Incidence and risk factors for and the effect of a program to reduce the incidence of surgical site infection after cardiac surgery.

Background: Surgical site infection (SSI) after cardiac surgery (CS) is a serious complication that increases hospital length of stay (LOS), has a substantial financial impact, and increases mortality. The study described here was done to evaluate the effect of a program to reduce SSI after CS.

Methods: In January 2007, a multi-disciplinary CS infection-prevention team developed guidelines and implemented bundled tactics for reducing SSI.

Gender differences in risk of bloodstream and surgical site infections.

Background: Identifying patients most at risk for hospital- and community-associated infections is one essential strategy for preventing infections.

Objective: To investigate whether rates of community- and healthcare-associated bloodstream and surgical site infections varied by patient gender in a large cohort after controlling for a wide variety of possible confounders.

Design: Retrospective cohort study.

Frequency of patient contact with health care personnel and visitors: implications for infection prevention.

Background: Contact with health care workers may be an important means of infection transmission between patients, yet little is known about patterns of patient contact with staff and visitors in hospitals. In a cross-sectional study, the frequency, type, and duration of contacts made by health care workers, other hospital staff, and visitors to patients in acute care settings were documented.

Methods: Patients were observed in seven units of three academic hospitals, with recording of each occurrence of someone's entry into the patient's room.

Comparison of two computer algorithms to identify surgical site infections.

Background: Surgical site infections (SSIs), the second most common healthcare-associated infections, increase hospital stay and healthcare costs significantly. Traditional surveillance of SSIs is labor-intensive. Mandatory reporting and new non-payment policies for some SSIs increase the need for efficient and standardized surveillance methods.

A comparison of methods to detect urinary tract infections using electronic data.

Background: The use of electronic medical records to identify common health care-associated infections (HAIs), including pneumonia, surgical site infections, bloodstream infections, and urinary tract infections (UTIs), has been proposed to help perform HAI surveillance and guide infection prevention efforts. Increased attention on HAIs has led to public health reporting requirements and a focus on quality improvement activities around HAIs. Traditional surveillance to detect HAIs and focus prevention efforts is labor intensive, and computer algorithms could be useful to screen electronic data and provide actionable information.

Community-associated methicillin-resistant Staphylococcus aureus prevalence: how common is it? A methodological comparison of prevalence ascertainment.

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are becoming increasingly prevalent. There is geographic variation in their reported prevalence across the United States; however, studies reporting on CA-MRSA prevalence also demonstrate great variability in their case-finding methodology. We conducted a study to see how three different methods to ascertain CA-MRSA prevalence would lead to different estimates.

EpiPortal: an electronic decision support system for infection control.

A comprehensive, electronic hospital epidemiology decision support system serves diverse users but its primary user is the infection control professional (ICP). Utilizing off-the-shelf components and accepted standards enables the system to be open, vendor-independent and ICP-controlled. Its development can flexibly respond to the evolving nature of infection control practice.

Automated real-time detection and notification of positive infection cases.

Infection control in the healthcare setting is an essential component for patient safety and quality of care. To assist with daily infection control functions, we have implemented an alert in the Vigilens Health Monitor (a clinical decision support system at our institution) for real-time detection and notification of positive infection cases in both inpatient and outpatient settings.