Becker's Clinical Quality & Infection Control

50 QUALITY IMPROVEMENT & MEASUREMENT Increase in BMI linked to higher risk of surgical site infection By Anuja Vaidya A n increase in body mass in- dex increases the likelihood of developing surgical site infections, according to a study pub- lished in Infection Control & Hospital Epidemiology. Researchers gathered 2012–2017 data from a Dutch national surveil- lance network on frequently per- formed surgical procedures across specialties. ey divided 387,919 patients into five categories: • Underweight (BMI is less than 18.5 kg/m 2 ): 3,676 patients • Normal weight (BMI is between 18.5 and 25 kg/m 2 ): 116,778 • Overweight (BMI is between 25 and 30 kg/m 2 ): 154,339 • Obese (BMI is between 30 and 40 kg/m 2 ): 104,288 • Morbidly obese (BMI is more than 40 kg/m 2 ): 8,838 Researchers found that when BMI increased from normal to morbidly obese, there was an increase in the risk of developing surgical site in- fections in almost all surgery types. "The results of our research provide evidence for the need of preventive programs targeting SSI in overweight and obese patients, as well as for the prevention of obesity in the general population," study authors concluded. n How an Indiana clinic is beating the odds on patient-care stats By Anne-Marie Kommers G oshen, Ind.-based Maple City Health Care Center boasts patient-care metrics that are astronomically higher than those of many other fed- erally funded clinics throughout the state and the nation, according to Kaiser Health News. Eighty-four percent of Maple City's patients are fully vaccinated by age 2, for ex- ample, compared to the federal goal of 80 percent and the Indiana state average of 27 percent. The clinic has seen similar success with several other metrics, such as adult screenings for colon cancer and depression. Maple City is performing significantly better than other federally qualified health centers or community-based clinics in underserved areas that serve all patients regardless of ability to pay. The clinic's success is largely due to trust-based relationships with patients, James Gingerich, MD, Maple City's founder, told Kaiser Health News. Maple City earns that trust partly by listening carefully, which Dr. Gingerich called one of the most important aspects of primary care. The health center structures providers' days to make them as available as possible for patients and offers affordable care, charging as little as $5 for a prescription, made possible by federal funding. n Sepsis readmissions decrease with home nursing visits, physician follow-up By Anne-Marie Kommers S epsis survivors are less likely to be readmitted to the hospital if they are pro- vided with a combination of home nursing care and early physician follow-up after discharge, according to a study published in Medical Care. To conduct the study, researchers examined 30-day all-cause hospital readmis- sions for 170,571 sepsis patients, which they collected from Medicare administra- tive and claim files and the home health Outcome and Assessment Information Set. They evaluated which patients received early home health nursing, defined as one visit within two days and another visit within a week of hospital discharge, and which patients received early physician follow-up, defined as one outpatient visit in the first week following discharge. Neither protocol had a significant effect on readmission rates alone, but the two of them together reduced the likelihood that patients would be readmitted to the hospital within 30 days by seven percentage points. "Our study revealed much room for improvement, as only 28.1 percent of sepsis survivors transitioned to HHC received this intervention," said Kathryn Bowles, PhD, a co-author on the study and professor of nursing at the Philadelphia-based University of Pennsylvania School of Nursing. n

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