Browsing by Author "Bartsch, Nicole"

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    Predicting a surgical site hospital acquired infection : a case study
    (Stellenbosch : Stellenbosch University, 2020-03) Bartsch, Nicole; Nieuwoudt, Isabelle; Stellenbosch University. Faculty of Economic and Management Sciences. Dept. of Logistics. Logistics.
    ENGLISH SUMMARY : In this study a logistic regression model for a private healthcare group, was used to determine the predicted number of Surgical Site Infections (SSIs) of an operative procedure at a healthcare facility. The purpose of this study is to determine the Standard Infection Ratio (SIR) which compares the actual number of SSIs that were contracted by patients at a hospital against the number of SSIs predicted. A SIR of above 1 is regarded as a bad result as the model predicted less infections to occur at a hospital than the actual number of infections that did occur. A SIR of below 1 is an ideal and good result that hospitals should aspire to achieve. The SIR is calculated across three hospitals, across three years (2016, 2017 and 2018) and across ve operative procedure groups (HYST, SB, BILI, CARD and KPRO). Speci c signi cant risk variables were taken into account per operative procedure group. These variables ranged from whether the patient was a diabetic or not, the age of the patient, which hospital the patient was admitted to, the BMI of the patient and the ASA score of the patient. Since the American Society of Anesthesiologists Classi cation (ASA) score is not captured electronically per patient, a logic was developed to determine the ASA score of a patient based on their clinical coding information and level of care they received. The logistic regression model was developed per operative procedure group and determines the probability of a patient contracting an SSI. A Hosmer-Lemmeshow goodness of t test was conducted to compare the actual events against the predicted events across 10 subgroups of the model's population. Finally, the SIR was calculated by dividing the actual number of SSIs by the predicted number of SSIs at a hospital. There is a clear di erence in the SIR results across the three hospitals that were considered, over the three years being analysed. Hospital A needs to focus on the operative procedure group CARD and Hospital B needs to focus on all ve operative procedures except for the operative procedure group SB where they scored an SIR of below 1. Hospital C achieved exceptional SIR results with all operative procedure groups across all three years having an SIR result of below 1. Both Hospital A and Hospital B need to improve the infection prevention and control practices at their hospitals as well as schedule interventions to decrease the number of SSIs occurring at their hospitals.