Implementation of the World Health Organization checklist and debriefing improves accuracy of surgical wound class documentation.

Abstract

BACKGROUND:

Surgical wound classification (SWC) is a component of surgical site infection risk stratification. Studies have demonstrated that SWC is often incorrectly documented. This study examines the accuracy of SWC after implementation of a multifaceted plan targeted at accurate documentation.

METHODS:

A reviewer examined operative notes of 8 pediatric operations and determined SWC for each case. This SWC was compared with nurse-documented SWC. Percent agreement pre- and postintervention was compared. Analysis was performed using chi-square and a P value less than .05 was significant.

RESULTS:

Preintervention concordance was 58% (112/191) and postintervention was 83% (163/199, P = .001). Appendectomy accuracy was 28% and increased to 80% (P = .0005). Fundoplication accuracy increased from 44% to 84% (P = .016) and gastrostomy tube from 56% to 100% (P = .0002). The most accurate operation preintervention was pyloromyotomy and postintervention was gastrostomy tube and inguinal hernia. The least accurate pre- and postintervention was cholecystectomy.

CONCLUSION:

Implementation of a multifaceted approach improved accuracy of documented SWC.

• Authors: Deidre L Wyrick, Samuel D Smith, Melvin S Dassinger
• Journal: American journal of surgery (Am J Surg) Vol. 210 Issue 6 Pg. 1051-4; discussion 1054-5 (Dec 2015) ISSN: 1879-1883 [Electronic] United States
• PMID: 26460055 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Topics

• Checklist
• Child
• Documentation (standards)
• Humans
• Quality Improvement
• Surgical Procedures, Operative (standards)
• Surgical Wound Infection (classification)
• World Health Organization