying diagnoses (12%). Few errors (1%) were found in the nurses' observations of the wounds. (3) All wound infections were diagnosed in a uniform manner by convening a panel of four specialists at the central Israeli Study of Surgical Infections (ISSI) office. (4) The definition of infection that was finally chosen for this multicenter study had to be broadened to include, in addition to pus, “discharge other than pus,” because of the higher reliability among panel members. This definition was also clinically valid in terms of morbidity. (5) The rate of postdischarge infections was estimated and was not found to be related to the discharge policies in the various hospitals.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

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Footnotes

Ms. Tevaglioglo is deceased.