Orthopaedic SSI surveillance

Background

Since 2003, all health boards in Wales are required by the Welsh Government to participate in the surveillance of SSI following primary hip and knee orthopaedic procedures. Since 2014 data collected has been expanded to include any readmissions to hospital following these procedures, including revision surgery.

For this scheme, data are collected using a web form designed in conjunction with orthopaedic surgeons in Wales. Data collected on the form includes demographic details of the patient, detail on the procedure carried out. For orthopaedic procedures all patients are given antibiotics prior to the procedure to lower the risk of infection occurring. This data is important and the antibiotic(s) prescribed are captured on the form. Importantly, data is captured on whether a patient develops an infection after the surgery and this can be recorded for up to 30 days after surgery or 90 days if implant surgery. Details are recorded on the type of infection that develops and if any bacteria are involved. In addition, details are recorded on whether the patient is readmitted to hospital and the treatment required. This may include treatment to manage a wound or in some cases revision surgery to treat the wound. In some cases revision surgery may occur to explore a possible infection or be necessary due to mechanical failure of the joint. Surgical teams capture all the required data before being analysed by Public Health Wales. 

Protocol, guidance and training

The orthopaedic SSI surveillance protocol includes detail on the data capture method used and analysis of the data

A guide to the SSI web form details how to access and enter the required orthopaedic dataset 

SSI web form user guide

Data can be submitted to the surveillance scheme here.

Access to the web form is restricted to authorised staff members only. To request to be added to the authorised users list, please send an email to harp@wales.nhs.uk, and include your NADEX ID (e.g. ab123456).

HARP has developed an SSI training package specific to C-section surgery that includes a training booklet and a presentation for local training, complete with trainer notes. The training package can be used or adapted to cover SSI training around orthopaedic procedures.

Further guidance around risk factors of SSIs and reducing these infections can be found at the following:

Feedback of data collected via reports are monthly to hospitals themselves and published data on an annual basis at a Wales and hospital level (link to the Wales reports here). Hospitals are able to view progress on their infection numbers / rates and compliance with the scheme on an NHS dashboard.