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

2. 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

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

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

5. Results:
Infection rates were steady during the last seven years

6. 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 %; cases pending - 1.8%;
being assessment %; lost to follow-up %
Closed cases (n= 7037; 85.6%)
cases with infection question (n = 6772; 96.2%)
cases with clinically significant infection (n= 2,342; 34.6%)

7. 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

8. Results:

9. Results:

10. 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.

11. 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

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

13. Remember….
IT IS YOUR DATA

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

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

16. Thanks to a great team….

17. Finally
Any Questions??????????