Health Care Quality Assessment

Often, patients get wound infections or blood clots during their stay in a hospital following surgery. Hospitals can reduce this risk by administering the proper medicines at the correct time on the same day of surgery.

Symptoms of a wound infection

Signs of possible infection after surgery can include: a surgical wound that is red, hot and swollen; a fever of over 100 degrees following hospital discharge; a smelly or yellow/green fluid oozing out of the wound; or increased pain while taking pain medication.

The measures listed below represent the best practices for the prevention of infections and blood clots after selected surgeries (e.g., colon surgery, hip and knee arthroplasty, abdominal and vaginal hysterectomy, cardiac surgery and vascular surgery).

These scores show how well hospitals are providing their surgery patients with care to prevent infections and blood clots. Patients with contraindications, those at higher risk of experiencing complications to any of the recommended treatments are excluded from the scores for that treatment. Higher percentages indicate better performance. The goal is to reach 100%.

Preventive Antibiotic Started 1 Hour Before Surgery

• THIS SCORE TELLS YOU the percent of eligible patients who received prophylactic or preventive antibiotics within one hour prior to surgical incision.
  
  
• THIS INFORMATION IS IMPORTANT because surgery patients given antibiotics, medicines that prevent and treat infections, within the hour before their operation are less likely to get wound infections. Getting an antibiotic over an hour earlier or after surgery begins is not as effective.

Preventive Antibiotic Stopped Within 24 Hours

• THIS SCORE TELLS YOU the percent of eligible surgical patients whose prophylactic or preventive antibiotics were stopped within 24 hours after surgery ended (or 48 hours after Coronary Artery Bypass Graft or other cardiac surgery). Antibiotics are medicines that prevent and treat infections.
  
  
• THIS INFORMATION IS IMPORTANT because taking antibiotics for more than 24 hours after routine surgery is usually not necessary and can increase the risk of side effects, such as stomach aches, serious types of diarrhea, and resistance to the antibiotic (the use of too much antibiotic can prevent them from being effective). There are, however, exceptions. If the surgical site has been contaminated, there may be a need for additional antibiotics after 24 hours. Talk to your doctor to determine how long you should take antibiotics after surgery.

Appropriate Antibiotic Received

• THIS SCORE TELLS YOU the percent of surgery patients who received the appropriate preventive antibiotic(s) for their surgery in order to prevent a surgical wound infection.
  
  
• THIS INFORMATION IS IMPORTANT because certain antibiotics are recommended to help prevent wound infection for particular types of surgery. Hospitals can reduce the risk of wound infection after surgery by making sure the patient gets the right medication at the right time on the day of their surgery.

Urinary Catheter Removal

• THIS SCORE TELLS YOU the percent of surgery patients who had a urinary catheter removed on the first or second day after surgery
  
  
• THIS INFORMATION IS IMPORTANT because medical research has shown that the longer a catheter is in place, the greater the risk of the patient getting an urinary tract infection (UTI). This measure excludes patients who had a urological, gynecological or perineal procedure.

Treatment Preventing Blood Clots (VTEs) Received

• THIS SCORE TELLS YOU the percent of patients who received the appropriate treatment to prevent blood clots called venous thromboembolism (VTE) at the right time.
  
  
• THIS INFORMATION IS IMPORTANT because venous thrombosis is a condition in which blood clots (thrombus) form in the vein, usually in the leg, thigh or pelvis, and may limit blood flow, causing swelling, redness and pain. If the clot breaks off, it can lodge itself in the lungs, causing a pulmonary embolism, which can lead to death. Doctors can order preventive treatments to reduce the risk. These treatments may include blood thinning medications, elastic support stockings, or mechanical air stockings that promote blood circulation.

Controlled Blood Sugar for Heart Surgery Patients

• THIS SCORE TELLS YOU the percent of all heart surgery patients whose blood sugar (blood glucose) is kept under good control in the days right after surgery.
  
  
• THIS INFORMATION IS IMPORTANT because all heart surgery patients get their blood sugar checked after surgery. Any patient who has high blood sugar after heart surgery has a greater chance of getting an infection.

Beta Blocker Continued Before and After Surgery

• THIS SCORE TELLS YOU the percent of surgery patients who were taking heart drugs called beta blockers before coming to the hospital and were kept on the beta blockers during the period just before and after their surgery (the perioperative period).
  
  
• THIS INFORMATION IS IMPORTANT because when heart patients who take beta blockers suddenly stop taking them, they can experience heart problems. Although it is standard procedure to stop patients medications before and after their surgery, staying on beta blockers before and after surgery makes it less likely for problems to occur.

  Beta blockers are medicines that lower blood pressure, treat chest pain (angina) and heart failure, and help prevent heart attacks.