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Surgeon-Specific Wound Infection Rates-A Potentially Dangerous and Misleading Strategy

Published online by Cambridge University Press:  21 June 2016

William E. Scheckler*
Affiliation:
Department of Family Medicine and Practice, University of Wisconsin Medical School, Madison, Wisconsin
*
Department of Family Practice and Medicine, University of Wisconsin Medical School, 777 South Mills Street, Madison, WI 53 715

Extract

Some colleagues are now touting the calculation and confidential reporting of surgeon-specific wound infection rates as the most important mechanism to reduce nosocomial surgical wound infections.' Several studies purport to show either a decline of surgical wound infections after such reporting is introduced or to demonstrate large differences in rates of wound infections among surgeons in a specific hospital. The purpose of this article is to clarify the numerous problems and deficiencies in the development of this concept and to show the essential statistical implausibility of demonstrating its effectiveness.

Type
Perspective
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1988

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References

1. RW, Haley: Managing Hospital Infection Control for Cost-Effectiveness. Chicago, American Hospital Publishing Inc, 1986, pp 5455.Google Scholar
2. Haley, RW, DH, Culver, White, JW, et al: The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985; 121:182205.CrossRefGoogle ScholarPubMed
3. Condon, RE, WJ, Schulte, Malangoni, MA, et al: Effectiveness of a surgical wound surveillance program. Arch Surg 1983; 118:303307.CrossRefGoogle ScholarPubMed
4. Cruse, PJE, Foord, R: The epidemiology of wound infection-A IO-year prospective study of 62,939 wounds. Surg Clin North Am 1980; 60:2740.CrossRefGoogle ScholarPubMed
5. MJ, Gil-Egea, MT, Pi-Sunyer, Verdaguer, A, et al: Surgical wound infections: Prospective study of 4,468 clean wounds. Inject Control 1987; 8:277280.Google Scholar
6. Collier, C, Miller, DP, Borst, M: Community hospital surgeon-specific infection rates. Infect Control 1987; 8:249254.CrossRefGoogle ScholarPubMed
7. Olson, M, O'Connor, M, ML, Schwartz: Surgical wound infections-A 5-year prospective study of 20.193 wounds at the Minneapolis VA medical center. Ann Surg 1984; 199:253259.CrossRefGoogle ScholarPubMed
8. Mead, PB, SE, Pories, Hall, P: Decreasing the incidence of surgical wound infections. Arch Surg 1986: 121:458461.CrossRefGoogle ScholarPubMed
9. Haley, RW, WM, Morgan, Culver, DH, et al: Update from the SENIC project. Am J Infect Control 1985; 13:97108.CrossRefGoogle ScholarPubMed
10. Brachman, PS, BB, Dan, Haley, RW, et al: Nosocomial surgical infections: Incidence and cost. Surg Clin North Am 1980; 60: 1525.CrossRefGoogle ScholarPubMed
11. Ary, D, Jacobs, LC, Razarich, A: Introduction to Research in Education. New York, Holt Rmehart and Winston Inc, 1972, pp 226, 237.Google Scholar
12. Haley, RW, OH, Culver, Morgan, WM, et al: Identifying patients at high risk of surgical wound infection. Am J Epidemiol 1985: 121:206215.CrossRefGoogle ScholarPubMed
13. Jencks, SF, Dobson, A: Refining case-mix adjustment. N Engl J Med 1987; 317:679686.CrossRefGoogle ScholarPubMed
14. AB, Kaiser: Antimicrobial prophylaxis in surgery. N Engl J Med 1986: 315:11291138.Google Scholar
15. JS, Garner: CDC guidelines for the prevention and control of nosocomial infections: Guideline for the prevention of surgical wound infections, 1985. Am J Infect Control 1986; 14:7180.Google Scholar