Infections in QASM surgical patients Therese Rey-Conde Dr John North QASM QASM seminar: 2 November 2018 Lady Cilento Children’s Hospital

Infections in QASM surgical patients No conflict of interest to declare STAFF: John North Therese Rey-Conde Sonya Faint Kyrsty Webb Jenny Allen Candice Postin

Queensland Audit of Surgical Mortality: >10 YEARS since we began >10,000 cases audited (today nearly 12,000) 100% public and private hospitals 100% surgeon participation 2011 infection question added

Methods: Infections (July 2011 – June 2018) Notified cases (n= 8,224) Closed cases (n= 7,037) Clinically significant infections (n= 2,342; 35%)

Results: Infection rates were steady during the last seven years

Results: When infections were acquired (n = 2,255) before admission (n= 974; 43%) during admission (n= 1,281; (57%) Type of Infection (n=1,271) Data missing = 10 Pneumonia (n=717; (56%) Septicaemia (n=245; 19%) Intra-abdominal sepsis (n=183; 14%) Other (n=126; 10%) During admission (n = 1,183) [data missing = 98] post-operatively (n= 763; (65%)36 diff organisms pre-operatively (n= 217; 18%) 50 different surgical site infection (n= 102; 9%) 25 different organisms other invasive site (n= 104; 9%) 13 diff or Notified cases (n = 8224) Excluded (n= 1,187; 14.4%) terminal care - 8.4%; error - 3.1%; cases pending - 1.8%; being assessment - 1.0%; lost to follow-up - 0.1% Closed cases (n= 7037; 85.6%) cases with infection question (n = 6772; 96.2%) cases with clinically significant infection (n= 2,342; 34.6%)

Results: General Surgery n = 2,481 total patients Vascular Surgery = 587 patients Urology = 241 patients Neurosurgery = 1,073 patients Orthopaedics = 1,548 patients Otolaryngology = 88 patients Ophthalmology = 8 patients Paediatrics = 60 patients O&G = 37 patients Plastic surgery = 59 patients Oral/Maxillofacial = 2 patients Cardiothoracic = 585 patients

Results:

Results:

had acquired infections Results In all surgical patients who died in seven years 19% (1,281 / 6,772) had acquired infections while in hospital. Need baseline data to interpret this accurately.

Learning from the data: PUBLICATIONS: Hospital-acquired infections and QASM patients (2017) Hospital-acquired infections and Private hospital patients (2017) Processes of care in surgical patients who died with hospital-acquired infections in Australian hospitals. Allen J, Rey-Conde T, North JB, Kruger P, Babidge WJ, Wysocki AP, Ware RS, Veerman JL, Maddern GJ. Journal of Hospital Infection (2017) Lessons from the audit (vol 18) Please also see the reading list suggested by Graham Spooner, RACS College Librarian. IMPACT: Professional practice Hospital practice

Thank you: Surgeons of Queensland Queensland Health RACS Staff commitment and support

Remember…. IT IS YOUR DATA

IT IS YOUR DATA Why not use it Remember…. IT IS YOUR DATA Why not use it

IT IS YOUR DATA Why not use it We can assist Remember…. IT IS YOUR DATA Why not use it We can assist

Thanks to a great team….

Finally Any Questions??????????