Surgical Site Infection Improvement Programme

This manual provides guidance for implementing and delivering the national cardiac surgery Surgical Site Infection Improvement Programme (SSIIP) in New Zealand. The programme will enable standardisation of data, which can be analysed and reported both locally and nationally.

The intended audiences are: infection prevention and control (IPC) specialists, clinical microbiologists and infectious disease physicians, quality teams, nurses, anaesthetists and surgeons, and all of those involved in the SSIIP at a local level. A multidisciplinary approach is essential so the programme has the appropriate expertise

Please use the SSII Programme orthopaedic and cardiac data collection forms to record your data before entering it into the SSII Programme database.

The additional antibiotic microbiology form can be used for orthopaedic and cardiac surgery

Form 1: SSIP: Additional Antibotics Microbiology form (November 2018) [DOCX, 213 KB]

Form 2: SSIIP: Cardiac Data Collection (July 2019)  [DOCX, 222 KB]

Form 3: SSIIP: Orthopaedic Data Collection  (November 2018)   [DOCX, 220 KB]

This document was produced to encourage health care professionals to use skin antisepsis preparation more effectively to improve the safety and quality of care that patients receive.

Preoperative skin antisepsis is a simple and effective measure to reduce the risk of surgical site infections (Maiwald, 2012). The primary source of organisms contributing to infection following surgery is the bacteria on a patient’s skin. The aim of skin antisepsis is to eliminate and rapidly kill skin flora at the site of a planned surgical incision (Safer Healthcare Now, 2011).  

This guide provides guidance for the implementation and delivery of the national Surgical Site Infection Improvement Programme (SSIIP) for orthopaedic surgery in New Zealand.

The intended audiences are: infection prevention and control (IPC) specialists, clinical microbiologists and infectious disease physicians, quality teams, nurses, anaesthetists and surgeons, and all of those involved in the SSIIP at a local level. A multidisciplinary approach is essential to ensure the programme has the appropriate expertise.

The orthopaedic monitoring tool (VLAD report) is a tool to track orthopaedic surgical site infections (SSI) in your region. It is updated quarterly.

The report, consisting of a VLAD chart and a coloured infection risk status box, compliments other HQSC orthopaedic surgical site infection (SSI) reports. It is used to help the early identification of an increase in the risk of infections so that timely intervention can occur.

A more detailed description and explanation of the report is provided on login. The learning resource below also provides an overview of how this report can assist region's monitor orthopaedic SSI.

Introduction: SSI Investigation Tool [DOCX, 143 KB]

Attachment 1: SSI - Investigation Summary [XLSX, 25 KB]

Attachment 2: SSI-tool (print version) [PDF, 182 KB] 

Attachment 3: SSI tool (word print version)  [DOCX, 92 KB]

Attachment 4: SSI tool (electronic version) [DOCX, 106 KB]

This document outlines the process for undertaking ‘light surveillance’ for the orthopaedic SSIIP. It supplements the Orthopaedic surgery implementation manual.

Contact the Infection Prevention and Control Team at SSIIP@TeWhatuOra.govt.nz if you would like to discuss changing to light surveillance.

The IPC team can support you with the transition and determine the start date for your organisation.

A guide to implementing light surveillance [DOCX, 410 KB]

A guide to implementing light surveillance [PDF, 288 KB]

Joint replacements greatly improve quality of life. While subsequent prosthetic joint infection (PJI) is uncommon it can have a significant impact for the patient.

The accurate diagnosis of PJI is essential to ensure the best antibiotic treatment and surgical management of the patient. Because a significant proportion of PJIs are caused by common skin organisms, multiple samples are needed to allow reliable interpretation of culture results.

This sampling and culture guide provides advice on: • the type of samples to collect

• the number of samples to collect
• sample collection
• timing of surgical antibiotic prophylaxis with respect to tissue sampling
• culture approaches
• relevance of Propionibacterium acnes for shoulder PJI. 

The guide should improve the consistency of approach to diagnosing prosthetic joint infections.

Ngā pūtiki Anti-staph

Anti-staphyloccocal bundle to reduce SSI

Staphylococcus aureus is the most common cause of surgical site infections both in New Zealand and globally. It accounts for about 30 percent of orthopaedic SSIs identified in patients in New Zealand hospitals. To reduce the occurrence of Staphylococcus aureus surgical site infections, the Health Quality and Safety Commission developed an anti-staphyloccocal bundle.

A discussion paper regarding the evidence and proposed bundle of preoperative interventions to reduce Staphylococcus aureus surgical site infections was sent out to health sector stakeholders in late 2016.

Below is the feedback summary of this discussion paper, along with the recommended bundle and implementation plan.

This document has been developed as a guide for SSIIP champions to review and correct SSIIP data in National Monitor (the data entry platform for the Health Quality & Safety Commission’s surveillance).

Data should be reviewed for errors monthly and prior to the publication of national SSIIP reports.

For further assistance with reviewing and correcting data contact SSIIP@TeWhatuOra.govt.nz or ICNetSupport@cdhb.health.nz

This document provides answers to questions frequently raised about SSIP reporting

A printable brochure for patients and families/whānau on what surgical site infections are and how they can help prevent them. 

The following FAQs supplement the information on the ‘Overview’ and ‘Technical notes’ sections of the Methodology page in the VLAD report.