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Using ASEPSIS and National Nosocomial Infections Surveillance Risk Index in the Assessment of Surgical Site Infections After Cardiac Surgery Among Jordanian Patients

Hassan Al-Wahsh, Zeinab M. RN, PhD*; Wahsheh, Moayad A. PhD

Infectious Diseases in Clinical Practice: March 2011 - Volume 19 - Issue 2 - p 99-104
doi: 10.1097/IPC.0b013e3181f744cf
Original Articles

Background: Surgical site infections (SSIs) after cardiac surgery are associated with high mortality and morbidity rates. The objectives of this study were to identify the relationships between (1) the risk of SSIs (ie, 0, 1, 2, and 3) and the level of SSIs (ie, superficial or deep), (2) the level of SSIs and the severity of SSIs (ie, satisfactory healing, disturbance of healing, minor wound infection, moderate wound infection, and severe wound infections), and (3) patient variables (eg, age and sex) and the severity of SSIs.

Sample: Three hundred sixty-three people who underwent cardiac surgery over a 15-month period from April 2008 to July 2009 were included in the study.

Tools: The ASEPSIS and National Nosocomial Infections Surveillance assessment tools were used in the data collection.

Results: Surgical site infections were present in 11% (40/363). Risk index scores of 0, 1, and 2 were associated with superficial SSIs in 25 of 40 patients; and risk index scores of 2 and 3 were associated with a risk of deep SSIs in 15 of 40 patients. In contrast, superficial SSIs were found in 15 of 40 patients when the ASEPSIS score ranged between 21 and 30; deep SSIs (25/40) were found when the ASEPSIS score ranged between 31 and 70. Significant relationships were found between SSIs and patient variables (ie, smoking, diabetes, and hypertension).

Conclusions: Identification of modifiable risk factors for SSIs can serve as baseline data for health care workers to develop interventions that would enhance positive outcomes after cardiac surgeries.

From the *School of Nursing and †Faculty of Physical Education and Sport Sciences, Hashemite University, Zarqa, Jordan.

Correspondence to: Zeinab M. Hassan, RN, PhD, PO Box 150459, Zarqa 13115, Jordan. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2011 Lippincott Williams & Wilkins, Inc.