AORN Journal
Volume 86, Issue 2 , Pages 249-258 , August 2007

The Not-So-Hidden Costs of Surgical Site Infections

  • Todd E. Barnett, RN, MBA

      Affiliations

    • Todd E. Barnett, RN, MBA, is a clinical sales representative at LifeSync Corp, Ft Lauderdale, FL. He was the administrative director for surgical services at St Francis Medical Center, Midlothian, VA, at the time this article was written.

References 

  1. Greider K . Dirty hospitals. AARP Bulletin . http://www.aarp.org/bulletin/yourhealth/dirty_hospitals.html January 2007; Accessed June 11, 2007.
  2. Leaper DJ , van Goor H , Reilly J , et al.   Surgical site infection—a European perspective of incidence and economic burden . Int Wound J . 2004;1(4):247–273
  3. Vegas AA , Jorda VM , Garcia ML . Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization . Eur J Epidemiol . 1993;9(5):504–510
  4. Barnard BM . Fighting surgical site infections. Infect Control Today . http://www.infectioncontroltoday.com/articles/241feat1.html April 2002; Accessed June 11, 2007.
  5. Mangram AJ , Horan TC , Pearson MC , Silver LC , Jarvis WR . Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee . Infect Control Hosp Epidemiol . 1999;24(4):250–278
  6. Subcommittee examines staggering human, financial toll of hospital-acquired infections. The Committee on Energy and Commerce . http://republicans.energycommerce.house.gov/108/News/03302006_1831.htm Accessed June 11, 2007.
  7. Bush LM . Disposable items help prevent healthcare-acquired infections. Infect Control Today . http://www.infectioncontroltoday.com/articles/531feat2.html March 2005; Accessed June 11, 2007.
  8. Jancin B . Cell phones, ECG leads are nosocomial pathways . Ob Gyn News . 2003;38(23):45
  9. Jancin B . Antibiotic-resistant pathogens found on 77% of ECG lead wires . Cardiol News . 2004;2(3):14
  10. Kirkland KB , Briggs JP , Trivette SL , Wilkinson WE , Sexton DJ . The impact of surgical site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs . Infect Control Hosp Epidemiol . 1999;20(11):725–730
  11. Asensio A , Torres J . Quantifying excess length of postoperative stay attributable to infections: a comparison of methods . J Clin Epidemiol . 1999;52(12):1249–1256
  12. Zhan C , Miller MR . Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization . JAMA . 2003;290(14):1868–1874
  13. Green JW , Wenzel RP . Postoperative wound infection: a controlled study of the increased duration of hospital stay and direct cost of hospitalization . Ann Surg . 1977;185(3):264–268
  14. Connolly C . Infections take heavy toll on patients, profit . Washington Post . March 29, 2006;A03; http://www.washingtonpost.com/wp-dyn/content/article/2006/03/28/AR2006032801631.html Accessed June 26, 2007.
  15. Hospital-acquired infections in Pennsylvania. Pennsylvania Health Care Cost Containment Council . http://www.phc4.org/reports/hai/05/docs/hai2005report.pdf November 2006; Accessed June 11, 2007.
  16. Childs D . New report sheds sobering light on hospital infections. ABC News . http://abcnews.go.com/Health/story?id=2652355&page=1 November 14, 2006; Accessed June 11, 2007.
  17. Connolly C . Data show scourge of hospital infections . Washington Post . July 13, 2005;A01; http://www.washingtonpost.com/wp-dyn/content/article/2005/07/12/AR2005071201555.html Accessed June 26, 2007.
  18. The cost of infection: preventing infections makes hospitals more profitable. Committee to Reduce Infection Deaths . http://www.hospitalinfection.org/costofinfection.shtml Accessed June 26, 2007.
  19. S. 1932: deficit reduction act of 2005. Congressional Budget Office . http://www.cbo.gov/ftpdocs/70xx/doc7028/s1932conf.pdf January 27, 2006; Accessed June 11, 2007.
  20. Greenfield S , Kravitz R , Duan N , Kaplan SH . Heterogeneity of treatment effects: implications for guidelines, payment, and quality assessment . Am J Med . 2007;120(Suppl 1):S3–S9 (4)
  21. Levine S . Bug puts hospitals on edge, on guard. Washington Post . http://www.washingtonpost.com/wp-dyn/content/article/2007/05/13/AR2007051301193.html May 14, 2007; Accessed June 26, 2007.
  22. Hospitals' responsibility in reducing community risks of methicillin resistant Staphylococcus aureus (MRSA) infections: response to APIC and SHEA statement [news release]. Burbank, CA: Institute of Progressive Medicine . http://www.24-7pressrelease.com/pdf/2007/03/08/press_release_25419.pdf Accessed June 26, 2007.
  23. Jarvis WR . Benchmarking for prevention: the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance (NNIS) system experience . Infection . 2003;31(Suppl 2):44–48
  24. Weinstein RA . Controlling antimicrobial resistance in hospitals: infection control and use of antibiotics . Emerg Infect Dis . 2001;7(2):188–192
  25. HealthGrades  . Second annual Patient Safety in American Hospitals report. May 2005 . http://www.healthgrades.com/media/DMS/pdf/PatientSafetyInAmericanHospitalsReportFINAL42905Post.pdf Accessed June 26, 2007.
  26. Workshop. Issues of resistance: microbes, vectors, and the host. Institute of Medicine. February 6-7, 2002 . http://www.iom.edu/CMS/3783/3924/8620.aspx Accessed June 26, 2007.
  27. The Leapfrog Group for patient safety. The Leapfrog Group . http://www.leapfroggroup.org/home Accessed June 13, 2007.
  28. StopHospitalInfections.org. Consumers Union. https://secure.npsite.org/cu/site/Advocacy?JServSessionIdr010=j46el0jf41.app7a&cmd=display&page=UserAction&id=1209. Accessed June 13, 2007.
  29. Washington outlook. Premier, Inc. March 31, 2006. http://www.premierinc.com/advocacy/publications/outlook/06/mar-31.jsp. Accessed June 26, 2007.
  30. Trends in state public health legislation January 1, 2006–December 31, 2006. Healthy States Initiative . http://www.healthystates.csg.org/NR/rdonlyres/6C2AC17C-B6B3-44BA-B5B3-69C0E7F23931/0/Chapter12HospitalAcquiredInfections.pdf Accessed June 26, 2007.
  31. Aubrey A . States push to disclose hospital infection rates. NPR. May 11, 2006 . http://www.npr.org/templates/story/story.php?storyId=5397454 Accessed June 11, 2007.
  32. Kiddoo DA , Wollin TA , Mador DR . A population based assessment of complications following outpatient hydrocelectomy and spermatocelectomy . J Urol . 2004;171(Pt 1):746–748 (2)
  33. First-ever state report on hospital acquired infections shows staggering costs in lives and dollars [news release]. Yonkers, NY: Consumers Union; July 13, 2005 . http://www.consumersunion.org/pub/core_health_care/002490.html Accessed June 26, 2007.
  34. Quality update for January 31, 2003: JCAHO: hospital infections seriously underreported. The American Health Quality Association . http://www.ahqa.org/pub/connections/162_696_4137.cfm Accessed June 11, 2007.
  35. Facts about the 2007 National Patient Safety Goals. The Joint Commission . http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/07_npsg_facts.htm Accessed June 11, 2007.
  36. Making surgery safer: QIQ support for the Surgical Care Improvement Project. The American Health Quality Association . http://ahqa.org/pub/uploads/SCIP_051102.pdf Accessed June 12, 2007.
  37. Recommended practices for prevention of transmissible infections in the perioperative practice setting . In: Standards, Recommended Practices, and Guidelines . Denver, CO: AORN, Inc; 2007;p. 707–717
  38. Plonczynski DJ . Wise use of perioperative antibiotics . AORN J . 2005;81(6):1260–1272
  39. McNeil SA , Nordstrom-Lerner L , Malani PN , Zervos M , Kauffman CA . Outbreak of sternal surgical site infections due to Pseudomonas aeruginosa traced to a scrub nurse with onychomycosis . Clin Infect Dis . 2001;33(3):317–323
  40. Seropian R , Reynolds BM . Wound infections after preoperative depilatory versus razor preparation . Am J Surg . 1971;121(3):251–254
  41. Recommended practices for surgical hand antisepsis/hand scrubs . In: Standards, Recommended Practices, and Guidelines . Denver, CO: AORN, Inc; 2007;p. 565–573
  42. 56 hospitals collaborate to prevent surgical infections [news release]. Washington, DC: The American Health Quality Association; June 23, 2005 . http://www.ahqa.org/pub/media/159_678_5198.cfm Accessed June 13, 2007.
  43. Edwards FH , Engelman RM , Houck P , Shahian DM , Bridges CR , Society of Thoracic Surgeons  . The Society of Thoracic Surgeons practice guideline series: antibiotic prophylaxis in cardiac surgery, part I: duration . Ann Thorac Surg . 2006;81(1):397–404
  44. Antimicrobial prophylaxis for surgery . Treat Guidel Med Lett . 2004;2(20):27–32
  45. Hogan D . Asking good questions . Findings . September 2003;9–13 http://publications.nigms.nih.gov/findings/sept03/questions.html Accessed June 11, 2007.
  46. Hopf H , Sessler DI . Routine postoperative oxygen supplementation . Anesth Analg . 1994;79(3):615–616
  47. Latham R , Lancaster AD , Covington JF , Pirolo JS , Thomas CS . The association of diabetes and glucose control with surgical-site infections among cardiothoracic surgery patients . Infect Control Hosp Epidemiol . 2001;22(10):607–612
  48. Falk PS , Winnike J , Woodmansee C , Desai M , Mayhall CG . Outbreak of vancomycin-resistant entercocci in a burn unit . Infect Control Hosp Epidemiol . 2000;21(9):575–582
  49. Brown DQ . Electrocardiography wires: a potential source of infection . NTI News . May 24, 2006;B1–B4
  50. Furnary AP , Zerr KJ , Grunkemeier GL , Starr A . Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures . Ann Thorac Surg . 1999;67(2):352–362

PII: S0001-2092(07)00031-2

doi: 10.1016/j.aorn.2007.03.012

AORN Journal
Volume 86, Issue 2 , Pages 249-258 , August 2007

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