Methods matter: Comparison of two post-arthroplasty surgical site infection surveillance methodologies.

Background: This study compared post-total hip arthroplasty (THA) and total knee arthroplasty (TKA) surgical site infection (SSI) rates calculated using two surveillance methodologies to assess their reliability as quality indicators in a community hospital. SSI rates from the National Surgical Qual...

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Publicado en:Canadian Journal of Infection Control / Revue Canadienne de Prévention des Infections pp. 30 - 37
Autores principales: Noman, Fatima, Nadarajah, Jeya
Formato: research tables/charts Journal Article
Publicado: Infection Prevention & Control Canada (IPAC Canada) Spring2026
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: Canadian Journal of Infection Control / Revue Canadienne de Prévention des Infections
      issn: 11835702
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    pubinfo:
      dt: Spring2026
      pid: 30606
      pub: Infection Prevention & Control Canada (IPAC Canada)
      place: Winnipeg, Manitoba
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        10.36584/cjic.2026.001.04.30.36
        195098973
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        atl: Methods matter: Comparison of two post-arthroplasty surgical site infection surveillance methodologies.
      aug:
        au:
          Noman, Fatima
          Nadarajah, Jeya
        affil: Infection Prevention and Control department, Oak Valley Health, Ontario, Canada
      sug:
        subj:
          Arthroplasty, Replacement, Hip Adverse Effects
          Arthroplasty, Replacement, Knee Adverse Effects
          Surgical Wound Infection Diagnosis
          Disease Surveillance
          Clinical Indicators
          Infection Control
          Program Evaluation
          Human
          Inpatients
          Surgical Patients
          Hospitals, Community
          Prospective Studies
          Validation Studies
          Comparative Studies
          Descriptive Statistics
          Postoperative Period
          Quality Improvement
          Benchmarking
          Predictive Value of Tests
          Predictive Validity
          Quality Assessment
          Postoperative Complications
          Program Implementation
          Reliability
          Preventive Health Care
          Sensitivity and Specificity
          Health Screening
          Early Diagnosis
      ab: Background: This study compared post-total hip arthroplasty (THA) and total knee arthroplasty (TKA) surgical site infection (SSI) rates calculated using two surveillance methodologies to assess their reliability as quality indicators in a community hospital. SSI rates from the National Surgical Quality Improvement Program (NSQIP) were compared with those from an independent Infection Prevention and Control (IPAC) SSI surveillance program based on National Healthcare Safety Network (NHSN) guidance. Methods: The study period ranged from April 1, 2021, to March 31, 2023. The IPAC program actively reviewed all THA and TKA cases for 90 days post-operatively, while NSQIP followed a subset of patients for 30 days. Both methodologies applied the same NHSN case definitions to identify complex SSI cases, and SSI rates were calculated. All identified cases were reviewed and shared with stakeholders. The IPAC program audited compliance with SSI preventive measures beginning in April 2022. Results: In the first fiscal year, IPAC surveillance identified six complex SSI cases (THA: 3; TKA: 3), with SSI rates of 0.71 for THA and 0.54 for TKA. NSQIP identified one case (THA: 1; TKA: 0), with SSI rates of 0.87 for THA and 0 for TKA. In the second fiscal year, IPAC identified six additional complex SSI cases (THA: 3; TKA: 3), with SSI rates of 0.58 for THA and 0.36 for TKA, while NSQIP identified no cases. Using IPAC surveillance, SSI rates decreased by 18% for THA and 33% for TKA over the study period. Of the 12 SSI cases identified by IPAC, five (41.2%) were detected beyond 30 days post-operatively and would not have been captured by NSQIP. Improvements in preventive practices were observed, including normothermia compliance increasing from <20% to 80% and appropriate hair removal education improving from 60% to 93%. Conclusion: The IPAC SSI surveillance program provided a more accurate and sensitive indicator for detecting changes in SSI rates.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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