Surgical site infection surveillance service (SSISS)

Question

Accepted Answer

The UK Health Security Agency’s healthcare associated infection and antimicrobial resistance department (HCAI & AMR) run the surgical site infection surveillance service.

This service helps hospitals in England record and follow up incidents of infection after surgery, and use results to review or change practice as necessary.

This service supports both the mandatory surveillance of SSI in 4 categories of orthopaedics and voluntary surveillance in 13 categories of surgical procedures.

The HCAI & AMR department contributed England’s surgical site infection data to the healthcare-associated infections surveillance network (HAI-Net) to enable inter-country comparisons of SSI rates.

Surveillance service goals

The service:

provides hospitals with a protocol and tools to collect and analyse data on SSI using the minimum set of data required to take account of key risk factors
provides national data for use in benchmarking rates of SSI
ensures high standards of data quality
maintain, as far as possible, comparability with data previously collected so staff can evaluate trends over time
analyses data to improve our understanding of SSI epidemiology

The service includes:

SSISS surveillance protocol
training to use the protocol and follow surveillance methodology
access to the web-based data capture system for hospitals
suite of individual hospital reports generated via the web
help with interpreting data and further analyses
patient information leaflet: Monitoring surgical wounds for infection

Mandatory surveillance

Surveillance of infections in these procedures started in April 2004, specifying that each Trust should conduct surveillance for at least one orthopaedic category for one period in the financial year. The categories are:

hip replacements
knee replacements
repair of neck of femur
reduction of long bone fracture

Voluntary surveillance

The surveillance service records infections in other categories of procedures including:

abdominal hysterectomy
bile duct, liver, or pancreatic surgery
breast surgery
cardiac surgery
cranial surgery
cholecystectomy (non-laparoscopic)
coronary artery bypass graft
gastric surgery
large bowel surgery
limb amputation
small bowel surgery
spinal surgery
vascular surgery

See the eligible procedures for each category in the operating procedure codes (OPCS).

Register a hospital with the surveillance service

Register with the surgical site infection surveillance service

This form requires the contact details of a designated surveillance administrator, who is responsible for all communication between the hospital and SSISS. The administrator must receive training from SSISS before conducting surgical site infection surveillance.

Successful surveillance requires commitment, teamwork, effective communication and accurate data collection. A pilot period is strongly recommended to assess the resources required, make necessary amends and set up contingency plans.

We recommend that each Trust form a surveillance group, to plan how to run the surveillance locally. Membership of the group can vary, but ideally includes:

director of infection prevention and control (DIPC)
surgeons
anaesthetists
infection control team
surveillance staff
ward and theatre nurses
clinical governance
the Trust board

The surveillance group promotes surveillance within the Trust, interprets and distributes results to clinical staff and others who need to know about them, and enables policy and practice review when results indicate the need for further action.

Details on how patients data is collected and used are available via the Surgical site infection surveillance privacy notice.