A patient has chronic hip infections, has a hip replacement and develops an infection. After treatment, the patient returns to the OR for revision and develops an infection with the same organism. Is this person counted twice in the denominator and twice for an infection? The patient appeared to have been completely treated, so wound class was designated as "clean". 1/19/2006

Every patient that undergoes a HPRO procedure is included in the denominator - the replacement and revision are two separate procedures and should be counted as such. Either the patient has an infection at the time of surgery or he/she does not. The concept of "chronic infection" does not figure into the equation. The wound class is not assigned prior to the procedure, but at the conclusion of the procedure. If there does not appear to be an infection when the surgeon opens the patient, then it would be classified accordingly - if the patient then develops an infection it would be counted in the numerator. 

HAI - Surgical Site Infections (SSI) Manual

  1. If another surgery is performed during an abdominal hysterectomy (e.g., BSO, appendectomy, adhesion removal, etc.), how is the duration of the hysterectomy calculated? 11/2/2005
  2. If two separate procedures are done through two incisions (e.g., a breast augmentation and an abdominal liposuction), how is the duration of the breast surgery calculated? 3/5/2008
  3. What if a CABG patient returns to the operating room for bleeding greater than 24 hours after the initial surgery and subsequently develops an infection. Is the infection related to the CABG or is it related to the re-exploration for bleeding? 3/5/2008
  4. If a patient's chest is left open after a CABG, should they be captured in the denominator even though they would not be counted in the numerator if they developed an infection? 1/19/2006
  5. Are there additional "markers" for the superficial infection definition? For example, if the physician describes the wound as red and starts antibiotics, or antibiotics are started but the physician really does not think it is an infection. 1/19/2006
  6. Should a patient that has an infection in the hip joint at the time of their replacement or revision be included in the denominator and would they be counted as an SSI ff they developed a post-op infection? 1/19/2006
  7. A patient has chronic hip infections, has a hip replacement and develops an infection. After treatment, the patient returns to the OR for revision and develops an infection with the same organism. Is this person counted twice in the denominator and twice for an infection? The patient appeared to have been completely treated, so wound class was designated as "clean". 1/19/2006
  8. Are laparoscopic hysterectomies reportable? 1/19/2006
  9. If a patient has an infection at the donor site for a CBGB procedure, is it reported in MHIRS? 6/9/2006

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