There is wide variation in wound classification between surgeons, operating room nurses and National Surgical Quality Improvement Program reviewers, according to a study in the Journal of the American College of Surgeons.
Surgical wound classification is one factor used by NSQIP-Pediatric and other organizations to predict postoperative morbidity, including surgical site infection rates. To determine the variability in wound classification assigned by different providers, researchers analyzed classification assignments by surgeons, OR nurses and NSQIP surgical clinical reviewers for pediatric general surgery operations from 2010 to 2011.
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Overall, there was a 48 percent disagreement among all providers. Surgeons and NSQIP surgical clinical reviewers had a 23 percent disagreement. OR nurses and surgeons had a 38 percent disagreement, while nurses and NSQIP surgical clinical reviewers had a 40 percent disagreement.
The following procedures had the greatest overall rate of discrepancy in wound classification:
• Fundoplication — 73 percent
• Appendectomy — 71 percent
• Cholecystectomy — 60 percent
The authors concluded that comparing SSI rates requires a common understanding of wound classification among providers and institutions.
More Articles on SSIs:
Joint Commission: 1-Year SSI Surveillance for Implants No Longer Required
3 Steps to Reduce Post-Surgical Staph Infections
Patient Safety Tool: Joint Commission Guide to Reducing SSIs
