In Scotland the surgical site infection (SSI) surveillance programme commenced in April 2002 following the release of Health Department Letter HDL(2001)57 entitled 'A Framework for National Surveillance of Hospital Acquired Infection in Scotland'. Surveillance requirements were revised in 2006 with the release of the Chief Executive Letter (CEL) 11 (2009).
Aims of the SSI programme are:
To collect surveillance data on surgical site infections (SSI) to enable estimation of
the size of SSI risk in patients undergoing specific operations
To analyse and report SSI data and describe trends in
SSI rates throughout Scotland
- To work in collaboration with healthcare providers to reduce SSI rates
Project Manager: Jane McNeish, Senior Nurse Epidemiologist, Scottish Surveillance HAI Programme
What is the role of the Scottish Surveillance of Healthcare Associated Infection Programme (SSHAIP) team?
In 2002 the Scottish Government tasked Health Protection Scotland (HPS) with coordinating the SSI surveillance programme across NHSScotland. Within HPS this collaboration is over seen by the Scottish Surveillance of Healthcare Associated Infection Programme (SSHAIP) team. Support provided includes preparing a national protocol, developing and maintaining a web based data collection system, data management, data analysis and publication of reports. In collaboration with NHS Education (NES) training is provided for SSI definitions (vital to ensure standardisation of diagnosis of SSI) and data management.
The SSHAIP team provide timely feedback of local SSI rates to
assist healthcare providers to minimise the occurrence of SSI's and provide continuous support
and clinical advice relating to SSI surveillance. The SSHAIP team also collate and disseminate national data, and transfer selected data to the European Centre for Disease Prevention and Control (ECDC) for international comparison.
The SSHAIP team can be contacted at NSS.HPSSSHAIP@nhs.net
What is required of healthcare providers?
Each healthcare provider is required to conduct the mandatory elements of SSI surveillance. All hip arthroplasty and caesarean section procedures conducted are included in the surveillance programme which allows sufficient numbers for national comparison. In addition healthcare providers may choose to undertake surveillance for additional procedures included in the list of voluntary procedures, for further details refer to SSI surveillance protocol.
During 2011 the SSI surveillance programme in Scotland was amended to include the option for healthcare providers to conduct surveillance using fewer resources. This light surveillance method collects the number of procedures performed within the chosen category and only collects detailed data when an SSI is diagnosed.
It has been shown that active, rather than passive, feed back of surveillance results to clinical teams has the greatest effect in reducing SSI rates. When surgical teams are engaged in examining their SSI rates combined with appraising clinical processes to ensure guidelines and best practice are being followed this provides the best opportunity for infection rates to be reduced.
How SSI rates are analysed and reported by HPS
Complying with a national minimum dataset and definitions for SSI, enables the data submitted to HPS to be mapped into the national dataset following a rigorous quality assurance process. Via the web based system healthcare providers have direct access to a suite of reports which help monitor the trends in local SSI's and can be nationally compared.
In addition as of 5 July 2016 SSI data will be published quarterly along with data on Clostridium difficile infection (CDI) and Staphylococcus aureus bacteraemias (SAB) in Scotland.
Publications - Quarterly
Commentary on quarterly epidemiological data on Clostridium difficile infection (CDI) and Staphylococcus aureus bacteraemias (SAB) and Surgical Site Infection (SSI) in Scotland
SSI Surveillance Training
Training in the data definitions and data collection process is provided to all
staff who are involved in SSI surveillance. HPS can support the healthcare provider when setting up a new surveillance programme. Training modules for data definitions can be accessed via the web, for details contact the SSHAIP team at NSS.HPSSSHAIP@nhs.net
SSI Frequently Asked Questions