Who’s hacked our HAC data?
Holly Dodd1, , 1Hospitals North, Tasmanian Health, Launceston, Tasmania, Australia
What happened to a Hospital Acquired Complication (HAC) when you use Centre Disease Control (CDC) surveillance definitions to assess a surgical site infection (SSI).
On review of our Total Hip and Total Knee replacement surgical site infections, we used the HAC data from the ICD- 10-AM/ACHI procedure codes report. This was cross referenced with Diagnosis- related group (DRG) code reports.
The review of HAC data was undertaken using CDC Surgical Site Infection (SSI) definitions. This highlighted discrepancies between HAC and CDC SSI definitions. The breakdown of the data is as below, this includes combined Hip (n= 19) & Knee (n=14) HACs:
18.2 % HAC reassessed as not having an infection
48.4 % HAC attributed to community onset
12.2 % HAC attributed to another health care facility
21.2% HAC classified as SSI
This review using HAC data highlighted several inconsistencies with the classification.
•Several of the SSIs were incorrectly identified as HACs, patients who had been identified as having HAC, had generalised disease process symptoms post-surgery not infections.
•Another concerning issue was that 48.4% patients identified with having a HAC were not actually hospital acquired infections at all! Several patients had their initial surgery years ago.
This review highlighted that using HAC data for surgical site surveillance is problematic and unreliable and that our HAC data had been well and truly HACKED!
Biography
Holly, originally from Scotland. She has a certificate Infection Prevention and Control from Sydney Eye Hospital.
Holly has 11 years’ experience working as an Infection and Control Clinical Nurse Consultant across both small and large private metropolitan hospitals on the Australian mainland and latterly her experience is in the public sector in regional Australia. Holly draws on her previous nursing experience from working in the fields of Cardio-thoracic, ICU and CCU.
Holly works as an IPC Clinical Nurse Educator based in Launceston General Hospital, Tasmanian Health Service. She enjoys all aspects of this exciting, rewarding and at times, challenging role.