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AMBU-KISS one day surgery surveillance in Germany Petra Gastmeier, MD Charité – University Medicine Berlin, Germany and German National Reference Center for Surveillance of Nosocomial Infections. KISS.

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AMBU-KISS onedaysurgerysurveillance in GermanyPetra Gastmeier, MDCharité – University Medicine Berlin, Germanyand German National Reference Center for Surveillance of Nosocomial Infections

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KISS = Krankenhaus-Infektions-Surveillance-System= German national nosocomial infection surveillance system- supported by the German Ministry of Health- organized by 3 university institutes

principles of kiss participation
Principles of KISS participation
  • Voluntary participation
  • Confidentiality(instead of mandatory reporting)
participating hospitals
Participating hospitals

1997: 20

2007: 520

Total number of hospitals: 2000

neues in 2005
Neues in 2005

Feedback to the hospitals

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Reduction of SSI rates in KISS ?

  • Inclusion criteria
  • Surgical departments
  • with having had at least 4 years of ongoing participation (between 1997 and June 2004) and
  • with at least 30 operations per year registered for the operative procedure category in question.
  • 130 departments from 86 hospitals met the inclusion crieria
kiss d pooled ssi rates according to the year of participation in the surveillance system
KISS (D): Pooled SSI rates according to the year of participation in the surveillance system

RR = 0.75 (CI95: 0.68-0.82)

-25 %

(n = 119 114 operations from 130 departments)

Brandt, C. ICHE 2006

kiss components www nrz hygiene de13
KISS componentswww.nrz-hygiene.de

CDAD-KISS

ICU-KISS

MRSA-KISS

OP-KISS

ONKO-KISS

NEO-KISS

AMBU-KISS

DEVICE-KISS

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AMBU-KISS

Start:

January 2003

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METHOD

Do we need stratification according to the number of risk points?

Do we get sufficient information about the postoperative period?

pilot study patients with nnis risk points in ambulatory surgery
PILOT STUDY Patients with NNIS risk points in ambulatory surgery

Hirsemann S et al. AJIC 2005; 33:6-10

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Experience with data from hospitals (OP-KISS)

Does stratifying surgical site infection rates by the NNIS risk index influence the rank order of the hospitals in a surveillance system?

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Number of SSI for a procedure type = ------------------------------------------------------ x 100 Number of operations of this procedure type

Method AMBU-KISS

Calculation of crude SSI rates

method ambu kiss
Method AMBU-KISS

Mlangeni et al. Chirurg 2004; 75:265-68

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METHOD

Do we need stratification according to the number of risk points?

Do we get sufficient information about the postoperative period?

detecting of ssi in ambu kiss n 99
Detecting of SSI in AMBU-KISS, n=99

Blaich A et al. Der Chirurg 2007

question to the surgeon n 99
Question to the surgeon, n=99

Blaich A et al. Der Chirurg 2007

kiss data for hospitals 12 2006

Comparison

KISS dataforhospitals12/2006

KISS datafordaysurgerycenters

12/2007

KISS 12/2007

summary
Summary
  • Many day surgery centers are interested to participate and provide data
  • Calculation of crude SSI rates seems to be appropriate
  • Follow-up information seems to be appropriate
  • SSI rates from day surgery centers are in general lower, probable due
  • - to fewer underlying diseases in this patient group - to sufficient experience of the surgeons with this operation type