RETROSPECTIVE OR CLUE-BASED SURVEILLANCE? WHAT IS THE IMPACT ON THE NOTIFICATION OF SURGICAL SITE INFECTIONS IN CARDIAC SURGERIES1 1 Article extracted from the thesis - Determinant factors of the surgical site infection in patients undergoing revascularization of the myocardium and heart valve implants, presented to the Postgraduate Program in Nursing, Universidade Federal de Minas Gerais (UFMG), in 2017.

Nelma de Jesus Braz Silma de Souza Evangelista Síntia de Souza Evangelista Juliana Ladeira Garbaccio Adriana Cristina de Oliveira About the authors

ABSTRACT

Objective:

to assess the impact of surgical site infections reported by clue-based surveillance compared to those detected by the retrospective assessment of the patient’s medical record.

Method:

epidemiological study and reflection conducted in a large, public, university hospital.

Results:

the data collection was carried out through register of notifications by clues, performed by the infection control commission and analysis of the medical records of patients submitted to cardiac surgeries between 2011 and 2014. The diagnosis of surgical site infection followed the criteria defined by the National Healthcare Surveillance Network of the Centers Disease Control. The data were analyzed in the Epi-info® 6.4program, through descriptive statistics. A total of 294 patients undergoing cardiac surgeries were analyzed by clue-based surveillance and 195 by the review of medical records. 17 (65.9%) superficial surgical site infections were reported; one that was deep (3.8%); eight (30,8%) of organ/cavity in clue-based monitoring; 25 (69,4%) superficial incisors; two (5,6%) deep ones, and nine (25%) of organ/cavity in the review of the medical records. The impact of surveillance by medical records was 38.4% (36/26) in relation to the clue-based monitoring.

Conclusion:

the surveillance by medical records, despite its acknowledged limitation, contributed in an important way to know, in fact, the rates of infection of the surgical site. It is suggested to the services of investigation of infections of the surgical site that the methods adopted for surveillance are rethought and, above all, that the rates obtained from different possible perspectives are validated.

DESCRIPTORS:
Surgical wound infection; Epidemiological surveillance; Epidemiological surveillance services; Nursing

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