Electronic Surveillance for Wound Infections after Ambulatory Pediatric Surgery

小儿门诊手术后伤口感染的电子监控

• 批准号: 8222006
• 负责人: SUSAN MD COFFIN
• 金额: $ 49.95万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-30 至 2016-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8222006
• 关键词: Electronic; Surveillance; Wound; Infections; after

DESCRIPTION (provided by applicant): Critical gaps in our understanding of surgical site infections (SSI), the second most commonly reported healthcare-associated infection in adults and children, prevent us from accurately identifying at-risk patients and focusing preventive actions. Children and ambulatory surgical patients represent two overlapping groups for whom basic knowledge of SSI incidence and risk factors is lacking. Little is known about the epidemiology of SSI after the most commonly performed pediatric surgeries. Similarly, few data support the prevailing assumption that ambulatory surgeries are associated with a low risk of SSI. Because outpatient surgery accounts for more than 75% of all surgical procedures conducted in the United States, the burden of these infections could be quite large even if the SSI rate is relatively low. Given finite infection prevention and control resources, new strategies to conduct efficient and targeted SSI surveillance are badly needed. The electronic health record (EHR) holds promise as a tool to increase our capacity to accurately and efficiently track patient outcomes after health encounters across varied settings, particularly when the number of patients under observation is large. The potential advantages of EHR-facilitated surveillance of SSIs are particularly evident for ambulatory Surgical patients, for which there are large numbers of exposed patients, each of whom may have a Relatively low risk of experiencing an adverse outcome. Our proposal examines key issues requested in the SEN, by 1) characterizing the epidemiological aspects SSI, 2) focusing on ambulatory surgery, and 3) using an EHR to guide surveillance across various settings of care. Aim 1 will define the incidence of and risk factors for SSI after ambulatory pediatric surgery using a prospective cohort study of patients across a large pediatric healthcare network and rigorous, comprehensive SSI surveillance techniques to establish a gold standard. Aim 2 will determine the EHR data elements associated with SSI and evaluate the performance of an HER based surveillance algorithm for identifying SSI as compared to the gold standard surveillance. Finally, Aim 3 will yield a vendor-agnostic, EHR-embedded SSI surveillance workstation that will be validated during the final year of funding. Upon completion of the project, a detailed technical appendix specifying the implementation process for the SSI surveillance workstation will be provided and any modifications to the framework will be provided open source and free of charge PUBLIC HEALTH RELEVANCE: Given that surgical site infections (SSI) are the second most common healthcare acquired infection and 75% of surgeries are performed in an ambulatory setting, SSI after pediatric ambulatory surgery are an important but neglected topic of study. Surveillance after ambulatory pediatric surgery is essential to provide data on the effectiveness of SSI preventive measures. This proposal is designed to determine the frequency and characteristics of and create an efficient surveillance mechanism for SSI after ambulatory pediatric surgery.

描述（由申请人提供）：我们对手术部位感染（SSI）的理解存在重大差距，SSI是成人和儿童中第二常见的医疗保健相关感染，这使我们无法准确识别高危患者并重点采取预防措施。儿童和门诊手术患者是两个重叠的群体，他们缺乏对SSI发生率和危险因素的基本了解。在最常见的儿科手术后，对SSI的流行病学知之甚少。同样，很少有数据支持门诊手术与低SSI风险相关的普遍假设。由于门诊手术占美国所有外科手术的75%以上，即使SSI率相对较低，这些感染的负担也可能相当大。