Summary
Background
The effect of hospital participation in the Japan Nosocomial Infection Surveillance
(JANIS) programme on surgical site infection (SSI) prevention is unknown.
Aim
To determine if participation in the JANIS programme improved hospital performance
in SSI prevention.
Methods
This retrospective before–after study analysed Japanese acute care hospitals that
joined the SSI component of the JANIS programme in 2013 or 2014. The study participants
comprised patients who had undergone surgeries targeted for SSI surveillance at JANIS
hospitals between 2012 and 2017. Exposure was defined as the receipt of an annual
feedback report 1 year after participation in the JANIS programme. The changes in
standardized infection ratio (SIR) from 1 year before to 3 years after exposure were
calculated for 12 operative procedures: appendectomy, liver resection, cardiac surgery,
cholecystectomy, colon surgery, caesarean section, spinal fusion, open reduction of
long bone fracture, distal gastrectomy, total gastrectomy, rectal surgery, and small
bowel surgery. Logistic regression models were used to analyse the association of
each post-exposure year with the occurrence of SSI.
Findings
In total, 157,343 surgeries at 319 hospitals were analysed. SIR values declined after
participation in the JANIS programme for procedures such as liver resection and cardiac
surgery. Participation in the JANIS programme was significantly associated with reduced
SIR for several procedures, especially after 3 years. The odds ratios in the third
post-exposure year (reference: pre-exposure year) were 0.86 [95% confidence interval
(CI) 0.79–0.84] for colon surgery, 0.72 (95% CI 0.56–0.92) for distal gastrectomy,
and 0.77 (95% CI 0.59–0.99) for total gastrectomy.
Conclusion
Participation in the JANIS programme was associated with improved SSI prevention performance
in several procedures in Japanese hospitals after 3 years.
Keywords
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Article info
Publication history
Published online: May 02, 2023
Accepted:
February 18,
2023
Received:
November 4,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
