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Surgical Site Infection Prevention

Definition

A Surgical Site Infection (SSI) is an infection that occurs after surgery, at the site where it was performed. These infections can affect the incision area or the deep tissue at the operation site. These infections can develop within 30 days after the surgery and up to one year after joint replacement or other surgeries involving an implant (including organ transplant, pacemaker, etc).

Surgical Site Infection Prevention refers to the proper administration of antibiotics within the appropriate time prior to surgery to help reduce the risk of an infection. This performance is monitored and reported for all primary joint replacement surgeries, including total, partial or hemi arthroplasties (replacements) of the knee or hip joint.

Cause

SSIs are caused by bacteria entering a surgical incision or wound. This bacterium is usually found in or on the patient's own body. Some surgeries are at higher risk for infections, especially in areas that have higher levels of bacteria.
 
These surgeries include gastrointestinal surgery where there are bacteria present in the gastrointestinal tract, and emergency surgery such as appendicitis, acute cholecystitis and bowel perforation where there is active infection at the time of surgery.

The most common bacteria associated with SSIs are Staphylococcus aureus (a bacterium frequently found in the nose and skin of a person) and Escherichia coli (often known as E. coli).

Enhancing patient safety

Patient safety and high quality clinical care are high priorities at North York General Hospital and we have become a leader in infectious disease control. We have made significant enhancements, including:
  • Working with Safer Health Care Now and the Ministry of Health and Long-Term Care to implement best practices that help reduce SSIs. These include:

  • Optimal use of prophylactic (preventative) antibiotics:

       • Determining the appropriate antibiotic to be used
       • Administering these antibiotics within 0 - 60 minutes before surgery time
       • Discontinuing the antibiotic in less than 24 hours

  • Monitoring surgical patients' core body temperature and maintaining the temperature at a minimum of 36 degrees Celsius throughout the entire surgery.

  • Enhancing our Infection Prevention and Control Program.

Performance

North York General Hospital Surgical Site Infection Prevention indicator compliance rate.

North York General regularly monitors and reviews infection rates and uses this information to execute best practice protective measures and continually improve patient care and safety.

The SSI Prevention Indicator is a measure of the hospital's proper administration of a prophylactic (preventative) antibiotic used to prevent surgical site infections in hip and knee joint replacement surgeries. This measure is reported on a quarterly basis.

The SSI indicator is a process measure where we report the percent of total primary hip and knee surgical patients who receive prophylactic antibiotics within the appropriate time prior to surgery.
 
Learn more about public reporting and patient safety on the Health Quality Ontario website.