Sequential analysis of uncommon adverse outcomes

Morton, A., Mengersen, K., Waterhouse, M., Steiner, S. and Looke, D. (2010) Sequential analysis of uncommon adverse outcomes. Journal of Hospital Infection, 76 2: 114-118. doi:10.1016/j.jhin.2010.04.022

Author Morton, A.
Mengersen, K.
Waterhouse, M.
Steiner, S.
Looke, D.
Title Sequential analysis of uncommon adverse outcomes
Journal name Journal of Hospital Infection   Check publisher's open access policy
ISSN 0195-6701
Publication date 2010-10-01
Sub-type Article (original research)
DOI 10.1016/j.jhin.2010.04.022
Volume 76
Issue 2
Start page 114
End page 118
Total pages 5
Place of publication London United Kingdom
Publisher WB Saunders Co.
Language eng
Formatted abstract
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.
Keyword Uncommon adverse events
Complex surgical site infections
MRSA bacteraemias
Statistical process control
Evidence-based systems
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 5 times in Scopus Article | Citations
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