Sequential analysis of uncommon adverse outcomes
| Autor: | David Looke, Anthony Morton, Mary Waterhouse, Stefan H. Steiner, Kerrie Mengersen |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Microbiology (medical)
Infection Control Funnel plot medicine.medical_specialty Quality Assurance Health Care Adverse outcomes business.industry Surgical wound General Medicine Audit Evidence-based medicine Biostatistics After discharge Infectious Diseases Data presentation Humans Surgical Wound Infection Medicine Statistical analysis business Intensive care medicine |
| Zdroj: | Journal of Hospital Infection. 76:114-118 |
| ISSN: | 0195-6701 |
| Popis: | Summary Sequential analysis of uncommon adverse outcomes (AEs) such as surgical site infections (SSIs) is desirable. Short postoperative lengths of stay (LOS) result in many SSIs occurring after discharge and they are often superficial. Deep and organ space (complex) SSIs occur less frequently but are detected more reliably and are suitable for monitoring wound care. Those occurring post-discharge usually require readmissison and can be counted accurately. Sequential analysis of meticillin-resistant Staphylococcus aureus bacteraemia is also needed. The key to prevention is to implement systems based on evidence, e.g. using ‘bundles' and checklists. Regular mortality and morbidity audit meetings are required and these may need to be followed by independent audits. Sequential statistical analysis is desirable for data presentation, to detect changes, and to discourage tampering with processes when occasional AEs occur in a reliable system. Tabulations and cumulative observed minus expected ( O − E ) charts and funnel plots are valuable, supplemented in the presence of apparent ‘runs' of AEs by cumulative sum analysis. Used prospectively, they may enable staff to visualise and detect patterns or shifts in rates and counts that might not otherwise be apparent. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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