[{"data":1,"prerenderedAt":9990},["ShallowReactive",2],{"commonen":3,"sb-page-en-resources/topics/hospital-harm":268,"sb-collection-cat-en-resources-1-9-{\"topics\":{\"in\":\"ebc0404e-2d82-4308-adf1-89c1a06750f5\"}}":327},{"globals":-1,"resourcesCategories":4},["Reactive",5],{"topics":6,"audience":113,"type":163,"regional":183,"programType":206,"format":228,"eventType":229,"updateType":244,"employeeTagType":259},[7,17,24,31,38,45,54,61,68,75,83,90,97,105],{"id":8,"slug":9,"title":10,"tooltip":11,"shortName":16},"ebc0404e-2d82-4308-adf1-89c1a06750f5","hospital-harm","Hospital harm",{"type":12,"content":13},"doc",[14],{"type":15},"paragraph","",{"id":18,"slug":19,"title":20,"tooltip":21,"shortName":16},"fda74309-2934-4763-91d0-623be56f6dae","pandemic-response","Pandemic response",{"type":12,"content":22},[23],{"type":15},{"id":25,"slug":26,"title":27,"tooltip":28,"shortName":16},"731ba20c-b343-4fbd-b412-da5f433c3cc3","technology","Technology",{"type":12,"content":29},[30],{"type":15},{"id":32,"slug":33,"title":34,"tooltip":35,"shortName":16},"7c337fd8-a1db-4958-82bb-1c161491e0af","patient-engagement","Patient engagement",{"type":12,"content":36},[37],{"type":15},{"id":39,"slug":40,"title":41,"tooltip":42,"shortName":16},"ee3eb162-d375-4435-a721-cef65b6ca9d9","policy","Policy",{"type":12,"content":43},[44],{"type":15},{"id":46,"slug":47,"title":48,"tooltip":49,"shortName":16},"f3a1127a-c8bd-4c8f-9897-ea26dd756bdd","health-equity","Health equity",{"type":12,"content":50},[51],{"type":15,"attrs":52},{"textAlign":53},null,{"id":55,"slug":56,"title":57,"tooltip":58,"shortName":16},"03da87c9-81bf-43ed-842d-70d46135a3f7","value-based-care","Value-based care",{"type":12,"content":59},[60],{"type":15},{"id":62,"slug":63,"title":64,"tooltip":65,"shortName":16},"f6d48d07-4fff-4746-a299-309770762992","first-nations-inuit-and-metis-priorities","First Nations, Inuit and Métis priorities",{"type":12,"content":66},[67],{"type":15},{"id":69,"slug":70,"title":71,"tooltip":72,"shortName":16},"c3aff865-c637-4fb2-98b8-226312d9123a","aging-in-place","Aging in place",{"type":12,"content":73},[74],{"type":15},{"id":76,"slug":77,"title":78,"tooltip":79,"shortName":16},"29f68b94-07a1-481f-8b76-8d6863f16566","patient-safety","Patient safety",{"type":12,"content":80},[81],{"type":15,"attrs":82},{"textAlign":53},{"id":84,"slug":85,"title":86,"tooltip":87,"shortName":16},"e25206d8-8359-493f-b7b3-9c997a6f9d9b","health-workforce","Health workforce",{"type":12,"content":88},[89],{"type":15},{"id":91,"slug":92,"title":93,"tooltip":94,"shortName":16},"a7155a6b-90f8-4226-94c3-c578d1471a52","cultural-safety","Cultural Safety",{"type":12,"content":95},[96],{"type":15},{"id":98,"slug":99,"title":100,"tooltip":101,"shortName":16},"c2209086-26d0-49e0-b219-9729e6dffc22","primary-and-community-care","Primary and community care",{"type":12,"content":102},[103],{"type":15,"attrs":104},{"textAlign":53},{"id":106,"slug":107,"title":108,"tooltip":109,"shortName":16},"dfe12160-9f94-4cc2-99ef-30773d0829d5","long-term-care","Long-term care",{"type":12,"content":110},[111],{"type":15,"attrs":112},{"textAlign":53},[114,121,128,135,142,149,156],{"id":115,"slug":116,"title":117,"tooltip":118,"shortName":16},"000cf75f-2e05-4bd3-a9b7-4bf20c5e6fc5","community-organization","Community organization",{"type":12,"content":119},[120],{"type":15},{"id":122,"slug":123,"title":124,"tooltip":125,"shortName":16},"0e05a490-d9f0-4cf7-8cc9-216d6554989c","people-with-lived-living-experience","Person with lived/living experience",{"type":12,"content":126},[127],{"type":15},{"id":129,"slug":130,"title":131,"tooltip":132,"shortName":16},"2cf95539-4f34-458d-a047-56c9dc2da53d","point-of-care-provider","Point of care provider",{"type":12,"content":133},[134],{"type":15},{"id":136,"slug":137,"title":138,"tooltip":139,"shortName":16},"86f97179-4380-431e-ab06-2706b1c8f2d9","policy-advisor-or-analyst","Policy advisor or analyst",{"type":12,"content":140},[141],{"type":15},{"id":143,"slug":144,"title":145,"tooltip":146,"shortName":16},"e38cf314-1f29-478d-9c26-4ca1006f5812","healthcare-leader","Healthcare leader",{"type":12,"content":147},[148],{"type":15},{"id":150,"slug":151,"title":152,"tooltip":153,"shortName":16},"ec852192-bb35-42bf-93be-705d65c56c76","quality-or-safety-improvement-lead","Quality or safety improvement lead",{"type":12,"content":154},[155],{"type":15},{"id":157,"slug":158,"title":159,"tooltip":160,"shortName":16},"a3f7559a-74e8-43da-9690-29616f5bf0f3","student","Student",{"type":12,"content":161},[162],{"type":15},[164,169,173,178],{"id":165,"slug":166,"title":167,"tooltip":16,"shortName":168},"cddd560c-81d2-4865-adb6-cc04420aa8fb","on-demand-webinars","On-demand webinars ","Webinars",{"id":170,"slug":171,"title":172,"tooltip":16,"shortName":16},"ef367cb8-3b7d-401d-ad2d-c7c24e9772d0","reports","Reports",{"id":174,"slug":175,"title":176,"tooltip":16,"shortName":177},"4f42dc6d-7f83-4f7a-ac0f-76b7fe7d2b25","guides-toolkits-frameworks","Guides, Toolkits & Frameworks","Guides & Toolkit",{"id":179,"slug":180,"title":181,"tooltip":16,"shortName":182},"e1d5bd1d-21e3-4a2a-9166-c95f4fd1487b","case-studies-and-promising-practices","Case Studies and Promising Practices","Case study",[184,191,199],{"id":185,"slug":186,"title":187,"tooltip":188,"shortName":16},"f3c3ffc4-e42b-4629-be78-8d554a3c6a60","remote","Remote",{"type":12,"content":189},[190],{"type":15},{"id":192,"slug":193,"title":194,"tooltip":195,"shortName":16},"6cc8c6b3-906d-43fb-8d14-bcad45583ebc","rural","Rural",{"type":12,"content":196},[197],{"type":15,"attrs":198},{"textAlign":53},{"id":200,"slug":201,"title":202,"tooltip":203,"shortName":16},"12a19edc-d1fe-46aa-b247-cad08621fcdb","urban","Urban",{"type":12,"content":204},[205],{"type":15},[207,214,221],{"id":208,"slug":209,"title":210,"tooltip":211,"shortName":16},"cdb22f45-79d9-443c-9fd6-327b5d57f43e","patient-partnerships-and-engagement","Patient Partnerships and Engagement",{"type":12,"content":212},[213],{"type":15},{"id":215,"slug":216,"title":217,"tooltip":218,"shortName":16},"00e891cd-7805-487f-a0a5-e135d6c451ea","e-learning","E-learning ",{"type":12,"content":219},[220],{"type":15},{"id":222,"slug":223,"title":224,"tooltip":225,"shortName":16},"49246508-5dd9-40ec-9512-7f4f0817f014","facilitated-programs","Facilitated Programs",{"type":12,"content":226},[227],{"type":15},[],[230,237],{"id":231,"slug":232,"title":233,"tooltip":234,"shortName":16},"b847d999-38e0-47c9-9e04-4cae376493bc","webinar","Webinar",{"type":12,"content":235},[236],{"type":15},{"id":238,"slug":239,"title":240,"tooltip":241,"shortName":16},"89b73ff0-cea7-4362-a6a3-69e9c371890f","events","Events",{"type":12,"content":242},[243],{"type":15},[245,252],{"id":246,"slug":247,"title":248,"tooltip":249,"shortName":16},"b662c26e-fd41-473b-a2fd-ba25f2369050","blogs","Blogs",{"type":12,"content":250},[251],{"type":15},{"id":253,"slug":254,"title":255,"tooltip":256,"shortName":16},"c9fe4371-04c1-4ee9-85b0-0de39efae772","news","News",{"type":12,"content":257},[258],{"type":15},[260,264],{"id":261,"slug":262,"title":263,"tooltip":16,"shortName":16},"64559fec-0310-4102-8ffa-cb7d93e907dc","vice-chair","Vice-Chair",{"id":265,"slug":266,"title":267,"tooltip":16,"shortName":16},"28ee14ad-994e-48cc-98e6-c61456328689","chair","Chair",{"story":269,"cv":316,"rels":317,"links":318,"assets":319},{"name":270,"created_at":271,"published_at":272,"updated_at":273,"id":274,"uuid":275,"content":276,"slug":9,"full_slug":303,"sort_by_date":53,"position":304,"tag_list":305,"is_startpage":286,"parent_id":306,"meta_data":53,"group_id":307,"first_published_at":308,"release_id":53,"lang":309,"path":53,"alternates":310,"default_full_slug":303,"translated_slugs":311},"Hospital Harm","2026-02-21T02:04:35.291Z","2026-03-10T16:07:33.920Z","2026-03-10T16:07:33.965Z",147250689243354,"e810da59-1dac-470d-a9fa-5791fc96027f",{"seo":16,"_uid":277,"hero":278,"type":16,"topic":8,"Noindex":301,"component":302},"f2307644-d5f1-4535-afd6-2d6fb676aa13",[279],{"_uid":280,"image":281,"title":270,"component":287,"description":288},"74a90013-9a07-4340-babd-c6b0fccf4f55",{"id":282,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":283,"copyright":16,"fieldtype":284,"meta_data":285,"is_external_url":286},139012135884161,"https://a-ca.storyblok.com/f/850807391887861/1543x1027/46c7e6c48c/shapes-2.webp","asset",{},false,"hero-level-2",{"type":12,"content":289},[290],{"type":15,"attrs":291,"content":292},{"textAlign":53},[293],{"text":294,"type":295,"marks":296},"Healthcare Excellence Canada has developed Hospital Harm Improvement Resources – a compilation of resources to support patient safety and improvement efforts.","text",[297],{"type":298,"attrs":299},"textStyle",{"color":300},"#000000",true,"hec-page-resource-hub-cat","resources/topics/hospital-harm",-150,[],109647067522966,"06cbc3d6-eb77-4af4-b474-c9dfb0307c3f","2026-03-10T16:03:42.230Z","default",[],[312],{"path":313,"name":314,"lang":315,"published":301},"ressources/sujets/prejudices-a-l-hopital","Préjudices à l’hôpital","fr",1776087000,[],[],[320],{"id":282,"alt":16,"content_length":321,"content_type":322,"copyright":16,"created_at":323,"deleted_at":53,"focus":16,"is_private":286,"title":16,"updated_at":324,"s3_filename":325,"meta_data":326},22174,"image/webp","2026-01-28T19:21:49.733Z","2026-01-28T19:21:50.335Z","f/850807391887861/1543x1027/46c7e6c48c/shapes-2.webp",{},{"stories":328,"total":9989},[329,679,1756,3557,4166,4863,6286,7679,8459],{"name":330,"created_at":331,"published_at":332,"updated_at":333,"id":334,"uuid":335,"content":336,"slug":663,"full_slug":664,"sort_by_date":53,"position":665,"tag_list":666,"is_startpage":286,"parent_id":667,"meta_data":668,"group_id":672,"first_published_at":673,"release_id":53,"lang":309,"path":53,"alternates":674,"default_full_slug":664,"translated_slugs":675},"Hospital harm is everyone’s concern","2025-11-26T23:54:23.590Z","2026-03-10T16:41:35.329Z","2026-03-10T16:41:35.368Z",116783774126329,"3b0b67e4-3791-4e2d-9008-4c21c4bdf065",{"new":286,"seo":337,"_uid":341,"hero":342,"type":174,"topics":353,"Noindex":286,"content":354,"audience":660,"duration":16,"regional":661,"component":662},{"title":338,"plugin":339,"description":340},"Hospital harm is everyone's concern","seo_metatags","The latest data from the Canadian Institute for Health Information (CIHI) tell an important story.","8e624ebf-eb4e-4bea-9f7e-81b5bd89d027",[343],{"_uid":344,"file":345,"image":346,"title":330,"format":16,"component":351,"description":352,"key_learning":16,"prerequisite":16},"59878162-b570-4be5-8e41-efed207adfe5",[],{"id":347,"alt":348,"name":16,"focus":16,"title":348,"source":16,"filename":349,"copyright":16,"fieldtype":284,"meta_data":350,"is_external_url":286},114297456569708,"General Image Three","https://a-ca.storyblok.com/f/850807391887861/084049412e/general-image-three.jpg",{},"hero-resource","The latest data from the Canadian Institute for Health Information (CIHI) tell an important story",[76,8],[355,634],{"_uid":356,"content":357,"component":633},"f9e12454-174d-45b0-81a8-1fb83aa01d8c",[358],{"_uid":359,"content":360,"component":632},"f9f65de1-3b96-4100-ba75-0256bb4e5ab9",{"type":12,"content":361},[362,378,390,403,405,412,424,429,434,480,488,493,498,522,527,541,545,550,560,565,579,584,614,619],{"type":15,"attrs":363,"content":364},{"textAlign":53},[365,367,376],{"text":366,"type":295},"One in 17 hospital stays in 2024-25 involved unintended harm. Specifically, ",{"text":368,"type":295,"marks":369},"CIHI’s Hospital Harm measure ",[370],{"type":371,"attrs":372},"link",{"href":373,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://www.cihi.ca/en/hospital-harm-project","_blank","url",{"text":377,"type":295},"shows that the rate of potentially preventable harm to patients in Canadian hospitals remained at 6 per 100 hospitalizations, for the fifth year in a row. Prior to that the rate was stable at about 5.4 per 100 hospitalizations from 2014-2015 to 2019-2020.In one out of four cases when a patient experienced harm during their hospital stay, there was more than one harmful event.",{"type":15,"attrs":379,"content":380},{"textAlign":53},[381,383,388],{"text":382,"type":295},"The ",{"text":384,"type":295,"marks":385},"Hospital Harm Measure ",[386],{"type":371,"attrs":387},{"href":373,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"text":389,"type":295},"reflects hospitalizations with at least one occurrence of potentially preventable harm — harm that could be prevented with the use of known, evidence-based practices.",{"type":15,"attrs":391,"content":392},{"textAlign":53},[393,395],{"text":394,"type":295},"Explore the latest numbers on patient harm in CIHI's updated infographic: ",{"text":396,"type":295,"marks":397},"Patient harm in Canadian hospitals? It does happen.",[398,401],{"type":371,"attrs":399},{"href":400,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://www.cihi.ca/en/patient-harm-in-canadian-hospitals-it-does-happen",{"type":402},"italic",{"type":15,"attrs":404},{"textAlign":53},{"type":406,"attrs":407,"content":409},"heading",{"level":408,"textAlign":53},2,[410],{"text":411,"type":295},"Hospital Harm Measure",{"type":15,"attrs":413,"content":414},{"textAlign":53},[415,417,422],{"text":416,"type":295},"The collaboration between the ",{"text":418,"type":295,"marks":419},"Canadian Institute for Health Information (CIHI) ",[420],{"type":371,"attrs":421},{"href":373,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"text":423,"type":295},"and Healthcare Excellence Canada on hospital harm is aimed at answering the question, \"How often do patients experience harm in hospital?\"",{"type":15,"attrs":425,"content":426},{"textAlign":53},[427],{"text":428,"type":295},"This initiative uses administrative data to develop a patient safety measure for inpatient care.",{"type":15,"attrs":430,"content":431},{"textAlign":53},[432],{"text":433,"type":295},"There are three outputs from this collaboration.",{"type":435,"attrs":436,"content":438},"ordered_list",{"order":437},1,[439,449,468],{"type":440,"content":441},"list_item",[442],{"type":15,"attrs":443,"content":444},{"textAlign":53},[445],{"text":411,"type":295,"marks":446},[447],{"type":371,"attrs":448},{"href":373,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":450},[451],{"type":15,"attrs":452,"content":453},{"textAlign":53},[454],{"text":455,"type":295,"marks":456},"Hospital Harm Improvement Resource",[457],{"type":371,"attrs":458},{"href":459,"uuid":460,"anchor":53,"custom":461,"target":462,"linktype":463,"story":464},"/resources/hospital-harm-improvement-resource","2fa59e87-8ca2-4dcf-96b5-e7ee0bf5217f",{},"_self","story",{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},119563150823813,"hospital-harm-improvement-resource","resources/hospital-harm-improvement-resource",{"type":440,"content":469},[470],{"type":15,"attrs":471,"content":472},{"textAlign":53},[473],{"text":474,"type":295,"marks":475},"Analytical Report (PDF)",[476],{"type":371,"attrs":477},{"href":478,"uuid":53,"anchor":53,"custom":479,"target":374,"linktype":375},"https://www.cihi.ca/sites/default/files/document/measuring-patient-harm-in-canadian-hospitals-report-en.pdf?locale=en&pf=PFC3312",{},{"type":406,"attrs":481,"content":482},{"level":408,"textAlign":53},[483],{"text":484,"type":295,"marks":485},"What is the Hospital Harm Measure?",[486],{"type":487},"bold",{"type":15,"attrs":489,"content":490},{"textAlign":53},[491],{"text":492,"type":295},"Hospital harm captured by this indicator is defined as the rate of acute care hospitalizations with at least one occurrence of unintended harm during a hospital stay that could have been potentially prevented by implementing known evidence-informed practices. While not all instances of harm captured by this indicator can be prevented, adoption of evidence-informed practices can help to reduce the rate of harm.",{"type":15,"attrs":494,"content":495},{"textAlign":53},[496],{"text":497,"type":295},"Harm is captured only when it:",{"type":499,"content":500},"bullet_list",[501,508,515],{"type":440,"content":502},[503],{"type":15,"attrs":504,"content":505},{"textAlign":53},[506],{"text":507,"type":295},"Is identified as having occurred after admission and within the same hospital stay;",{"type":440,"content":509},[510],{"type":15,"attrs":511,"content":512},{"textAlign":53},[513],{"text":514,"type":295},"Requires treatment, alters treatment or prolongs the hospital stay; and",{"type":440,"content":516},[517],{"type":15,"attrs":518,"content":519},{"textAlign":53},[520],{"text":521,"type":295},"Is one of the conditions from the 31 clinical groups in the Hospital Harm Framework",{"type":15,"attrs":523,"content":524},{"textAlign":53},[525],{"text":526,"type":295},"The Hospital Harm Measure is intended to monitor variations in patient safety in inpatient acute care settings at the national level across facilities over time. It is designed to help identify patient safety improvement opportunities in hospitals.",{"type":15,"attrs":528,"content":529},{"textAlign":53},[530,532,539],{"text":531,"type":295},"Results for categories and types of harm, aggregated at the national level (outside of Quebec), can be found in ",{"text":533,"type":295,"marks":534},"the data tables on CIHI’s website",[535],{"type":371,"attrs":536},{"href":537,"uuid":53,"anchor":53,"custom":538,"target":374,"linktype":375},"https://view.officeapps.live.com/op/view.aspx?src=https%3A%2F%2Fwww.cihi.ca%2Fsites%2Fdefault%2Ffiles%2Fdocument%2Fhospital-harm-results-2014-2024-data-tables-en.xlsx&wdOrigin=BROWSELINK?src=https%3A%2F%2Fwww.cihi.ca%2Fsites%2Fdefault%2Ffiles%2Fdocument%2Fhospital-harm-results-2014-2022-data-tables-en.xlsx&wdOrigin=BROWSELINK?src=https%3A%2F%2Fwww.cihi.ca%2Fsites%2Fdefault%2Ffiles%2Fdocument%2Fhospital-harm-results-2014-2022-data-tables-en.xlsx&wdOrigin=BROWSELINK",{},{"text":540,"type":295},".",{"type":406,"attrs":542,"content":543},{"level":408,"textAlign":53},[544],{"text":455,"type":295},{"type":15,"attrs":546,"content":547},{"textAlign":53},[548],{"text":549,"type":295},"Healthcare Excellence Canada has developed the Hospital Harm Improvement Resource – a compilation of resources to support patient safety and improvement efforts.",{"type":15,"attrs":551,"content":552},{"textAlign":53},[553],{"text":554,"type":295,"marks":555},"Access Now",[556],{"type":371,"attrs":557},{"href":459,"uuid":460,"anchor":53,"custom":558,"target":462,"linktype":463,"story":559},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"type":406,"attrs":561,"content":562},{"level":408,"textAlign":53},[563],{"text":564,"type":295},"Analytical Report",{"type":15,"attrs":566,"content":567},{"textAlign":53},[568,570,577],{"text":569,"type":295},"This analytical report, ",{"text":571,"type":295,"marks":572},"Measuring Patient Harm in Canadian Hospitals (PDF)",[573,576],{"type":371,"attrs":574},{"href":478,"uuid":53,"anchor":53,"custom":575,"target":374,"linktype":375},{},{"type":402},{"text":578,"type":295},", shares the approach to measuring hospital harm, provides an overview of the status of these patient safety events in Canada (outside of Quebec ¹) and identifies how the data and associated improvement resource can be used for ongoing improvement.",{"type":15,"attrs":580,"content":581},{"textAlign":53},[582],{"text":583,"type":295},"The report includes:",{"type":499,"content":585},[586,593,600,607],{"type":440,"content":587},[588],{"type":15,"attrs":589,"content":590},{"textAlign":53},[591],{"text":592,"type":295},"An overview of the status of patient safety in Canada",{"type":440,"content":594},[595],{"type":15,"attrs":596,"content":597},{"textAlign":53},[598],{"text":599,"type":295},"The number and types of harmful events",{"type":440,"content":601},[602],{"type":15,"attrs":603,"content":604},{"textAlign":53},[605],{"text":606,"type":295},"The types of patients and their outcomes",{"type":440,"content":608},[609],{"type":15,"attrs":610,"content":611},{"textAlign":53},[612],{"text":613,"type":295},"Information on how measurement can be used for improvement",{"type":15,"attrs":615,"content":616},{"textAlign":53},[617],{"text":618,"type":295},"¹ Data from Quebec as well as data for patients with selected mental health diagnoses has been excluded due to differences in data collection.",{"type":15,"attrs":620,"content":621},{"textAlign":53},[622,624,631],{"text":623,"type":295},"CIHI has also worked with stakeholders to further refine the methodology used to calculate hospital harm. The most current methodology can be found in ",{"text":625,"type":295,"marks":626},"CIHI's Indicator Library",[627],{"type":371,"attrs":628},{"href":629,"uuid":53,"anchor":53,"custom":630,"target":374,"linktype":375},"https://www.cihi.ca/en/indicators/hospital-harm",{},{"text":540,"type":295},"simple-richtext","wysiwyg-program",{"id":16,"_uid":635,"items":636,"component":659},"b97a538b-604c-46b1-80cf-a9584d104fba",[637],{"_uid":638,"link":639,"image":647,"title":651,"component":652,"description":653},"3899a935-c1ff-402c-85c0-9e1ac9062526",[640],{"_uid":641,"link":642,"label":645,"component":646},"2016395e-5568-4d6f-86ab-f84f6bb254a8",{"id":275,"url":16,"linktype":463,"fieldtype":643,"cached_url":303,"story":644},"multilink",{"name":270,"id":274,"uuid":275,"slug":9,"url":303,"full_slug":303,"_stopResolving":301},"See all resources","simple-link",{"id":648,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":649,"copyright":16,"fieldtype":284,"meta_data":650,"is_external_url":286},121293076058734,"https://a-ca.storyblok.com/f/850807391887861/2068x1484/1aea4e8fb2/senior-woman-holding-doctors-hand.webp",{},"Hospital Harm Resources","image-text-colored-item",{"type":12,"content":654},[655],{"type":15,"attrs":656,"content":657},{"textAlign":53},[658],{"text":294,"type":295},"image-text-colored",[143,115,122,129,136,150,157],[185,192,200],"hec-page-resource-single","hospital-harm-is-everyones-concern","resources/hospital-harm-is-everyones-concern",-18410,[],103604225865405,{"parent_slug":669,"umbraco_path":670,"umbraco_uuid":671},"resources","/HealthcareExcellenceCanada/Resources/HospitalHarmIsEveryonesConcern","f01ab755-8ca5-4f82-bc9e-5d6e8c27c67b","ad223968-2a8a-4790-b25b-a1333d083161","2025-11-26T23:54:23.658Z",[],[676],{"path":677,"name":678,"lang":315,"published":301},"ressources/les-prejudices-a-l-hopital-c-est-l-affaire-de-tout-le-monde","Les préjudices à l’hôpital, c’est l’affaire de tout le monde",{"name":680,"created_at":681,"published_at":682,"updated_at":683,"id":684,"uuid":685,"content":686,"slug":1745,"full_slug":1746,"sort_by_date":53,"position":1747,"tag_list":1748,"is_startpage":286,"parent_id":667,"meta_data":53,"group_id":1749,"first_published_at":1750,"release_id":53,"lang":309,"path":53,"alternates":1751,"default_full_slug":1746,"translated_slugs":1752},"UTI","2025-12-08T15:55:33.186Z","2026-03-10T16:40:51.248Z","2026-03-10T16:40:51.301Z",120912827454023,"84f2d6ed-e605-4661-a35e-a72925e2fd41",{"new":286,"seo":687,"_uid":690,"hero":691,"type":174,"topics":715,"Noindex":286,"content":716,"audience":1743,"duration":16,"regional":1744,"component":662},{"_uid":688,"title":680,"plugin":339,"og_image":16,"og_title":16,"description":689,"twitter_image":16,"twitter_title":16,"og_description":16,"twitter_description":16},"e6301e5d-7507-42bb-a36e-4d2f3ef5786d","Urinary Tract Infection (UTI) can be divided into upper tract infections, which involve the kidneys (pyelonephritis), and lower tract infections, which involve the bladder (cystitis), urethra (urethritis), and prostate (prostatitis).","fe2aa94c-215a-4302-89a5-1a8ebb48552a",[692],{"_uid":693,"image":694,"title":698,"format":699,"component":351,"description":702,"key_learning":709,"prerequisite":712},"efc60e6a-070a-4335-af48-979eea4f84ce",{"id":695,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":696,"copyright":16,"fieldtype":284,"meta_data":697,"is_external_url":286},121293751894639,"https://a-ca.storyblok.com/f/850807391887861/2216x1568/ea857fcb8e/shapes.webp",{"alt":16,"title":16,"source":16,"copyright":16},"Hospital Harm: UTI",{"type":12,"content":700},[701],{"type":15},{"type":12,"content":703},[704],{"type":15,"attrs":705,"content":706},{"textAlign":53},[707],{"text":708,"type":295},"Urinary Tract Infection (UTI) can be divided into upper tract infections, which involve the kidneys (pyelonephritis), and lower tract infections, which involve the bladder (cystitis), urethra (urethritis), and prostate (prostatitis). Infection may spread from one site to the other. Although urethritis and prostatitis are infections that involve the urinary tract, the term UTI usually refers to pyelonephritis and cystitis (Imam, 2020a).",{"type":12,"content":710},[711],{"type":15},{"type":12,"content":713},[714],{"type":15},[76,8],[717,732,849,890,1502,1562,1698,1725],{"_uid":718,"link":719,"image":720,"title":722,"component":723,"media_type":724,"description":725},"a40f3c31-2be0-450d-8ec3-bc72ad634bf2",[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":284,"meta_data":721},{},"Goal","info-block-program","none",{"type":12,"content":726},[727],{"type":15,"attrs":728,"content":729},{"textAlign":53},[730],{"text":731,"type":295},"Prevention of urinary tract infection by implementing recommended components of care.",{"_uid":733,"content":734,"component":633},"505d370d-0052-4f79-9349-5bb00c9999a7",[735,767,782,816,830],{"_uid":736,"content":737,"component":632},"977d04a2-16c7-4e97-85fe-5e7d2fc1ada2",{"type":12,"content":738},[739,744,757,762],{"type":406,"attrs":740,"content":741},{"level":408,"textAlign":53},[742],{"text":743,"type":295},"Overview",{"type":15,"attrs":745,"content":746},{"textAlign":53},[747,749,755],{"text":748,"type":295},"Healthcare Excellence Canada has developed this ",{"text":455,"type":295,"marks":750},[751],{"type":371,"attrs":752},{"href":459,"uuid":460,"anchor":53,"custom":753,"target":462,"linktype":463,"story":754},"[object Object]",{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":756,"type":295}," – a compilation of resources to support patient safety and improvement efforts.",{"type":15,"attrs":758,"content":759},{"textAlign":53},[760],{"text":761,"type":295},"Most cases of cystitis and pyelonephritis are caused by bacteria. The most common nonbacterial pathogens are fungi (usually candidal species), and, less commonly, mycobacteria, viruses, and parasites. Nonbacterial pathogens usually affect patients who are immunocompromised; have diabetes, urinary tract obstruction, or structural abnormalities; or have had recent urinary tract instrumentation. Urethritis is usually caused by sexually transmitted infections (STI). Prostatitis is usually caused by bacteria and sometimes STIs (Imam, 2020a).",{"type":15,"attrs":763,"content":764},{"textAlign":53},[765],{"text":766,"type":295},"Infections in the elderly often have atypical clinical presentation and residents of LTC can also be cognitively impaired or have comorbidities like dementia and stroke that impede communication of symptoms (Happe et al., 2017). Up to 50 per cent of elderly Canadians in long-term care facilities have bacteria in their urine without symptoms of a urinary tract infection. This is referred to as asymptomatic bacteriuria representing a colonization state — not an infection. The inappropriate use of antibiotics for elderly patients with asymptomatic bacteriuria exposes them to considerable harm and promotes antimicrobial resistance, which ultimately affects the health of all Canadians (Blondel-Hill et al., 2018).",{"_uid":768,"content":769,"component":632},"720dfb2c-cc61-4bc3-9660-a1885a75646a",{"type":12,"content":770},[771,777],{"type":406,"attrs":772,"content":774},{"level":773,"textAlign":53},3,[775],{"text":776,"type":295},"Healthcare-Associated UTI",{"type":15,"attrs":778,"content":779},{"textAlign":53},[780],{"text":781,"type":295},"Urinary tract infections (UTIs) are the fifth most common type of healthcare-associated infection, with an estimated 62,700 UTIs in acute care hospitals (US) in 2015. UTIs additionally account for more than 9.5 per cent of infections reported by acute care hospitals. Virtually all healthcare associated UTIs are caused by instrumentation of the urinary tract. (Centers for Disease Control and Prevention, 2021).",{"_uid":783,"content":784,"component":632},"9fdc9233-b802-4f15-b6d6-f9480198dd98",{"type":12,"content":785},[786,791,796,801,806,811],{"type":406,"attrs":787,"content":788},{"level":773,"textAlign":53},[789],{"text":790,"type":295},"Catheter-Associated Urinary Tract Infection (CAUTI)",{"type":15,"attrs":792,"content":793},{"textAlign":53},[794],{"text":795,"type":295},"A catheter-associated urinary tract infection (CAUTI) is a UTI in which the positive culture was taken when an indwelling urinary catheter had been in place for > 2 calendar days. Patients with indwelling bladder catheters are predisposed to bacteriuria and UTIs. Symptoms may be vague or may suggest sepsis. Diagnosis depends on the presence of symptoms (Imam, 2020b).",{"type":15,"attrs":797,"content":798},{"textAlign":53},[799],{"text":800,"type":295},"A urinary catheter provides a portal of entry into the urinary tract. The source of bacteria causing CAUTI is usually endogenous — typically via meatal, rectal, or vaginal colonization — but rarely may be exogenous, from equipment or contaminated hands of healthcare personnel (Association for Professionals in Infection Control and Epidemiology, 2014).",{"type":15,"attrs":802,"content":803},{"textAlign":53},[804],{"text":805,"type":295},"The most important risk factor for development of CAUTI is the duration of catheterization. Daily risk of acquisition of bacteriuria with urinary catheters is around seven per cent (Saint, 2000). Other factors predispose CAUTI including patient-related factors such as diabetes, fecal incontinence, incomplete emptying of the bladder, dehydration etc.; care provider related factors such as poor hand hygiene practices, poor insertion technique, etc.; and hospital, equipment, and/or environmental systems (APIC, 2014) and female sex (Imam, 2020b).",{"type":15,"attrs":807,"content":808},{"textAlign":53},[809],{"text":810,"type":295},"CAUTIs account for the majority of healthcare-associated UTIs and have been associated with increased morbidity, mortality, hospital cost, and length of stay (APIC, 2014). During hospitalization, from 12 to 16 per cent of patients may receive short-term indwelling urinary catheters. The average rate of CAUTI is higher in ICU patients than in non-ICU patients (APIC, 2014).",{"type":15,"attrs":812,"content":813},{"textAlign":53},[814],{"text":815,"type":295},"An estimated 17 to 69 per cent of CAUTIs may be preventable with implementation of evidence-based practices. Although there has been modest improvement in CAUTI rates, progress has been much slower than other device-associated infections (APIC, 2014).",{"_uid":817,"content":818,"component":632},"a1c7251e-5f45-4117-9636-2efeb947132a",{"type":12,"content":819},[820,825],{"type":406,"attrs":821,"content":822},{"level":773,"textAlign":53},[823],{"text":824,"type":295},"Post-partum UTI",{"type":15,"attrs":826,"content":827},{"textAlign":53},[828],{"text":829,"type":295},"Post-partum UTI may begin as asymptomatic bacteriuria during pregnancy and is sometimes associated with bladder catheterization to relieve urinary distention during or after labor (Imam 2020). Compared with intended vaginal delivery, intended caesarean delivery was significantly associated with a higher risk of postpartum urinary tract infection. The timing of the postpartum UTI diagnosis did not vary by mode of delivery because 75 per cent of the postpartum UTIs occurred within 15 days post partum, irrespective of mode of delivery (Gundersen et al., 2018). Physiological changes in the bladder occur during pregnancy and predispose women to develop post-partum urinary retention (PUR) during the first hours to days after birth which can lead to UTI (Leach, 2011).",{"_uid":831,"content":832,"component":632},"044b76be-1f40-4743-ac0e-f26e2ff6ebda",{"type":12,"content":833},[834,839,844],{"type":406,"attrs":835,"content":836},{"level":773,"textAlign":53},[837],{"text":838,"type":295},"UTIs Among Neonates",{"type":15,"attrs":840,"content":841},{"textAlign":53},[842],{"text":843,"type":295},"The characteristics of UTI in neonates differ from UTIs in infants and children. Its prevalence is much higher, male sex is affected predominantly non-Escherichia coli infections are more frequent, and there is a higher risk of urosepsis than in older age groups. UTI in neonates may be the first indicator of underlying abnormalities of kidneys and the urinary tract (Beetz, 2012). Some 35 to 50 per cent of term and preterm neonates with UTI have abnormal urinary tract ultrasounds (Bonadio & Maida, 2014; Goldman et al., 2000; Ismaili et al., 2011; Sastre et al., 2007).",{"type":15,"attrs":845,"content":846},{"textAlign":53},[847],{"text":848,"type":295},"The prevalence of UTIs among full-term neonates has been reported to be up to 1.1 per cent, increasing up to seven per cent among those with fever. Evidence indicates that up to approximately 15 per cent of febrile neonates have positive urine culture (Bonadio & Maida, 2014; Ismaili et al., 2011) and most UTI in neonates is related to pyelonephritis as compared to cystitis in older children. The presence of UTI is significantly higher in uncircumcised vs circumcised boys (Beetz, 2012).",{"_uid":850,"content":851,"component":633},"2b3dce56-63dc-4fd8-bc67-0a39ac6cbfb7",[852],{"_uid":853,"content":854,"component":632},"32d0ac83-1a8e-428e-b5eb-bff8e0da107f",{"type":12,"content":855},[856,861,866,874,885],{"type":406,"attrs":857,"content":858},{"level":408,"textAlign":53},[859],{"text":860,"type":295},"Importance to Patients and Families",{"type":15,"attrs":862,"content":863},{"textAlign":53},[864],{"text":865,"type":295},"Steps that can reduce the risk of UTIs include drinking plenty of liquids, especially water and possibly cranberry juice, and wiping from front to back (Mayo Clinic, 2020). ​​Catheters should be removed as soon as they are no longer clinically indicated. This often makes patients more comfortable, reduces their exposure to infections, and shortens their time in hospital (IHI, 2012).",{"type":406,"attrs":867,"content":869},{"level":773,"textAlign":868},"left",[870],{"text":871,"type":295,"marks":872},"Patient Story​​",[873],{"type":487},{"type":15,"attrs":875,"content":876},{"textAlign":868},[877],{"text":878,"type":295,"marks":879},"Don't get 'caught' in the CAUTI trap",[880,884],{"type":371,"attrs":881},{"href":882,"uuid":53,"anchor":53,"custom":883,"target":374,"linktype":375},"https://www.myamericannurse.com/dont-get-caught-in-the-cauti-trap/",{},{"type":487},{"type":15,"attrs":886,"content":887},{"textAlign":868},[888],{"text":889,"type":295},"One nurse's story: My father died of a heart attack at age 39, and our mother raised my siblings and me. We were all close to mom; however, as the oldest she and I had a special bond. At age 46 she had undergone a mitral valve replacement and her aortic valve was replaced about nine years later. She had survived a cardiac arrest and pulmonary artery rupture. When she was hospitalized with dehydration and acute kidney injury, we believed she would spend some time in the hospital and be discharged. Her kidney function improved with fluids, and her output was carefully monitored with a urinary catheter. She had a history of atrial fibrillation and her rate control medications were held. One day, her temperature soared to 102.8 F and her heart rate increased to 130 beats per minute. She developed sepsis, which placed further stress on her pulmonary and cardiovascular system. In June 2001 my mother died from complications related to a catheter associated urinary tract infection. She was 61 years old; I still miss her (Townsend et al, 2013).",{"_uid":891,"items":892,"title":1457,"component":1458,"description":1459},"56ab3959-1b16-41e9-818d-10a351c10b24",[893],{"_uid":894,"title":895,"ctaLeft":896,"ctaRight":897,"component":898,"columnLeft":899,"columnRight":919},"610b88a1-8386-4bd1-868e-1ec5ba02ae49","Expand to see a full list of resources",[],[],"accordion-item-columns",{"type":12,"content":900},[901],{"type":15,"attrs":902,"content":903},{"textAlign":53},[904,906,913,914,918],{"text":905,"type":295},"To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the ",{"text":907,"type":295,"marks":908},"Hospital Harm Improvement Resources Introduction",[909],{"type":371,"attrs":910},{"href":459,"uuid":460,"anchor":53,"custom":911,"target":462,"linktype":463,"story":912},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":540,"type":295},{"text":915,"type":295,"marks":916}," ",[917],{"type":487},{"text":915,"type":295},{"type":12,"content":920},[921,926,960,989,1368,1426],{"type":15,"attrs":922,"content":923},{"textAlign":53},[924],{"text":925,"type":295},"If your review reveals that your cases of UTI are linked to specific processes or procedures, you may find these resources helpful:",{"type":499,"content":927},[928],{"type":440,"content":929},[930,940],{"type":15,"attrs":931,"content":932},{"textAlign":53},[933,935],{"text":934,"type":295},"ACTT - Accelerating Change Transformation Team ",{"text":936,"type":295,"marks":937},"https://actt.albertadoctors.org/CPGs",[938],{"type":371,"attrs":939},{"href":936,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":499,"content":941},[942],{"type":440,"content":943},[944],{"type":15,"attrs":945,"content":946},{"textAlign":53},[947,949,953,955],{"text":948,"type":295},"Toward Optimized Practice (TOP). ",{"text":950,"type":295,"marks":951},"Diagnosis and Management of Urinary Tract Infection in Long Term Care Facilities: Clinical Practice Guideline.",[952],{"type":402},{"text":954,"type":295}," TOP; 2015. ",{"text":956,"type":295,"marks":957},"https://actt.albertadoctors.org/CPGs/Pages/Urinary-Tract-Infection---Long-Term-Care-Facilities.aspx",[958],{"type":371,"attrs":959},{"href":956,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":499,"content":961},[962],{"type":440,"content":963},[964,975],{"type":15,"attrs":965,"content":966},{"textAlign":53},[967,969],{"text":968,"type":295},"Association of Medical Microbiology and Infectious Disease Canada (AMMI Canada) ",{"text":970,"type":295,"marks":971},"ammi.ca",[972],{"type":371,"attrs":973},{"href":974,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.ammi.ca/",{"type":499,"content":976},[977],{"type":440,"content":978},[979],{"type":15,"attrs":980,"content":981},{"textAlign":53},[982,984],{"text":983,"type":295},"Association of Medical Microbiology and Infectious Disease Canada. Asymptomatic Bacteriuria. ",{"text":985,"type":295,"marks":986},"https://www.ammi.ca/?ID=127",[987],{"type":371,"attrs":988},{"href":985,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":499,"content":990},[991,1031,1064,1116,1148,1180,1214,1242,1271,1303,1335],{"type":440,"content":992},[993,1010],{"type":15,"attrs":994,"content":995},{"textAlign":53},[996,998,1002,1004],{"text":997,"type":295},"Association for Professionals in Infection Control and Epidemiology (APIC",{"text":999,"type":295,"marks":1000},")",[1001],{"type":402},{"text":1003,"type":295}," ",{"text":1005,"type":295,"marks":1006},"apic.org",[1007],{"type":371,"attrs":1008},{"href":1009,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.apic.org/",{"type":499,"content":1011},[1012],{"type":440,"content":1013},[1014],{"type":15,"attrs":1015,"content":1016},{"textAlign":53},[1017,1019,1023,1025],{"text":1018,"type":295},"Association for Professionals in Infection Control and Epidemiology. ",{"text":1020,"type":295,"marks":1021},"APIC Implementation Guide: Guide to Preventing Catheter-Associated Urinary Tract Infections",[1022],{"type":402},{"text":1024,"type":295},". APIC; 2014. ",{"text":1026,"type":295,"marks":1027},"https://apic.org/professional-practice/implementation-guides/#implementaion-guide-7454",[1028],{"type":371,"attrs":1029},{"href":1026,"uuid":53,"anchor":53,"custom":1030,"target":374,"linktype":375},{},{"type":440,"content":1032},[1033,1044],{"type":15,"attrs":1034,"content":1035},{"textAlign":53},[1036,1038],{"text":1037,"type":295},"Canadian Urological Association Journal ",{"text":1039,"type":295,"marks":1040},"cuaj.ca",[1041],{"type":371,"attrs":1042},{"href":1043,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.cuaj.ca/",{"type":499,"content":1045},[1046],{"type":440,"content":1047},[1048],{"type":15,"attrs":1049,"content":1050},{"textAlign":53},[1051,1053,1057,1059],{"text":1052,"type":295},"Hill TC, Baverstock R, Carlson KV, et al. Best practices for the treatment and prevention of urinary tract infection in the spinal cord injured population. ",{"text":1054,"type":295,"marks":1055},"CUAJ",[1056],{"type":402},{"text":1058,"type":295},". 2013;7(3-4):122-130. doi:10.5489/cuaj.337. ",{"text":1060,"type":295,"marks":1061},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3650772/",[1062],{"type":371,"attrs":1063},{"href":1060,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":1065},[1066,1078],{"type":15,"attrs":1067,"content":1068},{"textAlign":53},[1069,1071],{"text":1070,"type":295},"Centers for Disease Control and Prevention (CDC). ",{"text":1072,"type":295,"marks":1073},"www.cdc.gov",[1074],{"type":371,"attrs":1075},{"href":1076,"uuid":53,"anchor":53,"custom":1077,"target":374,"linktype":375},"https://www.cdc.gov/",{},{"type":499,"content":1079},[1080,1098],{"type":440,"content":1081},[1082],{"type":15,"attrs":1083,"content":1084},{"textAlign":53},[1085,1087,1091,1093],{"text":1086,"type":295},"Centers for Disease Control and Prevention. ",{"text":1088,"type":295,"marks":1089},"Urinary Tract Infection (Catheter-Associated Urinary TractInfection [CAUTI] and Non-Catheter-Associated Urinary TractInfection [UTI]) Events",[1090],{"type":402},{"text":1092,"type":295},". CDC; 2021. ",{"text":1094,"type":295,"marks":1095},"https://www.cdc.gov/nhsn/pdfs/pscmanual/7psccauticurrent.pdf",[1096],{"type":371,"attrs":1097},{"href":1094,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":1099},[1100],{"type":15,"attrs":1101,"content":1102},{"textAlign":53},[1103,1105,1109,1111],{"text":1104,"type":295},"Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, Healthcare Infection Control Practices Advisory Committee (HICPAC). ",{"text":1106,"type":295,"marks":1107},"Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009.",[1108],{"type":402},{"text":1110,"type":295}," Centers for Disease Control and Prevention (CDC); 2010. ",{"text":1112,"type":295,"marks":1113},"http://www.cdc.gov/hicpac/pdf/cauti/cautiguideline2009final.pdf",[1114],{"type":371,"attrs":1115},{"href":1112,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":1117},[1118,1128],{"type":15,"attrs":1119,"content":1120},{"textAlign":53},[1121,1123],{"text":1122,"type":295},"Cochrane Library ",{"text":1124,"type":295,"marks":1125},"https://www.cochranelibrary.com/",[1126],{"type":371,"attrs":1127},{"href":1124,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":499,"content":1129},[1130],{"type":440,"content":1131},[1132],{"type":15,"attrs":1133,"content":1134},{"textAlign":53},[1135,1137,1141,1143],{"text":1136,"type":295},"Flodgren G, Conterno L, Mayhew A, Omar O, Pereira C, Shepperd S. Interventions to improve professional adherence to guidelines for prevention of device‐related infections. ",{"text":1138,"type":295,"marks":1139},"Cochrane Database of Systematic Reviews",[1140],{"type":402},{"text":1142,"type":295},". 2013;(3). doi:10.1002/14651858.CD006559.pub2 ",{"text":1144,"type":295,"marks":1145},"https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006559.pub2/full",[1146],{"type":371,"attrs":1147},{"href":1144,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":1149},[1150,1160],{"type":15,"attrs":1151,"content":1152},{"textAlign":53},[1153,1155],{"text":1154,"type":295},"Heart & Lung - The Journal of Cardiopulmonary and Acute Care ",{"text":1156,"type":295,"marks":1157},"https://www.heartandlung.org/",[1158],{"type":371,"attrs":1159},{"href":1156,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":499,"content":1161},[1162],{"type":440,"content":1163},[1164],{"type":15,"attrs":1165,"content":1166},{"textAlign":53},[1167,1169,1173,1175],{"text":1168,"type":295},"Conway LJ, Larson EL. Guidelines to prevent catheter-associated urinary tract infection: 1980 to 2010. ",{"text":1170,"type":295,"marks":1171},"Heart & Lung: The Journal of Cardiopulmonary and Acute Care",[1172],{"type":402},{"text":1174,"type":295},". 2012;41(3):271-283. doi:10.1016/j.hrtlng.2011.08.001 ",{"text":1176,"type":295,"marks":1177},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3362394/",[1178],{"type":371,"attrs":1179},{"href":1176,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":1181},[1182,1194],{"type":15,"attrs":1183,"content":1184},{"textAlign":53},[1185,1187],{"text":1186,"type":295},"Infectious Diseases Society of America ",{"text":1188,"type":295,"marks":1189},"www.idsa.org",[1190],{"type":371,"attrs":1191},{"href":1192,"uuid":53,"anchor":53,"custom":1193,"target":374,"linktype":375},"https://www.idsa.org/",{},{"type":499,"content":1195},[1196],{"type":440,"content":1197},[1198],{"type":15,"attrs":1199,"content":1200},{"textAlign":53},[1201,1203,1207,1209],{"text":1202,"type":295},"Hooton TM, Bradley SF, Cardenas DD, et al. Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. ",{"text":1204,"type":295,"marks":1205},"Clinical Infectious Diseases",[1206],{"type":402},{"text":1208,"type":295},". 2010;50(5):625-663. doi:10.1086/650482 ",{"text":1210,"type":295,"marks":1211},"http://cid.oxfordjournals.org/content/50/5/625.long",[1212],{"type":371,"attrs":1213},{"href":1210,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":1215},[1216,1227],{"type":15,"attrs":1217,"content":1218},{"textAlign":53},[1219,1221],{"text":1220,"type":295},"Infection Prevention and Control Canada (IPAC CANADA) ",{"text":1222,"type":295,"marks":1223},"ipac-canada.org",[1224],{"type":371,"attrs":1225},{"href":1226,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.ipac-canada.org/",{"type":499,"content":1228},[1229],{"type":440,"content":1230},[1231],{"type":15,"attrs":1232,"content":1233},{"textAlign":53},[1234,1236,1240],{"text":1235,"type":295},"Happe J, Stoll F, Biluk L, et al. Surveillance Definitions of Infections in Canadian Long Term Care Facilities. ",{"text":1237,"type":295,"marks":1238},"Can J Infect Control",[1239],{"type":402},{"text":1241,"type":295},". 2017;(Suppl):10-17.",{"type":440,"content":1243},[1244,1256],{"type":15,"attrs":1245,"content":1246},{"textAlign":53},[1247,1249],{"text":1248,"type":295},"Institute for Healthcare Improvement (IHI) ",{"text":1250,"type":295,"marks":1251},"www.ihi.org",[1252],{"type":371,"attrs":1253},{"href":1254,"uuid":53,"anchor":53,"custom":1255,"target":374,"linktype":375},"https://www.ihi.org/",{},{"type":499,"content":1257},[1258],{"type":440,"content":1259},[1260],{"type":15,"attrs":1261,"content":1262},{"textAlign":53},[1263,1265,1269],{"text":1264,"type":295},"Institute for Healthcare Improvement.",{"text":1266,"type":295,"marks":1267}," How-to Guide: Prevent catheter-associated urinary tract infections",[1268],{"type":402},{"text":1270,"type":295},". Cambridge, MA: IHI; 2011.",{"type":440,"content":1272},[1273,1283],{"type":15,"attrs":1274,"content":1275},{"textAlign":53},[1276,1278],{"text":1277,"type":295},"International Journal for Quality Health Care ",{"text":1279,"type":295,"marks":1280},"https://academic.oup.com/intqhc",[1281],{"type":371,"attrs":1282},{"href":1279,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":499,"content":1284},[1285],{"type":440,"content":1286},[1287],{"type":15,"attrs":1288,"content":1289},{"textAlign":53},[1290,1292,1296,1298],{"text":1291,"type":295},"Clarke K, Tong D, Pan Y, et al. Reduction in catheter-associated urinary tract infections by bundling interventions. ",{"text":1293,"type":295,"marks":1294},"International Journal for Quality in Health Care",[1295],{"type":402},{"text":1297,"type":295},". 2013;25(1):43-49. doi:10.1093/intqhc/mzs077 ",{"text":1299,"type":295,"marks":1300},"http://intqhc.oxfordjournals.org/content/25/1/43",[1301],{"type":371,"attrs":1302},{"href":1299,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":1304},[1305,1315],{"type":15,"attrs":1306,"content":1307},{"textAlign":53},[1308,1310],{"text":1309,"type":295},"Journal of Nursing Care Quality ",{"text":1311,"type":295,"marks":1312},"https://journals.lww.com/jncqjournal/pages/default.aspx",[1313],{"type":371,"attrs":1314},{"href":1311,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":499,"content":1316},[1317],{"type":440,"content":1318},[1319],{"type":15,"attrs":1320,"content":1321},{"textAlign":53},[1322,1324,1328,1330],{"text":1323,"type":295},"Andreessen L, Wilde MH, Herendeen P. Preventing Catheter-Associated Urinary Tract Infections in Acute Care: The Bundle Approach. ",{"text":1325,"type":295,"marks":1326},"Journal of Nursing Care Quality",[1327],{"type":402},{"text":1329,"type":295},". 2012;27(3). doi:10.1097/NCQ.0b013e318248b0b1 ",{"text":1331,"type":295,"marks":1332},"https://journals.lww.com/jncqjournal/Fulltext/2012/07000/Preventing_Catheter_Associated_Urinary_Tract.4.aspx",[1333],{"type":371,"attrs":1334},{"href":1331,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":1336},[1337,1348],{"type":15,"attrs":1338,"content":1339},{"textAlign":53},[1340,1342],{"text":1341,"type":295},"New England Journal of Medicine ",{"text":1343,"type":295,"marks":1344},"www.nejm.org",[1345],{"type":371,"attrs":1346},{"href":1347,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.nejm.org/",{"type":499,"content":1349},[1350],{"type":440,"content":1351},[1352],{"type":15,"attrs":1353,"content":1354},{"textAlign":53},[1355,1357,1361,1363],{"text":1356,"type":295},"Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care-associated infections. ",{"text":1358,"type":295,"marks":1359},"N Engl J Med",[1360],{"type":402},{"text":1362,"type":295},". 2014;370(13):1198-1208. doi:10.1056/NEJMoa1306801 ",{"text":1364,"type":295,"marks":1365},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648343/",[1366],{"type":371,"attrs":1367},{"href":1364,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":499,"content":1369},[1370,1398],{"type":440,"content":1371},[1372,1383],{"type":15,"attrs":1373,"content":1374},{"textAlign":53},[1375,1377],{"text":1376,"type":295},"Society of Obstetricians and Gynaecologists of Canada ",{"text":1378,"type":295,"marks":1379},"www.sogc.org",[1380],{"type":371,"attrs":1381},{"href":1382,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.sogc.org/",{"type":499,"content":1384},[1385],{"type":440,"content":1386},[1387],{"type":15,"attrs":1388,"content":1389},{"textAlign":53},[1390,1392,1396],{"text":1391,"type":295},"Epp A, Larochelle A, Lovatsis D, et al. Recurrent Urinary Tract Infection. ",{"text":1393,"type":295,"marks":1394},"Journal of Obstetrics and Gynaecology Canada",[1395],{"type":402},{"text":1397,"type":295},". 2010;32(11):1082-1090. doi:10.1016/S1701-2163(16)34717-X",{"type":440,"content":1399},[1400,1411],{"type":15,"attrs":1401,"content":1402},{"textAlign":53},[1403,1405],{"text":1404,"type":295},"Government of Saskatchewan –eHealth ",{"text":1406,"type":295,"marks":1407},"www.ehealthsask.ca",[1408],{"type":371,"attrs":1409},{"href":1410,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://www.ehealthsask.ca/",{"type":499,"content":1412},[1413],{"type":440,"content":1414},[1415],{"type":15,"attrs":1416,"content":1417},{"textAlign":53},[1418,1420,1424],{"text":1419,"type":295},"Government of Saskatchewan Ministry of Health. ",{"text":1421,"type":295,"marks":1422},"Guidelines for the Prevention and Treatment of Urinary Tract Infections (UTIs) in Continuing Care Settings.",[1423],{"type":402},{"text":1425,"type":295}," Government of Saskatchewan; 2013.",{"type":499,"content":1427},[1428],{"type":440,"content":1429},[1430,1442],{"type":15,"attrs":1431,"content":1432},{"textAlign":53},[1433,1435],{"text":1434,"type":295},"The Joint Commission ",{"text":1436,"type":295,"marks":1437},"www.jointcommission.org",[1438],{"type":371,"attrs":1439},{"href":1440,"uuid":53,"anchor":53,"custom":1441,"target":374,"linktype":375},"https://www.jointcommission.org/",{},{"type":499,"content":1443},[1444],{"type":440,"content":1445},[1446],{"type":15,"attrs":1447,"content":1448},{"textAlign":53},[1449,1451,1455],{"text":1450,"type":295},"The Joint Commission. Surgical Care Improvement Project (SCIP). SCIP-Inf-9: Urinary catheter removed on postoperative day 1 (POD 1) or postoperative day 2 (POD 2) with day or surgery being day zero. ",{"text":1452,"type":295,"marks":1453},"Specifications manual for national hospital inpatient quality measures.",[1454],{"type":402},{"text":1456,"type":295}," Joint Commission; 2013. ","Clinical and System Reviews, Incident Analyses","accordion-2-columns",{"type":12,"content":1460},[1461,1466,1471],{"type":15,"attrs":1462,"content":1463},{"textAlign":53},[1464],{"text":1465,"type":295},"Given the broad range of potential causes of hospital associated UTI, clinical and system reviews should be conducted to identify latent causes and determine appropriate recommendations.",{"type":15,"attrs":1467,"content":1468},{"textAlign":53},[1469],{"text":1470,"type":295},"Occurrences of harm are often complex with many contributing factors. Organizations need to:",{"type":435,"attrs":1472,"content":1473},{"order":437},[1474,1481,1488,1495],{"type":440,"content":1475},[1476],{"type":15,"attrs":1477,"content":1478},{"textAlign":53},[1479],{"text":1480,"type":295},"Measure and monitor the types and frequency of these occurrences.",{"type":440,"content":1482},[1483],{"type":15,"attrs":1484,"content":1485},{"textAlign":53},[1486],{"text":1487,"type":295},"Use appropriate analytical methods to understand the contributing factors.",{"type":440,"content":1489},[1490],{"type":15,"attrs":1491,"content":1492},{"textAlign":53},[1493],{"text":1494,"type":295},"Identify and implement solutions or interventions that are designed to prevent recurrence and reduce risk of harm.",{"type":440,"content":1496},[1497],{"type":15,"attrs":1498,"content":1499},{"textAlign":53},[1500],{"text":1501,"type":295},"Have mechanisms in place to mitigate consequences of harm when it occurs.",{"_uid":1503,"items":1504,"title":1548,"component":1549,"description":1550},"be3b7a82-b7ec-4b53-a512-e4112073c052",[1505,1516,1524,1532,1540],{"_uid":1506,"image":1507,"title":1511,"component":1512,"description":1513},"458f36cf-6776-4902-a081-12df8c65ad9f",{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":1510,"is_external_url":286},119537678778928,"https://a-ca.storyblok.com/f/850807391887861/600x600/c301964117/checkmark-icon.png",{},"Whenever possible, use measures you are already collecting for other programs.","small-text-image-item",{"type":12,"content":1514},[1515],{"type":15},{"_uid":1517,"image":1518,"title":1520,"component":1512,"description":1521},"498e534c-913a-4ac0-90da-3396951645da",{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":1519,"is_external_url":286},{},"Evaluate your choice of measures in terms of the usefulness of the results and the resources required to obtain them; try to maximize the former while minimizing the latter.",{"type":12,"content":1522},[1523],{"type":15},{"_uid":1525,"image":1526,"title":1528,"component":1512,"description":1529},"5c88ef3c-3fd2-442e-b9cf-478a0643de91",{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":1527,"is_external_url":286},{},"Try to include both process and outcome measures in your measurement scheme.",{"type":12,"content":1530},[1531],{"type":15},{"_uid":1533,"image":1534,"title":1536,"component":1512,"description":1537},"6c6d04c8-d218-424c-945d-1f645847d838",{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":1535,"is_external_url":286},{},"You may use different measures or modify the measures to make them more appropriate and/or useful to your particular setting. However, be aware that modifying measures may limit the comparability of your results to others.",{"type":12,"content":1538},[1539],{"type":15},{"_uid":1541,"image":1542,"title":1544,"component":1512,"description":1545},"9e41e082-bfdc-43b9-9572-3826795c8d91",{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":1543,"is_external_url":286},{},"Posting your measure results within your hospital is a great way to keep your teams motivated and aware of progress. Try to include measures that your team will find meaningful and exciting (IHI, 2011).",{"type":12,"content":1546},[1547],{"type":15},"Measures","small-text-image",{"type":12,"content":1551},[1552,1557],{"type":15,"attrs":1553,"content":1554},{"textAlign":53},[1555],{"text":1556,"type":295},"Vital to quality improvement is measurement, and this applies specifically to implementation of interventions. The chosen measures will help to determine whether an impact is being made (primary outcome), whether the intervention is being carried out (process measures), and whether any unintended consequences ensue (balancing measures).",{"type":15,"attrs":1558,"content":1559},{"textAlign":53},[1560],{"text":1561,"type":295},"In selecting your measures, consider the following:",{"_uid":1563,"items":1564,"title":1680,"component":1458,"description":1681},"ed575e2d-c13a-4a32-9df1-afe3f84c8465",[1565,1628,1652],{"_uid":1566,"title":1567,"ctaLeft":1568,"ctaRight":1569,"component":898,"columnLeft":1570,"columnRight":1581},"31df90e3-3c2a-448e-8c03-8cbb7c9f6e6f","Selection Criteria",[],[],{"type":12,"content":1571},[1572],{"type":15,"attrs":1573,"content":1574},{"textAlign":53},[1575,1579],{"text":1576,"type":295,"marks":1577},"Codes: ",[1578],{"type":487},{"text":1580,"type":295},"Code descriptions",{"type":12,"content":1582},[1583,1592,1599,1619],{"type":15,"attrs":1584,"content":1585},{"textAlign":53},[1586,1590],{"text":1587,"type":295,"marks":1588},"N39.0: ",[1589],{"type":487},{"text":1591,"type":295},"Identified as diagnosis type (2)",{"type":15,"attrs":1593,"content":1594},{"textAlign":53},[1595],{"text":1596,"type":295,"marks":1597},"OR",[1598],{"type":487},{"type":15,"attrs":1600,"content":1601},{"textAlign":53},[1602,1604,1608,1610,1613,1615],{"text":1603,"type":295},"Identified as diagnosis type (3) ",{"text":1605,"type":295,"marks":1606},"AND ",[1607],{"type":487},{"text":1609,"type":295},"T83.5 as diagnosis type (2) ",{"text":1605,"type":295,"marks":1611},[1612],{"type":487},{"text":1614,"type":295},"Y60–Y84",{"text":1616,"type":295,"marks":1617}," in the same diagnosis cluster",[1618],{"type":487},{"type":15,"attrs":1620,"content":1621},{"textAlign":53},[1622,1626],{"text":1623,"type":295,"marks":1624},"O86.202:",[1625],{"type":487},{"text":1627,"type":295}," Identified as diagnosis type (M), (1), (2), (W), (X) or (Y)",{"_uid":1629,"title":1630,"ctaLeft":1631,"ctaRight":1632,"component":898,"columnLeft":1633,"columnRight":1640},"c821949f-5ba5-41b7-a677-56ff361a10be","Exclusions",[],[],{"type":12,"content":1634},[1635],{"type":15,"attrs":1636,"content":1637},{"textAlign":53},[1638],{"text":1639,"type":295},"Abstracts with a length of stay less than 2 days",{"type":12,"content":1641},[1642,1647],{"type":15,"attrs":1643,"content":1644},{"textAlign":53},[1645],{"text":1646,"type":295},"N39.0: Urinary tract infection, site not specified",{"type":15,"attrs":1648,"content":1649},{"textAlign":53},[1650],{"text":1651,"type":295},"O86.202: Urinary tract infection following delivery; delivered with mention of postpartum complication",{"_uid":1653,"title":1654,"ctaLeft":1655,"ctaRight":1656,"component":898,"columnLeft":1657,"columnRight":1661},"32bd8385-b4be-47b5-a175-d653a6661ba3","Additional codes & Inclusions",[],[],{"type":12,"content":1658},[1659],{"type":15,"attrs":1660},{"textAlign":53},{"type":12,"content":1662},[1663,1668],{"type":15,"attrs":1664,"content":1665},{"textAlign":53},[1666],{"text":1667,"type":295},"T83.5: Infection and inflammatory reaction due to prosthetic device, implant, and graft in urinary system",{"type":15,"attrs":1669,"content":1670},{"textAlign":53},[1671,1673],{"text":1672,"type":295},"Y60-84: Complications of medical and surgical care (refer to Appendix A) of the ",{"text":1674,"type":295,"marks":1675},"Hospital Harm Indicator General Methodology Notes",[1676],{"type":371,"attrs":1677},{"href":1678,"uuid":53,"anchor":53,"custom":1679,"target":374,"linktype":375},"http://indicatorlibrary.cihi.ca/download/attachments/10453027/Hospital%20Harm%20Indicator%20General%20Methodology%20Notes.pdf?version=1&modificationDate=1561404418000&api=v2",{},"Discharge Abstract Database",{"type":12,"content":1682},[1683,1688,1693],{"type":15,"attrs":1684,"content":1685},{"textAlign":53},[1686],{"text":1687,"type":295},"Discharge Abstract Database (DAD) Codes included in this clinical category: B13: Urinary Tract Infections",{"type":15,"attrs":1689,"content":1690},{"textAlign":53},[1691],{"text":1692,"type":295},"Concept: Urinary tract infections identified during a hospital stay.",{"type":15,"attrs":1694,"content":1695},{"textAlign":53},[1696],{"text":1697,"type":295},"Notes: In the neonatal age group, underestimation is probable, due to the identification of in-utero or birth process infections versus environment-acquired infections has been documented as a challenge.",{"_uid":1699,"content":1700,"component":633},"665cc2d1-be41-4f8c-adc8-d048e1b01858",[1701],{"_uid":1702,"content":1703,"component":632},"c85d8909-6e1f-47c3-9026-807694193ba4",{"type":12,"content":1704},[1705,1710,1720],{"type":406,"attrs":1706,"content":1707},{"level":408,"textAlign":53},[1708],{"text":1709,"type":295},"Success Stories",{"type":15,"attrs":1711,"content":1712},{"textAlign":53},[1713],{"text":1714,"type":295,"marks":1715},"Four BC Hospitals Recognized for Surgical Care Quality",[1716],{"type":371,"attrs":1717},{"href":1718,"uuid":53,"anchor":53,"custom":1719,"target":374,"linktype":375},"https://bcpsqc.ca/blog/four-bc-hospitals-recognized-for-surgical-care-quality/",{},{"type":15,"attrs":1721,"content":1722},{"textAlign":53},[1723],{"text":1724,"type":295},"Burnaby Hospital, Chilliwack General Hospital, Lions Gate Hospital and Surrey Memorial Hospital were recognized in November by the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) for exemplary results for patients in surgical care. [They] were recognized in the \"all cases\" category for outcomes in … urinary tract infection... Using validated, risk-adjusted data from NSQIP, sites are able to compare their data provincially, nationally, and internationally as well as identify specific areas on which to focus their improvement efforts. (BC Patient Safety & Quality Council, 2021).",{"id":16,"_uid":1726,"items":1727,"component":659},"aa499916-7a48-4002-b47b-f0c284a2a78b",[1728],{"_uid":1729,"link":1730,"image":1735,"title":651,"component":652,"description":1737},"a5693411-d442-4518-aadb-672a5005c6ec",[1731],{"_uid":1732,"link":1733,"label":645,"component":646},"baf98971-ae69-4fac-a979-802cbec6f986",{"id":275,"url":16,"linktype":463,"fieldtype":643,"cached_url":303,"story":1734},{"name":270,"id":274,"uuid":275,"slug":9,"url":303,"full_slug":303,"_stopResolving":301},{"id":648,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":649,"copyright":16,"fieldtype":284,"meta_data":1736,"is_external_url":286},{},{"type":12,"content":1738},[1739],{"type":15,"attrs":1740,"content":1741},{"textAlign":53},[1742],{"text":294,"type":295},[129,150,136,122,143,115,157],[185,192,200],"uti","resources/uti",-18580,[],"d40689f8-5c6f-40f0-8de3-e5cde9c62206","2025-12-08T16:05:33.442Z",[],[1753],{"path":1754,"name":1755,"lang":315,"published":301},"ressources/infections-urinaires","Infections urinaires",{"name":1757,"created_at":1758,"published_at":1759,"updated_at":1760,"id":1761,"uuid":1762,"content":1763,"slug":3547,"full_slug":3548,"sort_by_date":53,"position":1747,"tag_list":3549,"is_startpage":286,"parent_id":667,"meta_data":53,"group_id":3550,"first_published_at":3551,"release_id":53,"lang":309,"path":53,"alternates":3552,"default_full_slug":3548,"translated_slugs":3553},"Birth Trauma","2025-12-04T22:06:52.561Z","2026-03-10T16:41:01.042Z","2026-03-10T16:41:01.342Z",119588505956750,"7c1171d0-cb17-474d-b1fa-025552f9468e",{"new":286,"seo":1764,"_uid":690,"hero":1767,"type":174,"topics":1788,"Noindex":286,"content":1789,"audience":3545,"duration":16,"regional":3546,"component":662},{"_uid":688,"title":1765,"plugin":339,"og_image":16,"og_title":16,"description":1766,"twitter_image":16,"twitter_title":16,"og_description":16,"twitter_description":16},"Birth Trauma ","Healthcare Excellence Canada has developed this Hospital Harm Improvement Resource – a compilation of resources to support patient safety and improvement efforts.",[1768],{"_uid":693,"image":1769,"title":1771,"format":1772,"component":351,"description":1775,"key_learning":1782,"prerequisite":1785},{"id":695,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":696,"copyright":16,"fieldtype":284,"meta_data":1770,"is_external_url":286},{"alt":16,"title":16,"source":16,"copyright":16},"Hospital Harm: Birth Trauma",{"type":12,"content":1773},[1774],{"type":15},{"type":12,"content":1776},[1777],{"type":15,"attrs":1778,"content":1779},{"textAlign":53},[1780],{"text":1781,"type":295},"Birth injuries are those sustained during the birth process, which includes labor and delivery. They may be avoidable, or they may be unavoidable and occur despite skilled and competent obstetric care, as in an especially hard or prolonged labor or with an abnormal presentation (Prazad et al., 2019).",{"type":12,"content":1783},[1784],{"type":15},{"type":12,"content":1786},[1787],{"type":15},[76,8],[1790,1801,1989,2091,2119,2567,2602,3005,3340,3407,3527],{"_uid":718,"link":1791,"image":1792,"title":722,"component":723,"media_type":724,"description":1794},[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":284,"meta_data":1793},{},{"type":12,"content":1795},[1796],{"type":15,"attrs":1797,"content":1798},{"textAlign":53},[1799],{"text":1800,"type":295},"Reduce the incidence of injuries to the newborn during non-instrumented or instrument-assisted vaginal delivery, or Caesarean section.",{"_uid":1802,"content":1803,"component":633},"1010ae87-305e-4413-a52a-63495dbe7cf3",[1804],{"_uid":1805,"content":1806,"component":632},"a217acfe-5514-41a9-b405-799b24d56e71",{"type":12,"content":1807},[1808,1812,1823,1828,1833,1838,1843,1964,1969,1974,1979,1984],{"type":406,"attrs":1809,"content":1810},{"level":408,"textAlign":53},[1811],{"text":743,"type":295},{"type":15,"attrs":1813,"content":1814},{"textAlign":53},[1815,1816,1822],{"text":748,"type":295},{"text":455,"type":295,"marks":1817},[1818],{"type":371,"attrs":1819},{"href":459,"uuid":460,"anchor":53,"custom":1820,"target":462,"linktype":463,"story":1821},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":756,"type":295},{"type":15,"attrs":1824,"content":1825},{"textAlign":53},[1826],{"text":1827,"type":295},"Since 1981, because of refinements in obstetric techniques and the increased use of cesarean deliveries over difficult vaginal deliveries, a dramatic decline has occurred in birth injuries as a cause of neonatal death. Statistics reported for 2013-2014 did not cite birth injury as one of the 10 leading causes of postnatal death. Despite a reduction in related mortality rates, birth injuries still represent an important source of neonatal morbidity and neonatal intensive care unit admissions. Of particular concern are severe intracranial injuries after vacuum-assisted and forceps vaginal delivery and failed attempts at instrument-assisted vaginal delivery. Although many injuries are mild and self-limited, others are serious and potentially lethal (Prazad et al., 2019).",{"type":15,"attrs":1829,"content":1830},{"textAlign":53},[1831],{"text":1832,"type":295},"The incidence of neonatal injury resulting from difficult or traumatic deliveries is decreasing due to increasing use of cesarean delivery in place of difficult versions, vacuum extractions, or mid- or high-forceps deliveries. There is an increased risk of trauma when the infant is large for gestational age which is sometimes associated with maternal diabetes, or when there is a breech or other abnormal presentation, especially in a primipara (Stavis, 2019).",{"type":15,"attrs":1834,"content":1835},{"textAlign":53},[1836],{"text":1837,"type":295},"On the basis of frequencies alone, some of the major findings of Pressler's research, Classification of major newborn birth injuries, can be highlighted. For example, of the 20 major categories of neonatal injuries cited, eight (40 per cent) involve blood vessels and some type of hemorrhage. Nerves or the nervous system is involved in six (30 per cent) of the injuries, and a major organ is also involved in six (30 per cent) of the injuries. Only five (24 per cent) of the injuries are the result of some type of bone fracture. The cause of injuries is thought to be associated with the occurrence of shoulder dystocia in six (30 per cent) of the cases. Use of instrumental techniques (e.g., forceps or vacuum extractors) is stated as being involved in at least 11 (55 per cent) of the injuries. Six (30 per cent) of the birth injuries were reported as leading to a potentially fatal prognosis (Pressler, 2008).",{"type":15,"attrs":1839,"content":1840},{"textAlign":53},[1841],{"text":1842,"type":295},"Categories and related sub-categories of common birth injuries include (Stavis, 2019):",{"type":499,"content":1844},[1845,1852,1859,1866,1873,1880,1887,1894,1901,1908,1915,1922,1929,1936,1943,1950,1957],{"type":440,"content":1846},[1847],{"type":15,"attrs":1848,"content":1849},{"textAlign":53},[1850],{"text":1851,"type":295},"Head injury is the most common birth-related injury and is usually minor, but serious injuries sometimes occur.",{"type":440,"content":1853},[1854],{"type":15,"attrs":1855,"content":1856},{"textAlign":53},[1857],{"text":1858,"type":295},"Head molding",{"type":440,"content":1860},[1861],{"type":15,"attrs":1862,"content":1863},{"textAlign":53},[1864],{"text":1865,"type":295},"Scalp abrasions",{"type":440,"content":1867},[1868],{"type":15,"attrs":1869,"content":1870},{"textAlign":53},[1871],{"text":1872,"type":295},"Caput succedaneum",{"type":440,"content":1874},[1875],{"type":15,"attrs":1876,"content":1877},{"textAlign":53},[1878],{"text":1879,"type":295},"Subgaleal hemorrhage*",{"type":440,"content":1881},[1882],{"type":15,"attrs":1883,"content":1884},{"textAlign":53},[1885],{"text":1886,"type":295},"Cephalhematoma*",{"type":440,"content":1888},[1889],{"type":15,"attrs":1890,"content":1891},{"textAlign":53},[1892],{"text":1893,"type":295},"Depressed skull fractures",{"type":440,"content":1895},[1896],{"type":15,"attrs":1897,"content":1898},{"textAlign":53},[1899],{"text":1900,"type":295},"Facial Nerve Injury* - The facial nerve is injured most often. Although forceps pressure is a common cause, some injuries probably result from pressure on the nerve in utero.",{"type":440,"content":1902},[1903],{"type":15,"attrs":1904,"content":1905},{"textAlign":53},[1906],{"text":1907,"type":295},"Brachial Plexus Injuries* - frequently follow lateral stretching of the neck during delivery caused by shoulder dystocia, breech extraction, or hyperabduction of the neck in cephalic presentations.",{"type":440,"content":1909},[1910],{"type":15,"attrs":1911,"content":1912},{"textAlign":53},[1913],{"text":1914,"type":295},"Erb palsy",{"type":440,"content":1916},[1917],{"type":15,"attrs":1918,"content":1919},{"textAlign":53},[1920],{"text":1921,"type":295},"Klumpke palsy",{"type":440,"content":1923},[1924],{"type":15,"attrs":1925,"content":1926},{"textAlign":53},[1927],{"text":1928,"type":295},"Involvement of the entire plexus",{"type":440,"content":1930},[1931],{"type":15,"attrs":1932,"content":1933},{"textAlign":53},[1934],{"text":1935,"type":295},"Phrenic Nerve Injuries* - Most phrenic nerve injuries (about 75 per cent) are associated with brachial plexus injury. Injury is usually unilateral and caused by a traction injury of the head and neck.",{"type":440,"content":1937},[1938],{"type":15,"attrs":1939,"content":1940},{"textAlign":53},[1941],{"text":1942,"type":295},"Spinal Cord Injury* - Trauma usually occurs in breech deliveries after excess longitudinal traction to the spine.",{"type":440,"content":1944},[1945],{"type":15,"attrs":1946,"content":1947},{"textAlign":53},[1948],{"text":1949,"type":295},"Intracranial Hemorrhage - Hemorrhage in or around the brain can occur in any neonate but is particularly common among those born prematurely; about 25 per cent of premature infants \u003C 1500 g have intracranial hemorrhage.",{"type":440,"content":1951},[1952],{"type":15,"attrs":1953,"content":1954},{"textAlign":53},[1955],{"text":1956,"type":295},"Fractures* - Midclavicular fracture, the most common fracture during birth, occurs with shoulder dystocia and with normal, nontraumatic deliveries.",{"type":440,"content":1958},[1959],{"type":15,"attrs":1960,"content":1961},{"textAlign":53},[1962],{"text":1963,"type":295},"Soft -Tissue Injuries - All soft tissues are susceptible to injury during birth if they have been the presenting part or the fulcrum for the forces of uterine contraction.",{"type":15,"attrs":1965,"content":1966},{"textAlign":53},[1967],{"text":1968,"type":295},"*related to instrument-assisted delivery.",{"type":15,"attrs":1970,"content":1971},{"textAlign":53},[1972],{"text":1973,"type":295},"The incidence of birth injuries has dramatically decreased in the last two decades. Macrosomia and instrumental deliveries are major risk factors for birth injuries. Forceps use is the most common cause of facial nerve injury and is usually self-limited. Erb palsy is the most common brachial plexus injury. Shoulder dystocia is a major risk factor for brachial plexus injury. Planned cesarean delivery for breech presentation decreases mortality and morbidity. Posterior fossa hematoma can cause brain stem compression, leading to respiratory compromise (Akangire & Carter, 2016).",{"type":15,"attrs":1975,"content":1976},{"textAlign":53},[1977],{"text":1978,"type":295},"Now that forceps are used less frequently (e.g., especially use of mid- and high forceps), many of the injuries that were common before 1966 (e.g., skull fractures, facial bone fractures, femur fractures, facial) palsy, and cervical spine injuries are rarely seen in the United States today. Breech deliveries are less likely to be completed vaginally, and cesarean deliveries can be performed using a transverse incision instead of a midline incision approach. Nearly half of major birth injuries and serious negative outcomes are potentially avoidable with early detection and intervention. To avoid specific negative outcomes, various evaluative techniques, such as perinatal history, physical examination, radiographs, paracentesis, ultrasonography, computerized tomography scans, and magnetic resonance imaging, can be used to predict more accurately the abnormalities that place the fetus at high risk for major birth injuries. However, predicting the likelihood of an injury's occurrence does not guarantee that it will not happen, but instead may help lessen the severity of the injury approach (Pressler, 2008).",{"type":15,"attrs":1980,"content":1981},{"textAlign":53},[1982],{"text":1983,"type":295},"When assisted vaginal birth is deemed to have a higher risk of not being successful, it should be considered a trial of assisted vaginal birth and be conducted in a location where immediate recourse to Caesarean delivery is available (Hobson et al., 2019).",{"type":15,"attrs":1985,"content":1986},{"textAlign":53},[1987],{"text":1988,"type":295},"Performing a Caesarean section with extraction of a deeply impacted fetal head out of the maternal pelvis is technically challenging even for experienced obstetricians. The difficulty for the surgeon is to disengage the impacted head by hand due to a lack of space between the muscular and bony maternal pelvis and the deeply impacted fetal head. This procedure is associated with serious neonatal complications, for instance skull injuries causing cerebral haemorrhage and newborn hypoxia that result in higher neonatal admission rates. Head pushing is the most commonly practiced technique. However, reverse breech extraction has gradually been given higher priority. Recently assessed neonatal outcome show less morbidity after reverse breech extraction compared to the head pushing method for obstructed labour. The beneficial maternal-fetal results of performing the reverse breech procedure indicate that it is a reliable alternative to the standard head pushing method and should preferably be used in deeply impacted fetal head situations during Caesarean section in advanced labour (Lenz et al., 2019).",{"_uid":1990,"items":1991,"title":1994,"component":1458,"description":2087},"877fd3f0-799f-4b84-883b-4a0d1e431ac1",[1992],{"_uid":1993,"title":1994,"ctaLeft":1995,"ctaRight":1996,"component":898,"columnLeft":1997,"columnRight":2004},"22d6870f-4367-4d25-a46e-581cf92265e3","Risk Factors and Related Injuries",[],[],{"type":12,"content":1998},[1999],{"type":15,"attrs":2000,"content":2001},{"textAlign":53},[2002],{"text":2003,"type":295},"Factors predisposing the infant to birth injury and their related injuries include (Akangire, 2016):",{"type":12,"content":2005},[2006,2015,2024,2033,2042,2051,2060,2069,2078],{"type":15,"attrs":2007,"content":2008},{"textAlign":53},[2009,2013],{"text":2010,"type":295,"marks":2011},"Risk factors",[2012],{"type":487},{"text":2014,"type":295},": Related injuries",{"type":15,"attrs":2016,"content":2017},{"textAlign":53},[2018,2022],{"text":2019,"type":295,"marks":2020},"Forceps delivery",[2021],{"type":487},{"text":2023,"type":295},": Facial nerve injuries",{"type":15,"attrs":2025,"content":2026},{"textAlign":53},[2027,2031],{"text":2028,"type":295,"marks":2029},"Vacuum extraction",[2030],{"type":487},{"text":2032,"type":295},": Depressed skull fracture, subgaleal hemorrhage",{"type":15,"attrs":2034,"content":2035},{"textAlign":53},[2036,2040],{"text":2037,"type":295,"marks":2038},"Forceps/vacuum/forceps + vacuum",[2039],{"type":487},{"text":2041,"type":295},": Cephalohematoma, intracranial hemorrhage, shoulder dystocia, retinal hemorrhages",{"type":15,"attrs":2043,"content":2044},{"textAlign":53},[2045,2049],{"text":2046,"type":295,"marks":2047},"Breech presentation",[2048],{"type":487},{"text":2050,"type":295},": Brachial plexus palsy, intracranial hemorrhage, gluteal lacerations, long bone fractures",{"type":15,"attrs":2052,"content":2053},{"textAlign":53},[2054,2058],{"text":2055,"type":295,"marks":2056},"Macrosomia",[2057],{"type":487},{"text":2059,"type":295},": Shoulder dystocia, clavicle, and rib fractures, cephalohematoma, caput succedaneum",{"type":15,"attrs":2061,"content":2062},{"textAlign":53},[2063,2067],{"text":2064,"type":295,"marks":2065},"Abnormal presentation (face, brow, transverse, compound)",[2066],{"type":487},{"text":2068,"type":295},": Excessive bruising, retinal hemorrhage, lacerations",{"type":15,"attrs":2070,"content":2071},{"textAlign":53},[2072,2076],{"text":2073,"type":295,"marks":2074},"Prematurity",[2075],{"type":487},{"text":2077,"type":295},": Bruising, intracranial, and extracranial hemorrhage",{"type":15,"attrs":2079,"content":2080},{"textAlign":53},[2081,2085],{"text":2082,"type":295,"marks":2083},"Precipitous delivery",[2084],{"type":487},{"text":2086,"type":295},": Bruising, intracranial, and extracranial hemorrhage, retinal hemorrhage",{"type":12,"content":2088},[2089],{"type":15,"attrs":2090},{"textAlign":53},{"_uid":850,"content":2092,"component":633},[2093],{"_uid":853,"content":2094,"component":632},{"type":12,"content":2095},[2096,2100,2105,2110],{"type":406,"attrs":2097,"content":2098},{"level":408,"textAlign":53},[2099],{"text":860,"type":295},{"type":15,"attrs":2101,"content":2102},{"textAlign":53},[2103],{"text":2104,"type":295},"'I can't forget the horror of my son's birth'",{"type":15,"attrs":2106,"content":2107},{"textAlign":53},[2108],{"text":2109,"type":295},"Despite medical advancements, childbirth is a major cause of post-traumatic stress disorder – and yet nobody talks about it. Leah McLaren tells the harrowing story of the arrival of her second child – and her fight for treatment and support (McLaren, 2017).",{"type":15,"attrs":2111,"content":2112},{"textAlign":53},[2113],{"text":2114,"type":295,"marks":2115},"https://www.theguardian.com/lifeandstyle/2017/may/07/i-cant-forget-the-horror-of-my-sons-birth-post-traumatic-stress-disorder-childbirth",[2116],{"type":371,"attrs":2117},{"href":2114,"uuid":53,"anchor":53,"custom":2118,"target":374,"linktype":375},{},{"_uid":891,"items":2120,"title":1457,"component":1458,"description":2523},[2121],{"_uid":894,"title":895,"ctaLeft":2122,"ctaRight":2123,"component":898,"columnLeft":2124,"columnRight":2145},[],[],{"type":12,"content":2125},[2126],{"type":15,"attrs":2127,"content":2128},{"textAlign":53},[2129,2134,2141],{"text":2130,"type":295,"marks":2131},"To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for conducting chart audits and analysis methods are included in the ",[2132],{"type":298,"attrs":2133},{"color":300},{"text":2135,"type":295,"marks":2136},"Hospital Harm Improvement Resource Introduction",[2137],{"type":371,"attrs":2138},{"href":459,"uuid":460,"anchor":53,"custom":2139,"target":462,"linktype":463,"story":2140},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":540,"type":295,"marks":2142},[2143],{"type":298,"attrs":2144},{"color":300},{"type":12,"content":2146},[2147,2152,2157],{"type":15,"attrs":2148,"content":2149},{"textAlign":53},[2150],{"text":2151,"type":295},"Chart audits are recommended as a means to develop a more in-depth understanding of the care delivered to patients identified by the HHI. Chart audits help identify quality improvement opportunities.",{"type":15,"attrs":2153,"content":2154},{"textAlign":53},[2155],{"text":2156,"type":295},"If your review reveals that your cases of birth trauma are linked to specific processes or procedures, you may find these resources helpful:",{"type":499,"content":2158},[2159,2193,2226,2259,2281,2310,2404,2431,2452,2466,2499,2512],{"type":440,"content":2160},[2161,2172],{"type":15,"attrs":2162,"content":2163},{"textAlign":53},[2164,2166],{"text":2165,"type":295},"Association of Ontario Midwives ",{"text":2167,"type":295,"marks":2168},"www.ontariomidwives.ca",[2169],{"type":371,"attrs":2170},{"href":2171,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.ontariomidwives.ca/",{"type":499,"content":2173},[2174],{"type":440,"content":2175},[2176],{"type":15,"attrs":2177,"content":2178},{"textAlign":53},[2179,2181,2185,2187],{"text":2180,"type":295},"Corey J, MacDonald T. ",{"text":2182,"type":295,"marks":2183},"Management of the Uncomplicated Pregnancy Beyond 41+0 Weeks Gestation",[2184],{"type":402},{"text":2186,"type":295},". Association of Ontario Midwives; 2010. ",{"text":2188,"type":295,"marks":2189}," https://www.ontariomidwives.ca/sites/default/files/CPG%20full%20guidelines/CPG-Management-of-pregnancy-beyond-41-weeks-gestation-PUB.pdf",[2190],{"type":371,"attrs":2191},{"href":2192,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://www.ontariomidwives.ca/sites/default/files/CPG%20full%20guidelines/CPG-Management-of-pregnancy-beyond-41-weeks-gestation-PUB.pdf",{"type":440,"content":2194},[2195,2205],{"type":15,"attrs":2196,"content":2197},{"textAlign":53},[2198,2200],{"text":2199,"type":295},"British Medical Journal Open ",{"text":2201,"type":295,"marks":2202},"https://bmjopen.bmj.com/",[2203],{"type":371,"attrs":2204},{"href":2201,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":499,"content":2206},[2207],{"type":440,"content":2208},[2209],{"type":15,"attrs":2210,"content":2211},{"textAlign":53},[2212,2214,2218,2220],{"text":2213,"type":295},"Coroneos CJ, Voineskos SH, Christakis MK, Thoma A, Bain JR, Brouwers MC. Obstetrical brachial plexus injury (OBPI): Canada's national clinical practice guideline. ",{"text":2215,"type":295,"marks":2216},"BMJ Open",[2217],{"type":402},{"text":2219,"type":295},". 2017;7(1):e014141. doi:",{"text":2221,"type":295,"marks":2222},"10.1136/bmjopen-2016-014141",[2223],{"type":371,"attrs":2224},{"href":2225,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},"https://doi.org/10.1136/bmjopen-2016-014141",{"type":440,"content":2227},[2228,2238],{"type":15,"attrs":2229,"content":2230},{"textAlign":53},[2231,2233],{"text":2232,"type":295},"Cureus Journal of Medical Science ",{"text":2234,"type":295,"marks":2235},"https://www.cureus.com/",[2236],{"type":371,"attrs":2237},{"href":2234,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":499,"content":2239},[2240],{"type":440,"content":2241},[2242],{"type":15,"attrs":2243,"content":2244},{"textAlign":53},[2245,2247,2251,2253],{"text":2246,"type":295},"Ojumah N, Ramdhan RC, Wilson C, Loukas M, Oskouian RJ, Tubbs RS. Neurological Neonatal Birth Injuries: A Literature Review. ",{"text":2248,"type":295,"marks":2249},"Cureus",[2250],{"type":402},{"text":2252,"type":295},". 2017;9(12):e1938. doi:",{"text":2254,"type":295,"marks":2255},"10.7759/cureus.1938",[2256],{"type":371,"attrs":2257},{"href":2258,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://doi.org/10.7759/cureus.1938",{"type":440,"content":2260},[2261,2266],{"type":15,"attrs":2262,"content":2263},{"textAlign":53},[2264],{"text":2265,"type":295},"Fanaroff & Martin's Neonatal-Perinatal Medicine Eleventh Edition",{"type":499,"content":2267},[2268],{"type":440,"content":2269},[2270],{"type":15,"attrs":2271,"content":2272},{"textAlign":53},[2273,2275,2279],{"text":2274,"type":295},"Prazad PA, Rajpal MN, Mangurten HH, Puppala BL. Birth Injuries. In: ",{"text":2276,"type":295,"marks":2277},"Fanaroff and Martin's Neonatal-Perinatal Medicine",[2278],{"type":402},{"text":2280,"type":295},". 11th ed. Chapter 29. Elsevier; 2020:458-488",{"type":440,"content":2282},[2283,2294],{"type":15,"attrs":2284,"content":2285},{"textAlign":53},[2286,2288],{"text":2287,"type":295},"HIROC ",{"text":2289,"type":295,"marks":2290},"www.hiroc.com",[2291],{"type":371,"attrs":2292},{"href":2293,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.hiroc.com/",{"type":499,"content":2295},[2296,2303],{"type":440,"content":2297},[2298],{"type":15,"attrs":2299,"content":2300},{"textAlign":53},[2301],{"text":2302,"type":295},"Healthcare Insurance Reciprocal of Canada. Assisted Vaginal Deliveries. HIROC Risk Reference Sheets. Published September 2020. https://www.hiroc.com/resources/risk-reference-sheets/assisted-vaginal-deliveries",{"type":440,"content":2304},[2305],{"type":15,"attrs":2306,"content":2307},{"textAlign":53},[2308],{"text":2309,"type":295},"Healthcare Insurance Reciprocal of Canada. Shoulder Dystocia. HIROC Risk Reference Sheets. Published 2020. https://www.hiroc.com/resources/risk-reference-sheets/shoulder-dystocia",{"type":440,"content":2311},[2312,2323],{"type":15,"attrs":2313,"content":2314},{"textAlign":53},[2315,2317],{"text":2316,"type":295},"Journal of Obstetrics and Gynecology of Canada ",{"text":2318,"type":295,"marks":2319},"www.jogc.ca",[2320],{"type":371,"attrs":2321},{"href":2322,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},"http://www.jogc.ca/",{"type":499,"content":2324},[2325,2337,2350,2368,2386],{"type":440,"content":2326},[2327],{"type":15,"attrs":2328,"content":2329},{"textAlign":53},[2330,2332,2335],{"text":2331,"type":295},"Hobson S, Cassell K, Windrim R, Cargill Y. No. 381-Assisted Vaginal Birth. ",{"text":1393,"type":295,"marks":2333},[2334],{"type":402},{"text":2336,"type":295},". 2019;41(6):870-882. doi:10.1016/j.jogc.2018.10.020",{"type":440,"content":2338},[2339],{"type":15,"attrs":2340,"content":2341},{"textAlign":53},[2342,2344,2348],{"text":2343,"type":295},"Kotaska A, Menticoglou S. No. 384-Management of breech presentation at term. ",{"text":2345,"type":295,"marks":2346},"J Obstet Gynaecol Can",[2347],{"type":402},{"text":2349,"type":295},". 2019;41(8):1193 1205. doi:10.1016/j.jogc.2018.12.018",{"type":440,"content":2351},[2352],{"type":15,"attrs":2353,"content":2354},{"textAlign":53},[2355,2357,2360,2362],{"text":2356,"type":295},"Lefebvre G, Calder LA, De Gorter R, Bowman CL, Bell D, Bow M. Recommendations from a national panel on quality improvement in obstetrics. ",{"text":1393,"type":295,"marks":2358},[2359],{"type":402},{"text":2361,"type":295},". 2019; 41(5):653-659. doi:",{"text":2363,"type":295,"marks":2364},"10.1016/j.jogc.2019.02.011",[2365],{"type":371,"attrs":2366},{"href":2367,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://doi.org/10.1016/j.jogc.2019.02.011",{"type":440,"content":2369},[2370],{"type":15,"attrs":2371,"content":2372},{"textAlign":53},[2373,2375,2378,2380],{"text":2374,"type":295},"Bloch C, Dore S, Hobson S. Committee Opinion No. 415: Impacted fetal head, second-stage cesarean delivery. ",{"text":1393,"type":295,"marks":2376},[2377],{"type":402},{"text":2379,"type":295},". 2021;43(3):406-413. doi:",{"text":2381,"type":295,"marks":2382},"10.1016/j.jogc.2021.01.005",[2383],{"type":371,"attrs":2384},{"href":2385,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://doi.org/10.1016/j.jogc.2021.01.005",{"type":440,"content":2387},[2388],{"type":15,"attrs":2389,"content":2390},{"textAlign":53},[2391,2393,2396,2398],{"text":2392,"type":295},"Berger H, Gagnon R, Sermer M. Guideline No. 393-Diabetes in pregnancy. ",{"text":1393,"type":295,"marks":2394},[2395],{"type":402},{"text":2397,"type":295},". 2019;41(12):1814-1825.e1. doi:",{"text":2399,"type":295,"marks":2400},"10.1016/j.jogc.2019.03.008",[2401],{"type":371,"attrs":2402},{"href":2403,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://doi.org/10.1016/j.jogc.2019.03.008",{"type":440,"content":2405},[2406,2411],{"type":15,"attrs":2407,"content":2408},{"textAlign":53},[2409],{"text":2410,"type":295},"Journal of Perinatal and Neonatal Nursing",{"type":499,"content":2412},[2413],{"type":440,"content":2414},[2415],{"type":15,"attrs":2416,"content":2417},{"textAlign":53},[2418,2420,2424,2426],{"text":2419,"type":295},"Pressler JL. Classification of Major Newborn Birth Injuries. ",{"text":2421,"type":295,"marks":2422},"The Journal of Perinatal & Neonatal Nursing",[2423],{"type":402},{"text":2425,"type":295},". 2008;22(1). ",{"text":2427,"type":295,"marks":2428},"https://journals.lww.com/jpnnjournal/Fulltext/2008/01000/Classification_of_Major_Newborn_Birth_Injuries.13.aspx",[2429],{"type":371,"attrs":2430},{"href":2427,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":2432},[2433,2438],{"type":15,"attrs":2434,"content":2435},{"textAlign":53},[2436],{"text":2437,"type":295},"Merck Manual",{"type":499,"content":2439},[2440],{"type":440,"content":2441},[2442],{"type":15,"attrs":2443,"content":2444},{"textAlign":53},[2445,2447],{"text":2446,"type":295},"Stavis RL. Birth Injuries. Merck Manuals Professional Edition. Published July 2019. Accessed March 2021. ",{"text":2448,"type":295,"marks":2449},"https://www.merckmanuals.com/en-ca/professional/pediatrics/perinatal-problems/birth-injuries",[2450],{"type":371,"attrs":2451},{"href":2448,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":440,"content":2453},[2454],{"type":15,"attrs":2455,"content":2456},{"textAlign":53},[2457,2459,2464],{"text":2458,"type":295},"MORE",{"text":2460,"type":295,"marks":2461},"OB  ",[2462],{"type":2463},"superscript",{"text":2465,"type":295},"www.moreob.com",{"type":440,"content":2467},[2468,2478],{"type":15,"attrs":2469,"content":2470},{"textAlign":53},[2471,2473],{"text":2472,"type":295},"Pediatrics in Review ",{"text":2474,"type":295,"marks":2475},"https://pedsinreview.aappublications.org/",[2476],{"type":371,"attrs":2477},{"href":2474,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":499,"content":2479},[2480],{"type":440,"content":2481},[2482],{"type":15,"attrs":2483,"content":2484},{"textAlign":53},[2485,2487,2491,2493],{"text":2486,"type":295},"Akangire G, Carter B. Birth Injuries in Neonates. ",{"text":2488,"type":295,"marks":2489},"Pediatr Rev",[2490],{"type":402},{"text":2492,"type":295}," 2016;37(11):451. doi:",{"text":2494,"type":295,"marks":2495},"10.1542/pir.2015-0125",[2496],{"type":371,"attrs":2497},{"href":2498,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://doi.org/10.1542/pir.2015-0125",{"type":440,"content":2500},[2501],{"type":15,"attrs":2502,"content":2503},{"textAlign":53},[2504,2506],{"text":2505,"type":295},"Salus Global ",{"text":2507,"type":295,"marks":2508},"www.salusglobal.com",[2509],{"type":371,"attrs":2510},{"href":2511,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.salusglobal.com/",{"type":440,"content":2513},[2514],{"type":15,"attrs":2515,"content":2516},{"textAlign":53},[2517,2519],{"text":2518,"type":295},"Society of Obstetricians and Gynecologists of Canada ",{"text":1378,"type":295,"marks":2520},[2521],{"type":371,"attrs":2522},{"href":1382,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":12,"content":2524},[2525,2536,2540],{"type":15,"attrs":2526,"content":2527},{"textAlign":53},[2528,2530,2534],{"text":2529,"type":295},"Given the broad range of potential causes of ",{"text":2531,"type":295,"marks":2532},"birth trauma",[2533],{"type":402},{"text":2535,"type":295},", in addition to recommendations listed above, we recommend conducting clinical and system reviews to identify latent causes and determine appropriate recommendations.",{"type":15,"attrs":2537,"content":2538},{"textAlign":868},[2539],{"text":1470,"type":295},{"type":435,"attrs":2541,"content":2542},{"order":437},[2543,2549,2555,2561],{"type":440,"content":2544},[2545],{"type":15,"attrs":2546,"content":2547},{"textAlign":53},[2548],{"text":1480,"type":295},{"type":440,"content":2550},[2551],{"type":15,"attrs":2552,"content":2553},{"textAlign":53},[2554],{"text":1487,"type":295},{"type":440,"content":2556},[2557],{"type":15,"attrs":2558,"content":2559},{"textAlign":53},[2560],{"text":1494,"type":295},{"type":440,"content":2562},[2563],{"type":15,"attrs":2564,"content":2565},{"textAlign":53},[2566],{"text":1501,"type":295},{"_uid":1503,"items":2568,"title":1548,"component":1549,"description":2595},[2569,2576,2583,2589],{"_uid":1506,"image":2570,"title":2572,"component":1512,"description":2573},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":2571,"is_external_url":286},{},"You may use different measures or modify the measures described below to make them more appropriate and/or useful to your particular setting. However, be aware that modifying measures may limit the comparability of your results to others.",{"type":12,"content":2574},[2575],{"type":15},{"_uid":1517,"image":2577,"title":2579,"component":1512,"description":2580},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":2578,"is_external_url":286},{},"Evaluate your choice of measures in terms of the usefulness of the final results and the resources required to obtain them; try to maximize the former while minimizing the latter.",{"type":12,"content":2581},[2582],{"type":15},{"_uid":1525,"image":2584,"title":1511,"component":1512,"description":2586},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":2585,"is_external_url":286},{},{"type":12,"content":2587},[2588],{"type":15},{"_uid":1533,"image":2590,"title":1528,"component":1512,"description":2592},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":2591,"is_external_url":286},{},{"type":12,"content":2593},[2594],{"type":15},{"type":12,"content":2596},[2597],{"type":15,"attrs":2598,"content":2599},{"textAlign":53},[2600],{"text":2601,"type":295},"Vital to quality improvement is measurement, and this applies specifically to implementation of interventions. The chosen measures will help to determine whether an impact is being made (primary outcome), whether the intervention is actually being carried out (process measures), and whether any unintended consequences ensue (balancing measures). In selecting your measures, consider the following:",{"_uid":1563,"items":2603,"title":1680,"component":1458,"description":2979},[2604,2667,2740],{"_uid":1566,"title":1567,"ctaLeft":2605,"ctaRight":2606,"component":898,"columnLeft":2607,"columnRight":2623},[],[],{"type":12,"content":2608},[2609,2618],{"type":15,"attrs":2610,"content":2611},{"textAlign":53},[2612,2616],{"text":2613,"type":295,"marks":2614},"Code",[2615],{"type":487},{"text":2617,"type":295},": Code descriptions ",{"type":15,"attrs":2619,"content":2620},{"textAlign":53},[2621],{"text":2622,"type":295},"P10–P15: Identified as diagnosis type (M), (1), (2), (W), (X) or (Y) AND Entry Code N*",{"type":12,"content":2624},[2625,2629],{"type":15,"attrs":2626,"content":2627},{"textAlign":53},[2628],{"text":1630,"type":295},{"type":435,"attrs":2630,"content":2631},{"order":437},[2632,2639,2646,2653,2660],{"type":440,"content":2633},[2634],{"type":15,"attrs":2635,"content":2636},{"textAlign":53},[2637],{"text":2638,"type":295},"Newborns whose mother’s abstract has intervention codes for instrument-assisted or Caesarean section delivery,† (5.MD.53.^^, 5.MD.54.^^, 5.MD.55.^^, 5.MD.56.NN, 5.MD.56.PC, 5.MD.56.NR, 5.MD.56.PF, 5.MD.56.NW, 5MD.56.PJ or 5.MD.60.^^)‡ OR",{"type":440,"content":2640},[2641],{"type":15,"attrs":2642,"content":2643},{"textAlign":53},[2644],{"text":2645,"type":295},"Newborn abstracts with brain damage due to birth injury (P10.–, P11.1 or P11.2) as diagnosis type (M) or (1) AND preterm and low birth weight (P07.– ) as diagnosis type (M), (1) or (2) OR",{"type":440,"content":2647},[2648],{"type":15,"attrs":2649,"content":2650},{"textAlign":53},[2651],{"text":2652,"type":295},"Newborn abstracts with termination of pregnancy affecting fetuses and newborns (P96.4) OR",{"type":440,"content":2654},[2655],{"type":15,"attrs":2656,"content":2657},{"textAlign":53},[2658],{"text":2659,"type":295},"Newborn abstracts with congenital malformations of the central nervous system (Q00–Q07) as diagnosis type (M) or (1) OR",{"type":440,"content":2661},[2662],{"type":15,"attrs":2663,"content":2664},{"textAlign":53},[2665],{"text":2666,"type":295},"Newborn abstracts with congenital malformations and deformations of the musculoskeletal system (Q65–Q79) as diagnosis type (M) or (1)",{"_uid":2668,"title":2669,"ctaLeft":2670,"ctaRight":2671,"component":898,"columnLeft":2672,"columnRight":2676},"b9b8c1e0-53ae-4f62-8dc7-54e61e464643","Codes & Code Descriptions",[],[],{"type":12,"content":2673},[2674],{"type":15,"attrs":2675},{"textAlign":53},{"type":12,"content":2677},[2678,2686,2695,2704,2713,2722,2731],{"type":15,"attrs":2679,"content":2680},{"textAlign":53},[2681,2684],{"text":2613,"type":295,"marks":2682},[2683],{"type":487},{"text":2685,"type":295},": Code Description",{"type":15,"attrs":2687,"content":2688},{"textAlign":53},[2689,2693],{"text":2690,"type":295,"marks":2691},"P10.-",[2692],{"type":487},{"text":2694,"type":295},": Intracranial laceration and hemorrhage due to birth injury",{"type":15,"attrs":2696,"content":2697},{"textAlign":53},[2698,2702],{"text":2699,"type":295,"marks":2700},"P11.-",[2701],{"type":487},{"text":2703,"type":295},": Other birth injuries to central nervous system",{"type":15,"attrs":2705,"content":2706},{"textAlign":53},[2707,2711],{"text":2708,"type":295,"marks":2709},"P12.-",[2710],{"type":487},{"text":2712,"type":295},": Birth injury to scalp",{"type":15,"attrs":2714,"content":2715},{"textAlign":53},[2716,2720],{"text":2717,"type":295,"marks":2718},"P13.-",[2719],{"type":487},{"text":2721,"type":295},": Birth injury to skeleton",{"type":15,"attrs":2723,"content":2724},{"textAlign":53},[2725,2729],{"text":2726,"type":295,"marks":2727},"P14.-",[2728],{"type":487},{"text":2730,"type":295},": Birth injury to peripheral nervous system",{"type":15,"attrs":2732,"content":2733},{"textAlign":53},[2734,2738],{"text":2735,"type":295,"marks":2736},"P15.-",[2737],{"type":487},{"text":2739,"type":295},": Other birth injuries",{"_uid":1629,"title":2741,"ctaLeft":2742,"ctaRight":2743,"component":898,"columnLeft":2744,"columnRight":2766},"Additional codes & Exclusions",[],[],{"type":12,"content":2745},[2746,2751,2756,2761],{"type":15,"attrs":2747,"content":2748},{"textAlign":53},[2749],{"text":2750,"type":295},"*Entry Code N indicates an infant was born alive in the reporting facility.",{"type":15,"attrs":2752,"content":2753},{"textAlign":53},[2754],{"text":2755,"type":295},"† Due to the unavailability of chart numbers for Prince Edward Island, birth trauma with and without the assistance of instruments cannot be differentiated; therefore, all birth trauma in P.E.I. is included in this group regardless of the use of instruments or method of delivery.",{"type":15,"attrs":2757,"content":2758},{"textAlign":53},[2759],{"text":2760,"type":295},"‡ Newborns whose mothers are discharged from acute care facilities in a different fiscal year cannot be linked to the mothers' records; therefore, a few birth trauma cases that belong to D04 could be misclassified to A04 as the linkage is done within a fiscal year. A fiscal year is defined based on discharged date from April 1 of the current year to March 31 of the subsequent year.",{"type":15,"attrs":2762,"content":2763},{"textAlign":53},[2764],{"text":2765,"type":295},"§ These codes are part of the selection criteria, except when preterm and low birth weight is also coded. See the exclusion terms in the selection criteria section above.",{"type":12,"content":2767},[2768,2775,2784,2793,2802,2811,2820,2835,2844,2853,2862,2871,2880,2889,2898,2907,2916,2925,2934,2943,2952,2961,2970],{"type":15,"attrs":2769,"content":2770},{"textAlign":53},[2771,2774],{"text":2613,"type":295,"marks":2772},[2773],{"type":487},{"text":2685,"type":295},{"type":15,"attrs":2776,"content":2777},{"textAlign":53},[2778,2782],{"text":2779,"type":295,"marks":2780},"P07.-",[2781],{"type":487},{"text":2783,"type":295},": Disorders related to short gestation and low birth weight, not elsewhere classified",{"type":15,"attrs":2785,"content":2786},{"textAlign":53},[2787,2791],{"text":2788,"type":295,"marks":2789},"P10.–§",[2790],{"type":487},{"text":2792,"type":295},": \tIntracranial laceration and hemorrhage due to birth injury",{"type":15,"attrs":2794,"content":2795},{"textAlign":53},[2796,2800],{"text":2797,"type":295,"marks":2798},"P11.1§",[2799],{"type":487},{"text":2801,"type":295},": Other specified brain damage due to birth injury",{"type":15,"attrs":2803,"content":2804},{"textAlign":53},[2805,2809],{"text":2806,"type":295,"marks":2807},"P11.2§",[2808],{"type":487},{"text":2810,"type":295},": Unspecified brain damage due to birth injury",{"type":15,"attrs":2812,"content":2813},{"textAlign":53},[2814,2818],{"text":2815,"type":295,"marks":2816},"P96.4",[2817],{"type":487},{"text":2819,"type":295},": Termination of pregnancy, affecting fetus and newborn",{"type":15,"attrs":2821,"content":2822},{"textAlign":53},[2823,2827,2829],{"text":2824,"type":295,"marks":2825},"Q00–Q07",[2826],{"type":487},{"text":2828,"type":295},": ",{"text":2830,"type":295,"marks":2831},"Congenital malformations of the nervous system (refer to Appendix A)",[2832],{"type":298,"attrs":2833},{"color":2834},"#575757",{"type":15,"attrs":2836,"content":2837},{"textAlign":53},[2838,2842],{"text":2839,"type":295,"marks":2840},"Q65–Q79",[2841],{"type":487},{"text":2843,"type":295},": Congenital malformations and deformations of the musculoskeletal system (refer to Appendix A)",{"type":15,"attrs":2845,"content":2846},{"textAlign":53},[2847,2851],{"text":2848,"type":295,"marks":2849},"5.CA.20.^^",[2850],{"type":487},{"text":2852,"type":295},": Pharmacotherapy (in preparation for), termination of pregnancy",{"type":15,"attrs":2854,"content":2855},{"textAlign":53},[2856,2860],{"text":2857,"type":295,"marks":2858},"5.CA.24.^^",[2859],{"type":487},{"text":2861,"type":295},": Preparation by dilating cervix (for), termination of pregnancy",{"type":15,"attrs":2863,"content":2864},{"textAlign":53},[2865,2869],{"text":2866,"type":295,"marks":2867},"5.CA.88.^^",[2868],{"type":487},{"text":2870,"type":295},": Pharmacological termination of pregnancy",{"type":15,"attrs":2872,"content":2873},{"textAlign":53},[2874,2878],{"text":2875,"type":295,"marks":2876},"5.CA.89.^^",[2877],{"type":487},{"text":2879,"type":295},": Surgical termination of pregnancy",{"type":15,"attrs":2881,"content":2882},{"textAlign":53},[2883,2887],{"text":2884,"type":295,"marks":2885},"5.CA.93.^^",[2886],{"type":487},{"text":2888,"type":295},": Surgical removal of extrauterine pregnancy",{"type":15,"attrs":2890,"content":2891},{"textAlign":53},[2892,2896],{"text":2893,"type":295,"marks":2894},"5.MD.53.^^",[2895],{"type":487},{"text":2897,"type":295},": Forceps traction and rotation delivery",{"type":15,"attrs":2899,"content":2900},{"textAlign":53},[2901,2905],{"text":2902,"type":295,"marks":2903},"5.MD.54.^^",[2904],{"type":487},{"text":2906,"type":295},": Vacuum traction delivery",{"type":15,"attrs":2908,"content":2909},{"textAlign":53},[2910,2914],{"text":2911,"type":295,"marks":2912},"5.MD.55.^^",[2913],{"type":487},{"text":2915,"type":295},": Combination of vacuum and forceps delivery",{"type":15,"attrs":2917,"content":2918},{"textAlign":53},[2919,2923],{"text":2920,"type":295,"marks":2921},"5.MD.56.NN",[2922],{"type":487},{"text":2924,"type":295},": Breech delivery without episiotomy, partial breech extraction [assisted breech delivery] with forceps to aftercoming head",{"type":15,"attrs":2926,"content":2927},{"textAlign":53},[2928,2932],{"text":2929,"type":295,"marks":2930},"5.MD.56.PC",[2931],{"type":487},{"text":2933,"type":295},": Breech delivery with episiotomy, partial breech extraction [assisted breech delivery] with forceps to aftercoming head",{"type":15,"attrs":2935,"content":2936},{"textAlign":53},[2937,2941],{"text":2938,"type":295,"marks":2939},"5.MD.56.NR",[2940],{"type":487},{"text":2942,"type":295},": Breech delivery without episiotomy, total breech extraction with forceps to aftercoming head",{"type":15,"attrs":2944,"content":2945},{"textAlign":53},[2946,2950],{"text":2947,"type":295,"marks":2948},"5.MD.56.PF",[2949],{"type":487},{"text":2951,"type":295},": Breech delivery with episiotomy, total breech extraction with forceps to aftercoming head",{"type":15,"attrs":2953,"content":2954},{"textAlign":53},[2955,2959],{"text":2956,"type":295,"marks":2957},"5.MD.56.NW",[2958],{"type":487},{"text":2960,"type":295},": Breech delivery without episiotomy, unspecified breech extraction with forceps to aftercoming head",{"type":15,"attrs":2962,"content":2963},{"textAlign":53},[2964,2968],{"text":2965,"type":295,"marks":2966},"5.MD.56.PJ",[2967],{"type":487},{"text":2969,"type":295},": Breech delivery with episiotomy, unspecified breech extraction with forceps to aftercoming head",{"type":15,"attrs":2971,"content":2972},{"textAlign":53},[2973,2977],{"text":2974,"type":295,"marks":2975},"5.MD.60.^^",[2976],{"type":487},{"text":2978,"type":295},": Caesarean section delivery",{"type":12,"content":2980},[2981,2990,2995],{"type":15,"attrs":2982,"content":2983},{"textAlign":53},[2984,2986],{"text":2985,"type":295},"Discharge Abstract Database (DAD) Codes included in this clinical category: ",{"text":2987,"type":295,"marks":2988},"A04: Birth Trauma",[2989],{"type":487},{"type":15,"attrs":2991,"content":2992},{"textAlign":53},[2993],{"text":2994,"type":295},"Concept: Injuries to the newborn during non-instrumented vaginal delivery identified during the birth episode of care.",{"type":15,"attrs":2996,"content":2997},{"textAlign":53},[2998,3000,3003],{"text":2999,"type":295},"Notes: Refer to D04: Birth Trauma",{"text":1003,"type":295,"marks":3001},[3002],{"type":487},{"text":3004,"type":295},"for injuries during instrument-assisted or Caesarean section delivery.",{"_uid":3006,"items":3007,"title":1680,"component":1458,"description":3320},"257925ee-a19b-4c1b-8ec5-a44bf9af87a4",[3008,3067,3126,3227],{"_uid":3009,"title":1567,"ctaLeft":3010,"ctaRight":3011,"component":898,"columnLeft":3012,"columnRight":3028},"223a3e17-ab85-4c0d-b7ef-f22220d7c470",[],[],{"type":12,"content":3013},[3014,3018,3023],{"type":15,"attrs":3015,"content":3016},{"textAlign":53},[3017],{"text":2622,"type":295},{"type":15,"attrs":3019,"content":3020},{"textAlign":53},[3021],{"text":3022,"type":295},"AND",{"type":15,"attrs":3024,"content":3025},{"textAlign":53},[3026],{"text":3027,"type":295},"Newborns whose mother’s abstract has intervention codes for instrument-assisted or Caesarean section delivery, † (5.MD.53.^^, 5.MD.54.^^, 5.MD.55.^^, 5.MD.56.NN, 5.MD.56.PC, 5.MD.56.NR, 5.MD.56.PF, 5.MD.56.NW, 5MD.56.PJ or 5.MD.60.^^)‡",{"type":12,"content":3029},[3030,3034],{"type":15,"attrs":3031,"content":3032},{"textAlign":53},[3033],{"text":1630,"type":295},{"type":435,"attrs":3035,"content":3036},{"order":437},[3037,3049,3055,3061],{"type":440,"content":3038},[3039,3044],{"type":15,"attrs":3040,"content":3041},{"textAlign":53},[3042],{"text":3043,"type":295},"Newborn abstracts with brain damage due to birth injury (P10.–, P11.1 or P11.2) as diagnosis type (M) or (1) AND preterm and low birth weight",{"type":15,"attrs":3045,"content":3046},{"textAlign":53},[3047],{"text":3048,"type":295},"(P07.–) as diagnosis type (M), (1) or (2) OR",{"type":440,"content":3050},[3051],{"type":15,"attrs":3052,"content":3053},{"textAlign":53},[3054],{"text":2652,"type":295},{"type":440,"content":3056},[3057],{"type":15,"attrs":3058,"content":3059},{"textAlign":53},[3060],{"text":2659,"type":295},{"type":440,"content":3062},[3063],{"type":15,"attrs":3064,"content":3065},{"textAlign":53},[3066],{"text":2666,"type":295},{"_uid":3068,"title":2669,"ctaLeft":3069,"ctaRight":3070,"component":898,"columnLeft":3071,"columnRight":3075},"6bf3858b-72ad-4a23-8981-94657c6124af",[],[],{"type":12,"content":3072},[3073],{"type":15,"attrs":3074},{"textAlign":53},{"type":12,"content":3076},[3077,3084,3091,3098,3105,3112,3119],{"type":15,"attrs":3078,"content":3079},{"textAlign":53},[3080,3083],{"text":2613,"type":295,"marks":3081},[3082],{"type":487},{"text":2685,"type":295},{"type":15,"attrs":3085,"content":3086},{"textAlign":53},[3087,3090],{"text":2690,"type":295,"marks":3088},[3089],{"type":487},{"text":2694,"type":295},{"type":15,"attrs":3092,"content":3093},{"textAlign":53},[3094,3097],{"text":2699,"type":295,"marks":3095},[3096],{"type":487},{"text":2703,"type":295},{"type":15,"attrs":3099,"content":3100},{"textAlign":53},[3101,3104],{"text":2708,"type":295,"marks":3102},[3103],{"type":487},{"text":2712,"type":295},{"type":15,"attrs":3106,"content":3107},{"textAlign":53},[3108,3111],{"text":2717,"type":295,"marks":3109},[3110],{"type":487},{"text":2721,"type":295},{"type":15,"attrs":3113,"content":3114},{"textAlign":53},[3115,3118],{"text":2726,"type":295,"marks":3116},[3117],{"type":487},{"text":2730,"type":295},{"type":15,"attrs":3120,"content":3121},{"textAlign":53},[3122,3125],{"text":2735,"type":295,"marks":3123},[3124],{"type":487},{"text":2739,"type":295},{"_uid":3127,"title":1654,"ctaLeft":3128,"ctaRight":3129,"component":898,"columnLeft":3130,"columnRight":3148},"1dfc9e28-7e4c-41ec-aad1-0f1379b26608",[],[],{"type":12,"content":3131},[3132,3136,3140,3144],{"type":15,"attrs":3133,"content":3134},{"textAlign":53},[3135],{"text":2750,"type":295},{"type":15,"attrs":3137,"content":3138},{"textAlign":53},[3139],{"text":2755,"type":295},{"type":15,"attrs":3141,"content":3142},{"textAlign":53},[3143],{"text":2760,"type":295},{"type":15,"attrs":3145,"content":3146},{"textAlign":53},[3147],{"text":2765,"type":295},{"type":12,"content":3149},[3150,3157,3164,3171,3178,3185,3192,3199,3206,3213,3220],{"type":15,"attrs":3151,"content":3152},{"textAlign":53},[3153,3156],{"text":2613,"type":295,"marks":3154},[3155],{"type":487},{"text":2685,"type":295},{"type":15,"attrs":3158,"content":3159},{"textAlign":53},[3160,3163],{"text":2893,"type":295,"marks":3161},[3162],{"type":487},{"text":2897,"type":295},{"type":15,"attrs":3165,"content":3166},{"textAlign":53},[3167,3170],{"text":2902,"type":295,"marks":3168},[3169],{"type":487},{"text":2906,"type":295},{"type":15,"attrs":3172,"content":3173},{"textAlign":53},[3174,3177],{"text":2911,"type":295,"marks":3175},[3176],{"type":487},{"text":2915,"type":295},{"type":15,"attrs":3179,"content":3180},{"textAlign":53},[3181,3184],{"text":2920,"type":295,"marks":3182},[3183],{"type":487},{"text":2924,"type":295},{"type":15,"attrs":3186,"content":3187},{"textAlign":53},[3188,3191],{"text":2929,"type":295,"marks":3189},[3190],{"type":487},{"text":2933,"type":295},{"type":15,"attrs":3193,"content":3194},{"textAlign":53},[3195,3198],{"text":2938,"type":295,"marks":3196},[3197],{"type":487},{"text":2942,"type":295},{"type":15,"attrs":3200,"content":3201},{"textAlign":53},[3202,3205],{"text":2947,"type":295,"marks":3203},[3204],{"type":487},{"text":2951,"type":295},{"type":15,"attrs":3207,"content":3208},{"textAlign":53},[3209,3212],{"text":2956,"type":295,"marks":3210},[3211],{"type":487},{"text":2960,"type":295},{"type":15,"attrs":3214,"content":3215},{"textAlign":53},[3216,3219],{"text":2965,"type":295,"marks":3217},[3218],{"type":487},{"text":2969,"type":295},{"type":15,"attrs":3221,"content":3222},{"textAlign":53},[3223,3226],{"text":2974,"type":295,"marks":3224},[3225],{"type":487},{"text":2978,"type":295},{"_uid":3228,"title":2741,"ctaLeft":3229,"ctaRight":3230,"component":898,"columnLeft":3231,"columnRight":3249},"024fc506-ed63-4a19-8373-a8f12f8e31c4",[],[],{"type":12,"content":3232},[3233,3237,3241,3245],{"type":15,"attrs":3234,"content":3235},{"textAlign":53},[3236],{"text":2750,"type":295},{"type":15,"attrs":3238,"content":3239},{"textAlign":53},[3240],{"text":2755,"type":295},{"type":15,"attrs":3242,"content":3243},{"textAlign":53},[3244],{"text":2760,"type":295},{"type":15,"attrs":3246,"content":3247},{"textAlign":53},[3248],{"text":2765,"type":295},{"type":12,"content":3250},[3251,3258,3265,3272,3279,3286,3293,3307],{"type":15,"attrs":3252,"content":3253},{"textAlign":53},[3254,3257],{"text":2613,"type":295,"marks":3255},[3256],{"type":487},{"text":2685,"type":295},{"type":15,"attrs":3259,"content":3260},{"textAlign":53},[3261,3264],{"text":2779,"type":295,"marks":3262},[3263],{"type":487},{"text":2783,"type":295},{"type":15,"attrs":3266,"content":3267},{"textAlign":53},[3268,3271],{"text":2788,"type":295,"marks":3269},[3270],{"type":487},{"text":2792,"type":295},{"type":15,"attrs":3273,"content":3274},{"textAlign":53},[3275,3278],{"text":2797,"type":295,"marks":3276},[3277],{"type":487},{"text":2801,"type":295},{"type":15,"attrs":3280,"content":3281},{"textAlign":53},[3282,3285],{"text":2806,"type":295,"marks":3283},[3284],{"type":487},{"text":2810,"type":295},{"type":15,"attrs":3287,"content":3288},{"textAlign":53},[3289,3292],{"text":2815,"type":295,"marks":3290},[3291],{"type":487},{"text":2819,"type":295},{"type":15,"attrs":3294,"content":3295},{"textAlign":53},[3296,3299,3301],{"text":2824,"type":295,"marks":3297},[3298],{"type":487},{"text":3300,"type":295},": Congenital malformations of the nervous system (refer to Appendix A) of the ",{"text":1674,"type":295,"marks":3302},[3303],{"type":371,"attrs":3304},{"href":3305,"uuid":53,"anchor":53,"custom":3306,"target":374,"linktype":375},"https://www.cihi.ca/download/attachments/10453027/Hospital%20Harm%20Indicator%20General%20Methodology%20Notes.pdf?version=1&modificationDate=1561404418000&api=v2",{},{"type":15,"attrs":3308,"content":3309},{"textAlign":53},[3310,3313,3315],{"text":2839,"type":295,"marks":3311},[3312],{"type":487},{"text":3314,"type":295},": Congenital malformations and deformations of the musculoskeletal system (refer to Appendix A) of the ",{"text":1674,"type":295,"marks":3316},[3317],{"type":371,"attrs":3318},{"href":3305,"uuid":53,"anchor":53,"custom":3319,"target":374,"linktype":375},{},{"type":12,"content":3321},[3322,3330,3335],{"type":15,"attrs":3323,"content":3324},{"textAlign":53},[3325,3326],{"text":2985,"type":295},{"text":3327,"type":295,"marks":3328},"D04: Birth Trauma",[3329],{"type":487},{"type":15,"attrs":3331,"content":3332},{"textAlign":53},[3333],{"text":3334,"type":295},"Concept: Injuries to the newborn during an instrument-assisted or Caesarean section delivery.",{"type":15,"attrs":3336,"content":3337},{"textAlign":53},[3338],{"text":3339,"type":295},"Notes: Refer to A04: Refer to A04: Birth Trauma for injuries during vaginal delivery without the assistance of instruments.",{"_uid":1699,"content":3341,"component":633},[3342],{"_uid":1702,"content":3343,"component":632},{"type":12,"content":3344},[3345,3349,3354,3359,3364,3375,3380,3391,3396],{"type":406,"attrs":3346,"content":3347},{"level":408,"textAlign":53},[3348],{"text":1709,"type":295},{"type":15,"attrs":3350,"content":3351},{"textAlign":53},[3352],{"text":3353,"type":295},"The Salus Global Corporation has its roots in the successful launch of the MOREOB (Managing Obstetrical Risk Efficiently) Program, created by Dr. J. Kenneth Milne and his team during his tenure as acting Executive Vice President of the Patient Safety Division of the Society of Obstetricians and Gynaecologists of Canada (SOGC). The program was successfully piloted in 2002 to hospital obstetrical units in Canada and demand grew rapidly over the next few years. In 2007, seeking a strategic partner to help with geographic expansion and to bring the underlying principles embedded in the MOREOB Program to other clinical areas, the SOGC approached the Healthcare Insurance Reciprocal of Canada (HIROC). The two entities acted upon their common interest of improving patient safety and formed Salus Global Corporation (Salus Global) in July of that year (Salus Global, n.d.).",{"type":15,"attrs":3355,"content":3356},{"textAlign":53},[3357],{"text":3358,"type":295},"The MOREOB program is a comprehensive patient safety and performance improvement program for interprofessional obstetrical teams. The program has now been delivered in over 300 hospitals in Canada and the US and to more than 16,000 participants in the past 12 plus years. It has made a significant difference in clinical outcomes for mother and baby and in the way healthcare teams function together. The primary focus of the MOREOB Program is improving clinical outcomes. To date, there has been a 10 per cent reduction in severe infant mortality; 24 per cent reduction in infant morbidity; 33 per cent reduction in Hypoxic Ischemic Encephalopathy; and 77 per cent reduction in the number of newborns transferred to another hospital after a low-risk pregnancy and elective birth (MOREOB, n.d.).",{"type":406,"attrs":3360,"content":3361},{"level":773,"textAlign":53},[3362],{"text":3363,"type":295},"Institute for Healthcare Improvement",{"type":15,"attrs":3365,"content":3366},{"textAlign":53},[3367,3369,3374],{"text":3368,"type":295},"(",{"text":1250,"type":295,"marks":3370},[3371],{"type":371,"attrs":3372},{"href":1250,"uuid":53,"anchor":53,"custom":3373,"target":374,"linktype":375},{},{"text":999,"type":295},{"type":406,"attrs":3376,"content":3377},{"level":773,"textAlign":53},[3378],{"text":3379,"type":295},"Idealized design of perinatal care White Paper (2005)",{"type":15,"attrs":3381,"content":3382},{"textAlign":53},[3383,3385],{"text":3384,"type":295},"Cherouny PH, Federico FA, Haraden C, Leavitt Gullo S, Resar R. Idealized Design of Perinatal Care. IHI; 2005. ",{"text":3386,"type":295,"marks":3387},"http://www.ihi.org/resources/Pages/IHIWhitePapers/IdealizedDesignofPerinatalCareWhitePaper.aspx",[3388],{"type":371,"attrs":3389},{"href":3386,"uuid":53,"anchor":53,"custom":3390,"target":374,"linktype":375},{},{"type":406,"attrs":3392,"content":3393},{"level":773,"textAlign":53},[3394],{"text":3395,"type":295},"ECRI Institute",{"type":15,"attrs":3397,"content":3398},{"textAlign":53},[3399,3401],{"text":3400,"type":295},"ECRI Institute. Right On Time: Safe and Timely Delivery of Neonates. Presented at the: FTCA Risk Management Conference; August 7-8, 2012. Accessed March, 2021. ",{"text":3402,"type":295,"marks":3403},"https://www.youtube.com/watch?v=95v7osmALG4",[3404],{"type":371,"attrs":3405},{"href":3402,"uuid":53,"anchor":53,"custom":3406,"target":374,"linktype":375},{},{"_uid":3408,"items":3409,"title":3523,"component":1458,"description":3524},"d27e0ee6-d543-4ffe-ba19-0beac7b5077d",[3410],{"_uid":3411,"title":3412,"ctaLeft":3413,"ctaRight":3414,"component":898,"columnLeft":3415,"columnRight":3419},"d1d27db9-bb85-49f3-bb9e-7342f7791eb1","Expand to see a full list of references",[],[],{"type":12,"content":3416},[3417],{"type":15,"attrs":3418},{"textAlign":53},{"type":12,"content":3420},[3421,3426,3431,3436,3445,3455,3460,3465,3470,3483,3488,3493,3503,3514],{"type":15,"attrs":3422,"content":3423},{"textAlign":53},[3424],{"text":3425,"type":295},"Akangire G, Carter B. Birth Injuries in Neonates. Pediatr Rev. 2016;37(11):451. doi:10.1542/pir.2015-0125",{"type":15,"attrs":3427,"content":3428},{"textAlign":53},[3429],{"text":3430,"type":295},"Canadian Institute for Health Information. Appendix A. In: Hospital Harm Indicator: General Methodology Notes. Canadian Institute for Health Information; 2019.  https://indicatorlibrary.cihi.ca/display/HSPIL/Hospital+Harm?preview=/10453027/15564910/Hospital%20Harm%20Indicator%20General%20Methodology%20Notes.pdf",{"type":15,"attrs":3432,"content":3433},{"textAlign":53},[3434],{"text":3435,"type":295},"Canadian Patient Safety Institute (CPSI). Global Patient Safety Alerts. Published n.d. ",{"type":15,"attrs":3437,"content":3438},{"textAlign":53},[3439,3440],{"text":3384,"type":295},{"text":3386,"type":295,"marks":3441},[3442],{"type":371,"attrs":3443},{"href":3386,"uuid":53,"anchor":53,"custom":3444,"target":374,"linktype":375},{},{"type":15,"attrs":3446,"content":3447},{"textAlign":53},[3448,3450],{"text":3449,"type":295},"ECRI Institute. Right On Time: Safe and Timely Delivery of Neonates. Presented at the: FTCA Risk Management Conference; August 7-8, 2012. Accessed March 2021. ",{"text":3402,"type":295,"marks":3451},[3452],{"type":371,"attrs":3453},{"href":3402,"uuid":53,"anchor":53,"custom":3454,"target":374,"linktype":375},{},{"type":15,"attrs":3456,"content":3457},{"textAlign":53},[3458],{"text":3459,"type":295},"Hobson S, Cassell K, Windrim R, Cargill Y. No. 381-Assisted Vaginal Birth. Journal of Obstetrics and Gynaecology Canada. 2019;41(6):870-882. doi:10.1016/j.jogc.2018.10.020",{"type":15,"attrs":3461,"content":3462},{"textAlign":53},[3463],{"text":3464,"type":295},"Institute for Healthcare Improvement. How-to Guide: Prevent Surgical Site Infections. IHI; 2012. http://www.ihi.org/resources/pages/tools/howtoguidepreventsurgicalsiteinfection.aspx",{"type":15,"attrs":3466,"content":3467},{"textAlign":53},[3468],{"text":3469,"type":295},"Lenz F, Kimmich N, Zimmermann R, Kreft M. Maternal and neonatal outcome of reverse breech extraction of an impacted fetal head during caesarean section in advanced stage of labour: a retrospective cohort study. BMC Pregnancy and Childbirth. 2019;19(1):98. doi:10.1186/s12884-019-2253-3",{"type":15,"attrs":3471,"content":3472},{"textAlign":53},[3473,3475,3481],{"text":3474,"type":295},"McLaren L. 'I can't forget the horror of my son's birth.' The Guardian: International Edition. ",{"text":3476,"type":295,"marks":3477},"http://www.theguardian.com/lifeandstyle/2017/may/07/i-cant-forget-the-horror-of-my-sons-birth-post-traumatic-stress-disorder-childbirth.",[3478],{"type":371,"attrs":3479},{"href":3476,"uuid":53,"anchor":53,"custom":3480,"target":374,"linktype":375},{},{"text":3482,"type":295}," Published May 7, 2017. Accessed March 2021.",{"type":15,"attrs":3484,"content":3485},{"textAlign":53},[3486],{"text":3487,"type":295},"MOREOB. Program Features. MOREOB. Published n.d. Accessed March 2021. https://www.moreob.com/moreob-features",{"type":15,"attrs":3489,"content":3490},{"textAlign":53},[3491],{"text":3492,"type":295},"Prazad PA, Rajpal MN, Mangurten HH, Puppala BL. Birth Injuries. In: Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Chapter 29. Elsevier; 2020:458-488",{"type":15,"attrs":3494,"content":3495},{"textAlign":53},[3496,3498],{"text":3497,"type":295},"Pressler JL. Classification of Major Newborn Birth Injuries. The Journal of Perinatal & Neonatal Nursing. 2008;22(1). ",{"text":2427,"type":295,"marks":3499},[3500],{"type":371,"attrs":3501},{"href":2427,"uuid":53,"anchor":53,"custom":3502,"target":374,"linktype":375},{},{"type":15,"attrs":3504,"content":3505},{"textAlign":53},[3506,3508],{"text":3507,"type":295},"Salus Global. About. Published n.d. Accessed March 2021. ",{"text":3509,"type":295,"marks":3510},"https://www.salusglobal.com/about",[3511],{"type":371,"attrs":3512},{"href":3509,"uuid":53,"anchor":53,"custom":3513,"target":374,"linktype":375},{},{"type":15,"attrs":3515,"content":3516},{"textAlign":53},[3517,3518],{"text":2446,"type":295},{"text":2448,"type":295,"marks":3519},[3520],{"type":371,"attrs":3521},{"href":2448,"uuid":53,"anchor":53,"custom":3522,"target":374,"linktype":375},{},"References",{"type":12,"content":3525},[3526],{"type":15},{"id":16,"_uid":3528,"items":3529,"component":659},"fa1a47b4-4ea7-42ff-b1fc-3528ed535c63",[3530],{"_uid":3531,"link":3532,"image":3537,"title":651,"component":652,"description":3539},"29bce3ee-b20c-427e-9f64-7a2e2fcc9f11",[3533],{"_uid":3534,"link":3535,"label":645,"component":646},"00b91cd0-1f28-493b-809b-8e6e462fdcd7",{"id":275,"url":16,"linktype":463,"fieldtype":643,"cached_url":303,"story":3536},{"name":270,"id":274,"uuid":275,"slug":9,"url":303,"full_slug":303,"_stopResolving":301},{"id":648,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":649,"copyright":16,"fieldtype":284,"meta_data":3538,"is_external_url":286},{},{"type":12,"content":3540},[3541],{"type":15,"attrs":3542,"content":3543},{"textAlign":53},[3544],{"text":294,"type":295},[129,150,136,122,143,115,157],[185,192,200],"birth-trauma","resources/birth-trauma",[],"43be8ab7-13bb-4753-9a58-96dad3c0da20","2025-12-04T22:37:46.057Z",[],[3554],{"path":3555,"name":3556,"lang":315,"published":301},"ressources/traumatisme-a-la-naissance","Traumatisme à la naissance",{"name":3558,"created_at":3559,"published_at":3560,"updated_at":3561,"id":3562,"uuid":3563,"content":3564,"slug":4155,"full_slug":4156,"sort_by_date":53,"position":4157,"tag_list":4158,"is_startpage":286,"parent_id":667,"meta_data":53,"group_id":4159,"first_published_at":4160,"release_id":53,"lang":309,"path":53,"alternates":4161,"default_full_slug":4156,"translated_slugs":4162},"Delirium","2025-12-05T19:22:56.899Z","2026-03-10T16:40:39.481Z","2026-03-10T16:40:39.529Z",119902113526213,"f015ec1c-e106-427d-adb0-1e4995075e92",{"new":286,"seo":3565,"_uid":690,"hero":3566,"type":174,"topics":3587,"Noindex":286,"content":3588,"audience":4153,"duration":16,"regional":4154,"component":662},{"_uid":688,"title":3558,"plugin":339,"og_image":16,"og_title":16,"description":1766,"twitter_image":16,"twitter_title":16,"og_description":16,"twitter_description":16},[3567],{"_uid":693,"image":3568,"title":3570,"format":3571,"component":351,"description":3574,"key_learning":3581,"prerequisite":3584},{"id":695,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":696,"copyright":16,"fieldtype":284,"meta_data":3569,"is_external_url":286},{"alt":16,"title":16,"source":16,"copyright":16},"Hospital Harm: Delirium",{"type":12,"content":3572},[3573],{"type":15},{"type":12,"content":3575},[3576],{"type":15,"attrs":3577,"content":3578},{"textAlign":53},[3579],{"text":3580,"type":295},"Delirium is a state of confusion that comes on very suddenly and lasts hours to days. It can cause changes in a person’s ability to stay alert, remember, be oriented to time or place, speak or reason clearly.",{"type":12,"content":3582},[3583],{"type":15},{"type":12,"content":3585},[3586],{"type":15},[8,76],[3589,3600,3671,3727,3901,3944,3986,4055,4135],{"_uid":718,"link":3590,"image":3591,"title":722,"component":723,"media_type":724,"description":3593},[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":284,"meta_data":3592},{},{"type":12,"content":3594},[3595],{"type":15,"attrs":3596,"content":3597},{"textAlign":53},[3598],{"text":3599,"type":295},"To improve the early detection and reduce the incidence of delirium in at risk hospitalized patients in intensive and general care units through implementation of standardized delirium screening and prevention strategies.",{"_uid":1802,"content":3601,"component":633},[3602],{"_uid":1805,"content":3603,"component":632},{"type":12,"content":3604},[3605,3609,3620,3625,3630,3660],{"type":406,"attrs":3606,"content":3607},{"level":408,"textAlign":53},[3608],{"text":743,"type":295},{"type":15,"attrs":3610,"content":3611},{"textAlign":53},[3612,3613,3619],{"text":748,"type":295},{"text":455,"type":295,"marks":3614},[3615],{"type":371,"attrs":3616},{"href":459,"uuid":460,"anchor":53,"custom":3617,"target":462,"linktype":463,"story":3618},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":756,"type":295},{"type":15,"attrs":3621,"content":3622},{"textAlign":53},[3623],{"text":3624,"type":295},"Delirium can be caused by many things including having an infection, recent surgery, various medical conditions, untreated pain, starting, increasing or stopping some medicines, or not eating or sleeping well. Many things can make delirium worse including physical restraints, bed rest, bladder catheters and certain medications (Coalition for Seniors' Mental Health 2017; American Delirium Society 2015).",{"type":15,"attrs":3626,"content":3627},{"textAlign":53},[3628],{"text":3629,"type":295},"Delirium is a common problem in hospitalized ICU patients. It is sometimes not recognized or is misdiagnosed as another condition such as dementia or depression. Patients who experience delirium in the hospital (compared to patients without delirium) are more likely to:",{"type":499,"content":3631},[3632,3639,3646,3653],{"type":440,"content":3633},[3634],{"type":15,"attrs":3635,"content":3636},{"textAlign":53},[3637],{"text":3638,"type":295},"Stay longer in the hospital and have more hospital associated complications.",{"type":440,"content":3640},[3641],{"type":15,"attrs":3642,"content":3643},{"textAlign":53},[3644],{"text":3645,"type":295},"Experience higher mortality rates in the hospital and up to six to 12 months later.",{"type":440,"content":3647},[3648],{"type":15,"attrs":3649,"content":3650},{"textAlign":53},[3651],{"text":3652,"type":295},"Lose physical function in the hospital and need long-term care after the hospital.",{"type":440,"content":3654},[3655],{"type":15,"attrs":3656,"content":3657},{"textAlign":53},[3658],{"text":3659,"type":295},"Develop dementia or similar types of cognitive impairment even if the delirium clears (American Delirium Society 2015).  ",{"type":15,"attrs":3661,"content":3662},{"textAlign":53},[3663,3665,3669],{"text":3664,"type":295},"Delirium can be prevented. The most important step in delirium management is early recognition and prevention making it an important strategy for quality improvement (",{"text":3666,"type":295,"marks":3667},"Safer Healthcare Now! ",[3668],{"type":402},{"text":3670,"type":295},"2013).",{"_uid":850,"content":3672,"component":633},[3673],{"_uid":853,"content":3674,"component":632},{"type":12,"content":3675},[3676,3680,3691,3696,3702,3707,3712,3717,3722],{"type":406,"attrs":3677,"content":3678},{"level":408,"textAlign":53},[3679],{"text":860,"type":295},{"type":15,"attrs":3681,"content":3682},{"textAlign":53},[3683,3685,3689],{"text":3684,"type":295},"Delirium can also be referred to as \"sundowning\" or \"ICU psychosis\" (American Delirium Society 2015). It may be frightening to family members who are often more aware of the changes in a family member's mental status than are the care providers. With the proper care, delirium can be prevented or minimized (",{"text":3686,"type":295,"marks":3687},"Safer Healthcare Now!",[3688],{"type":402},{"text":3690,"type":295},", 2013). Family involvement, particularly in critical care, does not reduce delirium incidence but improves psychological recovery (Black 2011).",{"type":406,"attrs":3692,"content":3693},{"level":773,"textAlign":53},[3694],{"text":3695,"type":295},"Patient Story",{"type":406,"attrs":3697,"content":3699},{"level":3698,"textAlign":53},4,[3700],{"text":3701,"type":295},"Let's Respect",{"type":15,"attrs":3703,"content":3704},{"textAlign":53},[3705],{"text":3706,"type":295},"Mr. Graham was admitted to hospital with dysphagia and weight loss. He was very confused and uncooperative, believing that staff were trying to poison him. On admission, Mr. Graham's wife explained that he had Alzheimer's disease and described to staff how he usually presented and what he was able to do for himself. She also advised that he had recently been admitted in a confused state to another hospital. Mr. Graham was in fact in the early stages of dementia and had retained good insight into his problems. To many people, he would not usually have appeared 'confused' because of his good social skills.",{"type":15,"attrs":3708,"content":3709},{"textAlign":53},[3710],{"text":3711,"type":295},"Unfortunately, the diagnosis of 'dementia' became dominant in his hospital notes, to the degree that this prevailed over his presenting health problems. Despite the details his wife had given, it was assumed that all of Mr. Graham's confusion was due to his dementia and that this was 'normal' and therefore did not warrant further investigation. Mrs. Graham did not feel that all her husband's confusion was due to his dementia, but staff did not seem to be listening, and so she contacted their mental health liaison nurse. The nurse's assessment revealed that Mr. Graham was suffering from anaemia and she recommended further investigation.",{"type":15,"attrs":3713,"content":3714},{"textAlign":53},[3715],{"text":3716,"type":295},"It was found that he had indeed been admitted to another local hospital just two months earlier with the same problem. He had received four units of blood and his delirium improved. Mr. Graham received a further blood transfusion and much of his confusion cleared, but his haemoglobin levels were not maintained, and he continued to lose weight due to his difficulty with swallowing. By now, Mr. Graham had become very quiet and subdued. Further investigations eventually followed, and Mr. Graham was found to have a malignant growth in his oesophagus. He died in hospital two weeks later.",{"type":15,"attrs":3718,"content":3719},{"textAlign":53},[3720],{"text":3721,"type":295},"Mr. Graham's case demonstrates the dangers of failing to recognize Delirium in people who have dementia and subsequently denying them the assessment and care they are entitled to.",{"type":15,"attrs":3723,"content":3724},{"textAlign":53},[3725],{"text":3726,"type":295},"It also shows the importance of listening to those who know the patient well. The need for improved communication and further training and education for hospital staff is also indicated by this case (Let's Respect 2006).",{"_uid":891,"items":3728,"title":1457,"component":1458,"description":3863},[3729],{"_uid":894,"title":895,"ctaLeft":3730,"ctaRight":3731,"component":898,"columnLeft":3732,"columnRight":3749},[],[],{"type":12,"content":3733},[3734],{"type":15,"attrs":3735,"content":3736},{"textAlign":53},[3737,3738,3744,3745,3748],{"text":905,"type":295},{"text":907,"type":295,"marks":3739},[3740],{"type":371,"attrs":3741},{"href":459,"uuid":460,"anchor":53,"custom":3742,"target":462,"linktype":463,"story":3743},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":540,"type":295},{"text":915,"type":295,"marks":3746},[3747],{"type":487},{"text":915,"type":295},{"type":12,"content":3750},[3751,3756],{"type":15,"attrs":3752,"content":3753},{"textAlign":868},[3754],{"text":3755,"type":295},"If your review reveals that your cases of delirium are linked to specific processes or procedures, you may find these resources helpful:",{"type":499,"content":3757},[3758,3765,3777,3789,3801,3813,3851],{"type":440,"content":3759},[3760],{"type":15,"attrs":3761,"content":3762},{"textAlign":53},[3763],{"text":3764,"type":295},"American Delirium Society. https://www.americandeliriumsociety.org/",{"type":440,"content":3766},[3767],{"type":15,"attrs":3768,"content":3769},{"textAlign":53},[3770,3772],{"text":3771,"type":295},"Australian Commission on Safety and Quality in Health Care:  Delirium Clinical Care Standard. ",{"text":3773,"type":295,"marks":3774},"https://www.safetyandquality.gov.au/publications-and-resources/resource-library/delirium-clinical-care-standard-improve-care-and-prevention",[3775],{"type":371,"attrs":3776},{"href":3773,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":440,"content":3778},[3779],{"type":15,"attrs":3780,"content":3781},{"textAlign":53},[3782,3784],{"text":3783,"type":295},"Canadian Coalition for Seniors' Mental Health. ",{"text":3785,"type":295,"marks":3786},"http://www.ccsmh.ca/projects/delirium/",[3787],{"type":371,"attrs":3788},{"href":3785,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":440,"content":3790},[3791],{"type":15,"attrs":3792,"content":3793},{"textAlign":53},[3794,3796],{"text":3795,"type":295},"Critical Care Medicine; Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. (2018) ",{"text":3797,"type":295,"marks":3798},"https://journals.lww.com/ccmjournal/fulltext/2018/09000/Clinical_Practice_Guidelines_for_the_Prevention.29.aspx",[3799],{"type":371,"attrs":3800},{"href":3797,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":440,"content":3802},[3803],{"type":15,"attrs":3804,"content":3805},{"textAlign":53},[3806,3808],{"text":3807,"type":295},"European Delirium Association. ",{"text":3809,"type":295,"marks":3810},"http://www.europeandeliriumassociation.org/",[3811],{"type":371,"attrs":3812},{"href":3809,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":440,"content":3814},[3815,3825],{"type":15,"attrs":3816,"content":3817},{"textAlign":53},[3818,3820],{"text":3819,"type":295},"National Institutes for Clinical Excellence (NICE) ",{"text":3821,"type":295,"marks":3822},"https://www.nice.org.uk/",[3823],{"type":371,"attrs":3824},{"href":3821,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":499,"content":3826},[3827,3839],{"type":440,"content":3828},[3829],{"type":15,"attrs":3830,"content":3831},{"textAlign":53},[3832,3834],{"text":3833,"type":295},"Delirium: prevention, diagnosis and management Clinical guideline (Published 2010, updated 2019) ",{"text":3835,"type":295,"marks":3836},"https://www.nice.org.uk/guidance/cg103",[3837],{"type":371,"attrs":3838},{"href":3835,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":440,"content":3840},[3841],{"type":15,"attrs":3842,"content":3843},{"textAlign":53},[3844,3846],{"text":3845,"type":295},"Delirium in adults Quality standard (2014) ",{"text":3847,"type":295,"marks":3848},"https://www.nice.org.uk/guidance/qs63",[3849],{"type":371,"attrs":3850},{"href":3847,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":440,"content":3852},[3853],{"type":15,"attrs":3854,"content":3855},{"textAlign":53},[3856,3858],{"text":3857,"type":295},"Registered Nurses Association of Ontario (RNAO) - Delirium, Dementia, and Depression in Older Adults: Assessment and Care (2016). ",{"text":3859,"type":295,"marks":3860},"https://rnao.ca/bpg/guidelines/assessment-and-care-older-adults-delirium-dementia-and-depression",[3861],{"type":371,"attrs":3862},{"href":3859,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":12,"content":3864},[3865,3870,3874],{"type":15,"attrs":3866,"content":3867},{"textAlign":53},[3868],{"text":3869,"type":295},"Given the broad range of potential causes of Delirium, clinical and system reviews should be conducted to identify potential causes and determine appropriate recommendations.",{"type":15,"attrs":3871,"content":3872},{"textAlign":868},[3873],{"text":1470,"type":295},{"type":435,"attrs":3875,"content":3876},{"order":437},[3877,3883,3889,3895],{"type":440,"content":3878},[3879],{"type":15,"attrs":3880,"content":3881},{"textAlign":53},[3882],{"text":1480,"type":295},{"type":440,"content":3884},[3885],{"type":15,"attrs":3886,"content":3887},{"textAlign":53},[3888],{"text":1487,"type":295},{"type":440,"content":3890},[3891],{"type":15,"attrs":3892,"content":3893},{"textAlign":53},[3894],{"text":1494,"type":295},{"type":440,"content":3896},[3897],{"type":15,"attrs":3898,"content":3899},{"textAlign":53},[3900],{"text":1501,"type":295},{"_uid":1503,"items":3902,"title":1548,"component":1549,"description":3935},[3903,3909,3915,3921,3927],{"_uid":1506,"image":3904,"title":1511,"component":1512,"description":3906},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":3905,"is_external_url":286},{},{"type":12,"content":3907},[3908],{"type":15},{"_uid":1517,"image":3910,"title":2579,"component":1512,"description":3912},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":3911,"is_external_url":286},{},{"type":12,"content":3913},[3914],{"type":15},{"_uid":1525,"image":3916,"title":1528,"component":1512,"description":3918},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":3917,"is_external_url":286},{},{"type":12,"content":3919},[3920],{"type":15},{"_uid":1533,"image":3922,"title":2572,"component":1512,"description":3924},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":3923,"is_external_url":286},{},{"type":12,"content":3925},[3926],{"type":15},{"_uid":3928,"image":3929,"title":3931,"component":1512,"description":3932},"76a237f7-6280-4c10-9b4e-c9f00114db74",{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":3930,"is_external_url":286},{},"Posting your measure results within your hospital is a great way to keep your teams motivated and aware of progress. Try to include measures that your team will find meaningful and exciting (IHI 2012).",{"type":12,"content":3933},[3934],{"type":15},{"type":12,"content":3936},[3937],{"type":15,"attrs":3938,"content":3939},{"textAlign":53},[3940],{"text":2601,"type":295,"marks":3941},[3942],{"type":298,"attrs":3943},{"color":2834},{"_uid":1563,"items":3945,"title":1680,"component":1458,"description":3974},[3946,3960],{"_uid":1566,"title":1567,"ctaLeft":3947,"ctaRight":3948,"component":898,"columnLeft":3949,"columnRight":3953},[],[],{"type":12,"content":3950},[3951],{"type":15,"attrs":3952},{"textAlign":53},{"type":12,"content":3954},[3955],{"type":15,"attrs":3956,"content":3957},{"textAlign":53},[3958],{"text":3959,"type":295},"F05.–: Identified as diagnosis type (2)",{"_uid":2668,"title":2669,"ctaLeft":3961,"ctaRight":3962,"component":898,"columnLeft":3963,"columnRight":3967},[],[],{"type":12,"content":3964},[3965],{"type":15,"attrs":3966},{"textAlign":53},{"type":12,"content":3968},[3969],{"type":15,"attrs":3970,"content":3971},{"textAlign":53},[3972],{"text":3973,"type":295},"F05.–: Delirium, not induced by alcohol and other psychoactive substances",{"type":12,"content":3975},[3976,3981],{"type":15,"attrs":3977,"content":3978},{"textAlign":53},[3979],{"text":3980,"type":295},"Discharge Abstract Database (DAD) Codes included in this clinical category: A05: Delirium",{"type":15,"attrs":3982,"content":3983},{"textAlign":53},[3984],{"text":3985,"type":295},"Concept: Temporary disturbance in consciousness with changes in cognition identified during a hospital stay.",{"_uid":3987,"items":3988,"title":4050,"component":1458,"description":4051},"42ac371a-afd2-4bc4-90ef-f04fd7c47843",[3989,4020],{"_uid":3990,"title":3991,"ctaLeft":3992,"ctaRight":3993,"component":898,"columnLeft":3994,"columnRight":3998},"1206198e-595d-425e-8728-addb2417da98","Covenant Health",[],[],{"type":12,"content":3995},[3996],{"type":15,"attrs":3997},{"textAlign":53},{"type":12,"content":3999},[4000,4005,4010,4015],{"type":15,"attrs":4001,"content":4002},{"textAlign":53},[4003],{"text":4004,"type":295},"Covenant Health has implemented a data collection tool and processes to ensure 100 per cent of intensive care unit (ICU) patients are screened for Delirium. Delirium is very difficult to recognize in a critical care setting and very often goes undiagnosed. The most important step in Delirium management is early recognition. When Alberta Health Services asked its Edmonton zone to standardize and implement Delirium screening, the team at Covenant Health's Misericordia Hospital site, along with other teams in Edmonton, looked for help from the Safer Healthcare Now! Delirium and Medication Reconciliation Collaborative to improve care for critically ill patients.",{"type":15,"attrs":4006,"content":4007},{"textAlign":53},[4008],{"text":4009,"type":295},"To increase Delirium awareness for staff on the unit, Covenant Health created and put into practice a comprehensive education program. From this program came strategies to arm families of Delirium patients with support and information. The team has also developed noise reduction strategies to minimize sleep disturbance for patients in the ICU and a mobilization protocol to ensure that patients are out of bed when appropriate. A new pain assessment tool is under development for intubated patients who cannot express their pain level.",{"type":15,"attrs":4011,"content":4012},{"textAlign":53},[4013],{"text":4014,"type":295},"The Covenant Health team included the nurse practitioner, educator, supervisor, manager, pharmacist, respiratory therapist and two physiotherapists – all instrumental in the development of Delirium reduction strategies and making the mobilization protocol a reality. A physician group provided support in the ongoing management of appropriate medications.",{"type":15,"attrs":4016,"content":4017},{"textAlign":53},[4018],{"text":4019,"type":295},"\"The Covenant Health team has made huge strides in implementing a significant change in practice and improved care,\" says Kim Scherr, Nurse Practitioner. \"Our efforts to manage and prevent delirium have had a positive impact on the health and quality of life for countless ICU patients.\" (Safer Healthcare Now! One pager, 2013)",{"_uid":4021,"title":4022,"ctaLeft":4023,"ctaRight":4029,"component":898,"columnLeft":4030,"columnRight":4034},"8d6634e1-93b3-4851-b7cc-a77b09e6f538","Safer Elder Care Delirium Prevention Program",[4024],{"_uid":4025,"link":4026,"label":4022,"component":4028},"8e65e242-820f-4c2f-af23-a3113dd4f7e4",{"id":16,"url":4027,"linktype":375,"fieldtype":643,"cached_url":4027},"https://healthstandards.org/leading-practice/safer-elder-care-delirium-prevention-program/","simple-link-only",[],{"type":12,"content":4031},[4032],{"type":15,"attrs":4033},{"textAlign":53},{"type":12,"content":4035},[4036],{"type":15,"attrs":4037,"content":4038},{"textAlign":53},[4039,4041,4048],{"text":4040,"type":295},"Of the patients admitted to Halton Healthcare's Oakville Hospital, 65 per cent are aged 65 and over; among this group, those 85 and over represent the fastest growing age group in the Halton Region. Clinical staff at Halton Healthcare Services (HHS) recognized the unique needs of this population, and initiated an interdisciplinary Delirium prevention project in 2007 which would later evolve into the ",{"text":4042,"type":295,"marks":4043},"Hospital Elder Life Program (HELP)",[4044],{"type":371,"attrs":4045},{"href":4046,"uuid":53,"anchor":53,"custom":4047,"target":374,"linktype":375},"https://www.haltonhealthcare.on.ca/services_/28763/s29695-geriatric-and-senior-specialty-services/s30124-hospital-elder-life-program--help-",{},{"text":4049,"type":295}," in 2016. The Hospital Elder Life Program (HELP) is designed to prevent delirium by keeping hospitalized seniors oriented to their surroundings, meeting their needs for nutrition, fluids, and sleep, and keeping them mobile within the limitations of their physical condition. (Health Standards Organization, Leading Practice Library, 2010)","Prevention Success Stories",{"type":12,"content":4052},[4053],{"type":15,"attrs":4054},{"textAlign":53},{"_uid":3408,"items":4056,"title":3523,"component":1458,"description":4131},[4057],{"_uid":3411,"title":3412,"ctaLeft":4058,"ctaRight":4059,"component":898,"columnLeft":4060,"columnRight":4064},[],[],{"type":12,"content":4061},[4062],{"type":15,"attrs":4063},{"textAlign":53},{"type":12,"content":4065},[4066,4071,4081,4086,4096,4106,4116,4121],{"type":15,"attrs":4067,"content":4068},{"textAlign":53},[4069],{"text":4070,"type":295},"Health Standards Organization, Leading Practices Database: Safer Elder Care Program. Ottawa, ON: Health Standards Organization. Safer Elder Care' Delirium Prevention Program - HSO Health Standards Organization",{"type":15,"attrs":4072,"content":4073},{"textAlign":53},[4074,4076],{"text":4075,"type":295},"American Delirium Society. What is delirium? 2015. ",{"text":4077,"type":295,"marks":4078},"https://americandeliriumsociety.org/what-delirium",[4079],{"type":371,"attrs":4080},{"href":4077,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":15,"attrs":4082,"content":4083},{"textAlign":53},[4084],{"text":4085,"type":295},"Black P, Boore JR, Parahoo K. The effect of nurse-facilitated family participation in the psychological care of the critically ill patient. J Adv Nurs. 2011; 67 (5): 1091–1101. doi: 10.1111/j.1365-2648.2010.05558.x.",{"type":15,"attrs":4087,"content":4088},{"textAlign":53},[4089,4091],{"text":4090,"type":295},"Canadian Coalition for Seniors' Mental Health. Delirium. 2017. ",{"text":4092,"type":295,"marks":4093},"https://ccsmh.ca/projects/delirium/",[4094],{"type":371,"attrs":4095},{"href":4092,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":15,"attrs":4097,"content":4098},{"textAlign":53},[4099,4101],{"text":4100,"type":295},"Institute for Healthcare Improvement (IHI). How-to Guide: Prevent harm from high-alert medications. Cambridge, MA: IHI; 2012. ",{"text":4102,"type":295,"marks":4103},"http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventHarmfromHighAlertMedications.aspx",[4104],{"type":371,"attrs":4105},{"href":4102,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":15,"attrs":4107,"content":4108},{"textAlign":53},[4109,4111],{"text":4110,"type":295},"Let's Respect. Mr. Graham's Story. Department of Health, England. 2006. ",{"text":4112,"type":295,"marks":4113},"https://www.dignityincare.org.uk/",[4114],{"type":371,"attrs":4115},{"href":4112,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":15,"attrs":4117,"content":4118},{"textAlign":53},[4119],{"text":4120,"type":295},"Safer Healthcare Now! Prevention and Management of Delirium: Getting Started Kit. Canadian Patient Safety Institute. 2013. Getting Started Kit: (patientsafetyinstitute.ca)",{"type":15,"attrs":4122,"content":4123},{"textAlign":53},[4124,4126],{"text":4125,"type":295},"Safer Healthcare Now! Delirium management and prevention: one pager. Canadian Patient. ",{"text":4127,"type":295,"marks":4128},"http://www.patientsafetyinstitute.ca/en/toolsResources/Documents/Interventions/Prevention%20and%20Management%20of%20Delirium/Prevention%20of%20Delirium%20One%20Pager.pdf",[4129],{"type":371,"attrs":4130},{"href":4127,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":12,"content":4132},[4133],{"type":15,"attrs":4134},{"textAlign":53},{"id":16,"_uid":4136,"items":4137,"component":659},"99790bbd-3608-440e-bc3a-a36b27d64581",[4138],{"_uid":4139,"link":4140,"image":4145,"title":651,"component":652,"description":4147},"2a855f2a-1298-45bf-af3b-5550b16a0e78",[4141],{"_uid":4142,"link":4143,"label":645,"component":646},"1c655002-bbb9-4b07-a259-d910e3f4fd0a",{"id":275,"url":16,"linktype":463,"fieldtype":643,"cached_url":303,"story":4144},{"name":270,"id":274,"uuid":275,"slug":9,"url":303,"full_slug":303,"_stopResolving":301},{"id":648,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":649,"copyright":16,"fieldtype":284,"meta_data":4146,"is_external_url":286},{},{"type":12,"content":4148},[4149],{"type":15,"attrs":4150,"content":4151},{"textAlign":53},[4152],{"text":294,"type":295},[129,150,136,122,143,115,157],[185,192,200],"delirium","resources/delirium",-18600,[],"94606976-69f9-464d-bf1f-720674979d3b","2025-12-05T19:49:54.872Z",[],[4163],{"path":4164,"name":4165,"lang":315,"published":301},"ressources/le-delirium","Le délirium",{"name":4167,"created_at":4168,"published_at":4169,"updated_at":4170,"id":4171,"uuid":4172,"content":4173,"slug":4852,"full_slug":4853,"sort_by_date":53,"position":4854,"tag_list":4855,"is_startpage":286,"parent_id":667,"meta_data":53,"group_id":4856,"first_published_at":4857,"release_id":53,"lang":309,"path":53,"alternates":4858,"default_full_slug":4853,"translated_slugs":4859},"Retained Foreign Body","2025-12-08T17:44:29.385Z","2026-03-10T16:40:29.217Z","2026-03-10T16:40:29.260Z",120939599479373,"159d80cf-dc71-44f5-b2df-e6d99f32d834",{"new":286,"seo":4174,"_uid":690,"hero":4176,"type":174,"topics":4197,"Noindex":286,"content":4198,"audience":4850,"duration":16,"regional":4851,"component":662},{"_uid":688,"title":4167,"plugin":339,"og_image":16,"og_title":16,"description":4175,"twitter_image":16,"twitter_title":16,"og_description":16,"twitter_description":16},"A retained foreign body is a patient safety incident in which a surgical object is accidentally left in a body cavity or operation wound following a procedure.",[4177],{"_uid":693,"image":4178,"title":4180,"format":4181,"component":351,"description":4184,"key_learning":4191,"prerequisite":4194},{"id":695,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":696,"copyright":16,"fieldtype":284,"meta_data":4179,"is_external_url":286},{"alt":16,"title":16,"source":16,"copyright":16},"Hospital Harm: Retained Foreign Body",{"type":12,"content":4182},[4183],{"type":15},{"type":12,"content":4185},[4186],{"type":15,"attrs":4187,"content":4188},{"textAlign":53},[4189],{"text":4190,"type":295},"A retained foreign body is a patient safety incident in which a surgical object is accidentally left in a body cavity or operation wound following a procedure (Canadian Patient Safety Institute (CPSI), 2016a).",{"type":12,"content":4192},[4193],{"type":15},{"type":12,"content":4195},[4196],{"type":15},[76,8],[4199,4210,4400,4456,4602,4644,4675,4730,4832],{"_uid":718,"link":4200,"image":4201,"title":722,"component":723,"media_type":724,"description":4203},[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":284,"meta_data":4202},{},{"type":12,"content":4204},[4205],{"type":15,"attrs":4206,"content":4207},{"textAlign":53},[4208],{"text":4209,"type":295},"Reduce the incidence of retained foreign body.",{"_uid":1802,"content":4211,"component":633},[4212],{"_uid":1805,"content":4213,"component":632},{"type":12,"content":4214},[4215,4219,4230,4235,4240,4245,4250,4255,4285,4290,4295,4339,4343,4348,4353,4358,4395],{"type":406,"attrs":4216,"content":4217},{"level":408,"textAlign":53},[4218],{"text":743,"type":295},{"type":15,"attrs":4220,"content":4221},{"textAlign":53},[4222,4223,4229],{"text":748,"type":295},{"text":455,"type":295,"marks":4224},[4225],{"type":371,"attrs":4226},{"href":459,"uuid":460,"anchor":53,"custom":4227,"target":462,"linktype":463,"story":4228},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":756,"type":295},{"type":406,"attrs":4231,"content":4232},{"level":773,"textAlign":53},[4233],{"text":4234,"type":295},"Retained foreign body during surgery",{"type":15,"attrs":4236,"content":4237},{"textAlign":53},[4238],{"text":4239,"type":295},"Patients with retained foreign bodies may sustain both physical harm (perforation of the bowel, sepsis and even death) and emotional consequences (depression, post-traumatic stress disorder, anxiety) following the incident. These complications can occur early in the postoperative period, or even months or years later (Gawande et al., 2003; Healthcare Insurance Reciprocal of Canada (HIROC), 2016; The Joint Commission, 2013).",{"type":15,"attrs":4241,"content":4242},{"textAlign":53},[4243],{"text":4244,"type":295},"The Organisation for Economic Co-operation and Development (OECD) reports for the year 2017 that the average rate for a foreign body left inside the patient's body during a procedure, per 100,000 medical and surgical discharges is 3.8, versus the Canadian rate of 9.8, which represents a 14 per cent increase over the last five years (Canadian Institute for Health Information (CIHI, 2019a and CIHI, 2019b). ",{"type":15,"attrs":4246,"content":4247},{"textAlign":53},[4248],{"text":4249,"type":295},"A 10-year review of medico-legal cases in Canada between 2004 and 2013 found that retained foreign bodies or wrong surgery were identified in 12 to 18 per cent of surgical incidents (Canadian Medical Protective Association (CMPA & HIROC, 2016).",{"type":406,"attrs":4251,"content":4252},{"level":773,"textAlign":53},[4253],{"text":4254,"type":295},"Retained foreign bodies can include:",{"type":499,"content":4256},[4257,4264,4271,4278],{"type":440,"content":4258},[4259],{"type":15,"attrs":4260,"content":4261},{"textAlign":53},[4262],{"text":4263,"type":295},"Soft devices, such as sponges and towels",{"type":440,"content":4265},[4266],{"type":15,"attrs":4267,"content":4268},{"textAlign":53},[4269],{"text":4270,"type":295},"Small miscellaneous items, including unretrieved device components or fragments (such as broken parts of instruments), stapler components, parts of laparoscopic trocars, guidewires, catheters, and pieces of drains",{"type":440,"content":4272},[4273],{"type":15,"attrs":4274,"content":4275},{"textAlign":53},[4276],{"text":4277,"type":295},"Needles and other sharps",{"type":440,"content":4279},[4280],{"type":15,"attrs":4281,"content":4282},{"textAlign":53},[4283],{"text":4284,"type":295},"Instruments, most commonly malleable retractors",{"type":15,"attrs":4286,"content":4287},{"textAlign":53},[4288],{"text":4289,"type":295},"(The Joint Commission, 2013)",{"type":406,"attrs":4291,"content":4292},{"level":773,"textAlign":53},[4293],{"text":4294,"type":295},"The most common root causes of retained foreign objects reported to The Joint Commission are:",{"type":499,"content":4296},[4297,4304,4311,4318,4325,4332],{"type":440,"content":4298},[4299],{"type":15,"attrs":4300,"content":4301},{"textAlign":53},[4302],{"text":4303,"type":295},"The absence of policies and procedures",{"type":440,"content":4305},[4306],{"type":15,"attrs":4307,"content":4308},{"textAlign":53},[4309],{"text":4310,"type":295},"Failure to comply with existing policies and procedures",{"type":440,"content":4312},[4313],{"type":15,"attrs":4314,"content":4315},{"textAlign":53},[4316],{"text":4317,"type":295},"Problems with hierarchy and intimidation",{"type":440,"content":4319},[4320],{"type":15,"attrs":4321,"content":4322},{"textAlign":53},[4323],{"text":4324,"type":295},"Failure in communication with physicians",{"type":440,"content":4326},[4327],{"type":15,"attrs":4328,"content":4329},{"textAlign":53},[4330],{"text":4331,"type":295},"Failure of staff to communicate relevant patient information",{"type":440,"content":4333},[4334],{"type":15,"attrs":4335,"content":4336},{"textAlign":53},[4337],{"text":4338,"type":295},"Inadequate or incomplete education of staff",{"type":15,"attrs":4340,"content":4341},{"textAlign":53},[4342],{"text":4289,"type":295},{"type":15,"attrs":4344,"content":4345},{"textAlign":53},[4346],{"text":4347,"type":295},"Traditional methods of preventing retained foreign bodies included \"cavity sweeps\" and manual counting protocols – both of which are prone to human error. Current practices for counting sponges have a 10 to 15 per cent error rate. In addition, 80 per cent of retained sponges occur with what staff believe is a correct count (The Joint Commission, 2013)",{"type":406,"attrs":4349,"content":4350},{"level":773,"textAlign":53},[4351],{"text":4352,"type":295},"Catheter shearing leading to retained foreign body",{"type":15,"attrs":4354,"content":4355},{"textAlign":53},[4356],{"text":4357,"type":295},"Most catheter procedures occur without complications however the insertion and removal of catheters can lead to retained foreign bodies when part of the catheter breaks off. Shearing typically occurs during insertion or removal of the catheter from patients. Catheter fragments remaining in patients can result in serious complications due to the location or migration of the fragment or inflammation at the fragment site. Reasons for catheter shearing include the following:",{"type":499,"content":4359},[4360,4367,4374,4381,4388],{"type":440,"content":4361},[4362],{"type":15,"attrs":4363,"content":4364},{"textAlign":53},[4365],{"text":4366,"type":295},"Applying excessive force while removing the catheter",{"type":440,"content":4368},[4369],{"type":15,"attrs":4370,"content":4371},{"textAlign":53},[4372],{"text":4373,"type":295},"Withdrawing the catheter back through the insertion needle",{"type":440,"content":4375},[4376],{"type":15,"attrs":4377,"content":4378},{"textAlign":53},[4379],{"text":4380,"type":295},"Withdrawing the catheter over a deformed or damaged needle bevel",{"type":440,"content":4382},[4383],{"type":15,"attrs":4384,"content":4385},{"textAlign":53},[4386],{"text":4387,"type":295},"A flaw in the catheter from defects during the manufacturing process",{"type":440,"content":4389},[4390],{"type":15,"attrs":4391,"content":4392},{"textAlign":53},[4393],{"text":4394,"type":295},"Damaging the catheter during or after placement in the patient",{"type":15,"attrs":4396,"content":4397},{"textAlign":53},[4398],{"text":4399,"type":295},"(Pennsylvania Patient Safety Authority, 2009; Weinstein & Hagle, 2014)",{"_uid":4401,"items":4402,"title":860,"component":1458,"description":4449},"4cd50058-6039-4f5c-937b-e7f3c4004796",[4403,4429],{"_uid":4404,"title":4405,"ctaLeft":4406,"ctaRight":4412,"component":898,"columnLeft":4413,"columnRight":4417},"ee763740-c4c5-4ef7-bd5d-9c2a6bbe174b","'It felt like I had been stabbed,' says patient left with 33-cm metal plate inside after surgery",[4407],{"_uid":4408,"link":4409,"label":4411,"component":4028},"760eb174-713e-410c-9d1e-0fc055e3929e",{"id":16,"url":4410,"target":374,"linktype":375,"fieldtype":643,"cached_url":4410},"https://www.cbc.ca/news/canada/montreal/montreal-hospital-instrument-left-inside-patient-sylvie-dube-1.4181278","Read the article",[],{"type":12,"content":4414},[4415],{"type":15,"attrs":4416},{"textAlign":53},{"type":12,"content":4418},[4419,4424],{"type":15,"attrs":4420,"content":4421},{"textAlign":53},[4422],{"text":4423,"type":295},"Sylvie Dubé couldn't figure out why she was overcome with pain in her shoulder after she woke up following an operation…\"It felt like I had been stabbed,\" Dubé told Radio-Canada, recalling the surgery on March 14….As weeks went on, the pain worsened….Feeling discouraged, the couple showed up at the emergency room more than two months after the surgery..",{"type":15,"attrs":4425,"content":4426},{"textAlign":53},[4427],{"text":4428,"type":295},"That's when Dubé underwent an X-ray. Puzzled radiologists told her there was a large medical instrument lodged inside her stomach (Gentile, 2017).",{"_uid":4430,"title":4431,"ctaLeft":4432,"ctaRight":4437,"component":898,"columnLeft":4438,"columnRight":4442},"fa0acb5f-6618-44b4-842f-287a65dc301a","Canada worse than other wealthy countries in patient safety – including objects left in body after surgery, data show",[4433],{"_uid":4434,"link":4435,"label":4411,"component":4028},"795501df-2c34-4131-b4b7-6911852ffe1b",{"id":16,"url":4436,"target":374,"linktype":375,"fieldtype":643,"cached_url":4436},"https://www.theglobeandmail.com/life/health-and-fitness/article-canada-worse-than-other-wealthy-countries-in-patient-safety/",[],{"type":12,"content":4439},[4440],{"type":15,"attrs":4441},{"textAlign":53},{"type":12,"content":4443},[4444],{"type":15,"attrs":4445,"content":4446},{"textAlign":53},[4447],{"text":4448,"type":295},"Canada is lagging other wealthy countries when it comes to patient safety, according to new data that show our country's hospitals record significantly higher rates of obstetrical trauma, as well as foreign objects, such as sponges and instruments, left in patients after surgery…. (Leung, 2019).",{"type":12,"content":4450},[4451],{"type":15,"attrs":4452,"content":4453},{"textAlign":53},[4454],{"text":4455,"type":295},"​Communication failures are common in the operating room and can lead to increased complications such as retained foreign bodies. Use of a surgical safety checklist may prevent communication failures and reduce complications. While the physical act of \"checking the box\" may not necessarily prevent all adverse events, the checklist is a scaffold on which attitudes towards teamwork and communication can be encouraged and improved. Compliance with the checklist includes communication with the patient and is critical for the effects on patient safety to be realized (Pugel et al., 2015).",{"_uid":891,"items":4457,"title":1457,"component":1458,"description":4564},[4458],{"_uid":894,"title":895,"ctaLeft":4459,"ctaRight":4460,"component":898,"columnLeft":4461,"columnRight":4478},[],[],{"type":12,"content":4462},[4463],{"type":15,"attrs":4464,"content":4465},{"textAlign":53},[4466,4467,4473,4474,4477],{"text":905,"type":295},{"text":907,"type":295,"marks":4468},[4469],{"type":371,"attrs":4470},{"href":459,"uuid":460,"anchor":53,"custom":4471,"target":462,"linktype":463,"story":4472},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":540,"type":295},{"text":915,"type":295,"marks":4475},[4476],{"type":487},{"text":915,"type":295},{"type":12,"content":4479},[4480,4485],{"type":15,"attrs":4481,"content":4482},{"textAlign":53},[4483],{"text":4484,"type":295},"If your review reveals that your cases of retained foreign body are linked to specific processes or procedures, you may find these resources helpful:",{"type":499,"content":4486},[4487,4494,4501,4508,4515,4522,4529,4536,4543,4550,4557],{"type":440,"content":4488},[4489],{"type":15,"attrs":4490,"content":4491},{"textAlign":53},[4492],{"text":4493,"type":295},"Agency for Healthcare Research and Quality (AHRQ). https://www.ahrq.gov/",{"type":440,"content":4495},[4496],{"type":15,"attrs":4497,"content":4498},{"textAlign":53},[4499],{"text":4500,"type":295},"American College of Surgeons - Revised statement on the prevention of unintentionally retained surgical items after surgery (2016). http://bulletin.facs.org/2016/10/revised-statement-on-the-prevention-of-unintentionally-retained-surgical-items-after-surgery/#.WxVdN0xFyUl",{"type":440,"content":4502},[4503],{"type":15,"attrs":4504,"content":4505},{"textAlign":53},[4506],{"text":4507,"type":295},"Association of periOperative Registered Nurses (AORN). https://www.aorn.org/",{"type":440,"content":4509},[4510],{"type":15,"attrs":4511,"content":4512},{"textAlign":53},[4513],{"text":4514,"type":295},"Canadian Patient Safety Institute. Surgical Safety Checklist (2009)",{"type":440,"content":4516},[4517],{"type":15,"attrs":4518,"content":4519},{"textAlign":53},[4520],{"text":4521,"type":295},"Nothing Left Behind. www.nothingleftbehind.org",{"type":440,"content":4523},[4524],{"type":15,"attrs":4525,"content":4526},{"textAlign":53},[4527],{"text":4528,"type":295},"Pennsylvania Patient Safety Advisory. http://patientsafety.pa.gov/",{"type":440,"content":4530},[4531],{"type":15,"attrs":4532,"content":4533},{"textAlign":53},[4534],{"text":4535,"type":295},"Retained Surgical Items: Events and Guidelines Revisited (2017) http://patientsafety.pa.gov/ADVISORIES/Pages/201703_RSI.aspx",{"type":440,"content":4537},[4538],{"type":15,"attrs":4539,"content":4540},{"textAlign":53},[4541],{"text":4542,"type":295},"Epidural or Subarachnoid Catheter Shear (2009) http://patientsafety.pa.gov/ADVISORIES/Pages/200909_84.aspx",{"type":440,"content":4544},[4545],{"type":15,"attrs":4546,"content":4547},{"textAlign":53},[4548],{"text":4549,"type":295},"Plumer's Principles and Practice of InfusionTherapy. Text Book (Weinstein, S.M.; Hagle, M.E. 9th Edition.  2014).",{"type":440,"content":4551},[4552],{"type":15,"attrs":4553,"content":4554},{"textAlign":53},[4555],{"text":4556,"type":295},"The Joint Commission. Preventing unintended retained foreign objects. Sentinel Event Alert. Issue 51, 2013. Available at: https://www.jointcommission.org/assets/1/6/SEA_51_Retained foreign bodies_10_17_13_FINAL.pdf",{"type":440,"content":4558},[4559],{"type":15,"attrs":4560,"content":4561},{"textAlign":53},[4562],{"text":4563,"type":295},"World Health Organization - Safe Surgery. https://www.who.int/patientsafety/safesurgery/en/",{"type":12,"content":4565},[4566,4571,4575],{"type":15,"attrs":4567,"content":4568},{"textAlign":53},[4569],{"text":4570,"type":295},"Given the broad range of potential causes of a retained foreign body, clinical and system reviews should be conducted to identify potential causes and determine appropriate recommendations.",{"type":15,"attrs":4572,"content":4573},{"textAlign":868},[4574],{"text":1470,"type":295},{"type":435,"attrs":4576,"content":4577},{"order":437},[4578,4584,4590,4596],{"type":440,"content":4579},[4580],{"type":15,"attrs":4581,"content":4582},{"textAlign":53},[4583],{"text":1480,"type":295},{"type":440,"content":4585},[4586],{"type":15,"attrs":4587,"content":4588},{"textAlign":53},[4589],{"text":1487,"type":295},{"type":440,"content":4591},[4592],{"type":15,"attrs":4593,"content":4594},{"textAlign":53},[4595],{"text":1494,"type":295},{"type":440,"content":4597},[4598],{"type":15,"attrs":4599,"content":4600},{"textAlign":53},[4601],{"text":1501,"type":295},{"_uid":1503,"items":4603,"title":1548,"component":1549,"description":4637},[4604,4610,4616,4622,4629],{"_uid":1525,"image":4605,"title":1511,"component":1512,"description":4607},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":4606,"is_external_url":286},{},{"type":12,"content":4608},[4609],{"type":15},{"_uid":1517,"image":4611,"title":2579,"component":1512,"description":4613},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":4612,"is_external_url":286},{},{"type":12,"content":4614},[4615],{"type":15},{"_uid":1506,"image":4617,"title":1528,"component":1512,"description":4619},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":4618,"is_external_url":286},{},{"type":12,"content":4620},[4621],{"type":15},{"_uid":1533,"image":4623,"title":4625,"component":1512,"description":4626},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":4624,"is_external_url":286},{},"You may use different measures or modify measures to make them more appropriate and/or useful to your particular setting. However, be aware that modifying measures may limit the comparability of your results to others.",{"type":12,"content":4627},[4628],{"type":15},{"_uid":4630,"image":4631,"title":4633,"component":1512,"description":4634},"e130fcb1-7d15-415e-aba6-5da19d55c7fa",{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":4632,"is_external_url":286},{},"Posting your measure results within your hospital is a great way to keep your teams motivated and aware of progress. Try to include measures that your team will find meaningful and exciting (IHI, 2012).",{"type":12,"content":4635},[4636],{"type":15},{"type":12,"content":4638},[4639],{"type":15,"attrs":4640,"content":4641},{"textAlign":53},[4642],{"text":4643,"type":295},"​Vital to quality improvement is measurement, and this applies specifically to implementation of interventions. The chosen measures will help to determine whether an impact is being made (primary outcome), whether the intervention is actually being carried out (process measures), and whether any unintended consequences ensue (balancing measures).",{"_uid":1563,"items":4645,"title":1680,"component":1458,"description":4663},[4646],{"_uid":1566,"title":1567,"ctaLeft":4647,"ctaRight":4648,"component":898,"columnLeft":4649,"columnRight":4653},[],[],{"type":12,"content":4650},[4651],{"type":15,"attrs":4652},{"textAlign":53},{"type":12,"content":4654},[4655],{"type":15,"attrs":4656,"content":4657},{"textAlign":53},[4658,4662],{"text":4659,"type":295,"marks":4660},"T81.5 / T81.6: ",[4661],{"type":487},{"text":1591,"type":295},{"type":12,"content":4664},[4665,4670],{"type":15,"attrs":4666,"content":4667},{"textAlign":53},[4668],{"text":4669,"type":295},"Discharge Abstract Database (DAD) Codes included in this clinical category: D24: Retained Foreign Body",{"type":15,"attrs":4671,"content":4672},{"textAlign":53},[4673],{"text":4674,"type":295},"Concept: Foreign object or substance unintentionally left in the body during a medical or surgical procedure",{"_uid":3987,"items":4676,"title":1709,"component":1458,"description":4726},[4677,4702],{"_uid":3990,"title":4678,"ctaLeft":4679,"ctaRight":4685,"component":898,"columnLeft":4686,"columnRight":4690},"Surgical Instruments Management Program",[4680],{"_uid":4681,"link":4682,"label":4684,"component":4028},"ece800c9-6cd5-455d-9e73-f0243a5f4d77",{"id":16,"url":4683,"target":374,"linktype":375,"fieldtype":643,"cached_url":4683},"https://accreditation.ca/surgical-instruments-management-program","Learn more",[],{"type":12,"content":4687},[4688],{"type":15,"attrs":4689},{"textAlign":53},{"type":12,"content":4691},[4692,4697],{"type":15,"attrs":4693,"content":4694},{"textAlign":53},[4695],{"text":4696,"type":295},"Hopital Charles LeMoyne, Quebec, 2009",{"type":15,"attrs":4698,"content":4699},{"textAlign":53},[4700],{"text":4701,"type":295},"The surgical instruments management program at Hôpital Chalres LeMoyne is effective and provides the highest level of safety. There is a well–established, efficient tracking system. All instruments are identified with a unique number. When trays are prepared, instruments are logged using a scanner system. Trays are then identified with a barcode. During surgery, all instruments and devices are logged in a computer databank referenced to the patient's name. This system makes it possible to identify every instrument used in a specific operation (Hôpital Charles LeMoyne, 2009).",{"_uid":4021,"title":4703,"ctaLeft":4704,"ctaRight":4714,"component":898,"columnLeft":4715,"columnRight":4719},"Surgical error inspires doctor to champion the safety of all patients",[4705],{"_uid":4706,"link":4707,"label":4684,"component":4028},"b05eade3-5479-4581-a3f0-6ec8ac8db997",{"id":4708,"url":16,"linktype":463,"fieldtype":643,"cached_url":4709,"story":4710},"5f3dab6a-c8fb-450d-97d6-957200cf07e0","resources/healthcare-provider-stories",{"name":4711,"id":4712,"uuid":4708,"slug":4713,"url":4709,"full_slug":4709,"_stopResolving":301},"Healthcare Provider Stories",113881390448419,"healthcare-provider-stories",[],{"type":12,"content":4716},[4717],{"type":15,"attrs":4718},{"textAlign":53},{"type":12,"content":4720},[4721],{"type":15,"attrs":4722,"content":4723},{"textAlign":53},[4724],{"text":4725,"type":295},"Peter Pisters, [former] President and CEO of University Health Network also saw himself as the Chief Patient Safety Officer… a duty he takes very seriously, fuelled by the painful memory of a single surgical sponge left behind in one of his patients (CPSI, 2016b)",{"type":12,"content":4727},[4728],{"type":15,"attrs":4729},{"textAlign":53},{"_uid":3408,"items":4731,"title":3523,"component":1458,"description":4829},[4732],{"_uid":3411,"title":3412,"ctaLeft":4733,"ctaRight":4734,"component":898,"columnLeft":4735,"columnRight":4739},[],[],{"type":12,"content":4736},[4737],{"type":15,"attrs":4738},{"textAlign":53},{"type":12,"content":4740},[4741,4746,4756,4761,4766,4771,4776,4785,4795,4800,4809,4814,4819,4824],{"type":15,"attrs":4742,"content":4743},{"textAlign":53},[4744],{"text":4745,"type":295},"Canadian Institute for Health Information (CIHI). Canada continues to lag behind other OECD countries on measures of patient safety. Ottawa, ON: CIHI. 2019a. ",{"type":15,"attrs":4747,"content":4748},{"textAlign":53},[4749,4751],{"text":4750,"type":295},"Canadian Institute for Health Information (CIHI). OECD Interactive Tool: International Comparisons. Published 2019b. ",{"text":4752,"type":295,"marks":4753},"http://www.cihi.ca/en/oecd-interactive-tool-international-comparisons-patient-safety",[4754],{"type":371,"attrs":4755},{"href":4752,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":15,"attrs":4757,"content":4758},{"textAlign":53},[4759],{"text":4760,"type":295},"Canadian Medical Protective Association (CMPA), Healthcare Insurance Reciprocal of Canada (HIROC). Detailed Analysis. Surgical Safety in Canada: A 10-Year Review of CMPA and HIROC Medico-Legal Data. 2016. ",{"type":15,"attrs":4762,"content":4763},{"textAlign":53},[4764],{"text":4765,"type":295},"Canadian Patient Safety Institute (CPSI). Retained Foreign Object. Published 2016. ",{"type":15,"attrs":4767,"content":4768},{"textAlign":53},[4769],{"text":4770,"type":295},"Canadian Patient Safety Institute (CPSI). Surgical error inspires doctor to champion the safety of all patients. Published 2016.",{"type":15,"attrs":4772,"content":4773},{"textAlign":53},[4774],{"text":4775,"type":295},"Gawande AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ. Risk Factors for Retained Instruments and Sponges after Surgery. N Engl J Med. 2003;348(3):229-235. doi:10.1056/NEJMsa021721.",{"type":15,"attrs":4777,"content":4778},{"textAlign":53},[4779,4781],{"text":4780,"type":295},"Gentile D. \"It felt like I had been stabbed,\" says patient left with 33-cm metal plate inside after surgery. CBC News. Published June 28, 2017. ",{"text":4410,"type":295,"marks":4782},[4783],{"type":371,"attrs":4784},{"href":4410,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":15,"attrs":4786,"content":4787},{"textAlign":53},[4788,4790],{"text":4789,"type":295},"Hôpital Charles LeMoyne. Leading Practices: Surgical Instruments Management Program. Ottawa, ON: Health Standards Organization; 2009. ",{"text":4791,"type":295,"marks":4792},"https://healthstandards.org/leading-practice/surgical-instruments-management-program/",[4793],{"type":371,"attrs":4794},{"href":4791,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":15,"attrs":4796,"content":4797},{"textAlign":53},[4798],{"text":4799,"type":295},"Institute for Healthcare Improvement (IHI). How-to Guide: Prevent Harm from High-Alert Medications. Cambridge, MA: Institute for Healthcare Improvement (IHI); 2012. ",{"type":15,"attrs":4801,"content":4802},{"textAlign":53},[4803,4805],{"text":4804,"type":295},"Leung W. Canada worse than other wealthy countries in patient safety – including objects left in body after surgery, data show. The Globe and Mail. Published November 7, 2019. ",{"text":4436,"type":295,"marks":4806},[4807],{"type":371,"attrs":4808},{"href":4436,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":15,"attrs":4810,"content":4811},{"textAlign":53},[4812],{"text":4813,"type":295},"Pennsylvania Patient Safety Authority. Epidural or Subarachnoid Catheter Shear. Pa Patient Saf Auth. 2009;6(3):84-86. ",{"type":15,"attrs":4815,"content":4816},{"textAlign":53},[4817],{"text":4818,"type":295},"Pugel AE, Simianu VV, Flum DR, Patchen Dellinger E. Use of the surgical safety checklist to improve communication and reduce complications. J Infect Public Health. 2015;8(3):219-225. doi:10.1016/j.jiph.2015.01.001",{"type":15,"attrs":4820,"content":4821},{"textAlign":53},[4822],{"text":4823,"type":295},"The Joint Commission. Preventing unintended retained foreign objects. Sentin Event Alert. 2013;(51). ",{"type":15,"attrs":4825,"content":4826},{"textAlign":53},[4827],{"text":4828,"type":295},"Weinstein SM, Hagle ME. Plumer's Principles and Practice of Infusion Therapy. Ninth. Philadelphia, PA: Lippincott Williams & Wilkins; 2014.",{"type":12,"content":4830},[4831],{"type":15},{"id":16,"_uid":4833,"items":4834,"component":659},"5daed966-cc94-42ce-b27a-62b49a0a70b4",[4835],{"_uid":4836,"link":4837,"image":4842,"title":651,"component":652,"description":4844},"f6c78a9e-4f6a-45b8-bc79-ec2ceee3be6f",[4838],{"_uid":4839,"link":4840,"label":645,"component":646},"12f0bdd9-e669-4b10-bd38-8efcfa7b4d8e",{"id":275,"url":16,"linktype":463,"fieldtype":643,"cached_url":303,"story":4841},{"name":270,"id":274,"uuid":275,"slug":9,"url":303,"full_slug":303,"_stopResolving":301},{"id":648,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":649,"copyright":16,"fieldtype":284,"meta_data":4843,"is_external_url":286},{},{"type":12,"content":4845},[4846],{"type":15,"attrs":4847,"content":4848},{"textAlign":53},[4849],{"text":294,"type":295},[129,150,136,122,143,115,157],[185,192,200],"retained-foreign-body","resources/retained-foreign-body",-18610,[],"9227ce22-0205-4bad-8c4f-b2b84d6464f9","2025-12-08T17:45:28.460Z",[],[4860],{"path":4861,"name":4862,"lang":315,"published":301},"ressources/retention-d-un-corps-etranger","Rétention d’un corps étranger",{"name":4864,"created_at":4865,"published_at":4866,"updated_at":4867,"id":4868,"uuid":4869,"content":4870,"slug":6276,"full_slug":6277,"sort_by_date":53,"position":6278,"tag_list":6279,"is_startpage":286,"parent_id":667,"meta_data":53,"group_id":6280,"first_published_at":6281,"release_id":53,"lang":309,"path":53,"alternates":6282,"default_full_slug":6277,"translated_slugs":6283},"Sepsis","2025-12-08T22:21:25.214Z","2026-03-10T16:39:41.351Z","2026-03-10T16:39:41.426Z",121007657911080,"56837567-1639-458f-9e77-5f782ddae91f",{"new":286,"seo":4871,"_uid":690,"hero":4872,"type":174,"topics":4893,"Noindex":286,"content":4894,"audience":6274,"duration":16,"regional":6275,"component":662},{"_uid":688,"title":4864,"plugin":339,"og_image":16,"og_title":16,"description":1766,"twitter_image":16,"twitter_title":16,"og_description":16,"twitter_description":16},[4873],{"_uid":693,"image":4874,"title":4876,"format":4877,"component":351,"description":4880,"key_learning":4887,"prerequisite":4890},{"id":695,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":696,"copyright":16,"fieldtype":284,"meta_data":4875,"is_external_url":286},{"alt":16,"title":16,"source":16,"copyright":16},"Hospital Harm: Sepsis",{"type":12,"content":4878},[4879],{"type":15},{"type":12,"content":4881},[4882],{"type":15,"attrs":4883,"content":4884},{"textAlign":53},[4885],{"text":4886,"type":295},"Sepsis is defined as: \"life-threatening organ dysfunction caused by dysregulated host response to infection\" (Singer et al., 2016). It affects neonatal, pediatric, and adult patients worldwide. Differentiated from an uncomplicated infection by virtue of the dysregulated host response and acute organ dysfunction, sepsis can present as or progress to septic shock, recently redefined as: \"a subset of sepsis in which particularly profound circulatory, cellular and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone.\" (Singer et al., 2016). Maternal sepsis is a life-threatening condition defined as an organ dysfunction caused by an infection during pregnancy, delivery, puerperium, or after an abortion (Escobar et al., 2020).",{"type":12,"content":4888},[4889],{"type":15},{"type":12,"content":4891},[4892],{"type":15},[76,8],[4895,4906,5075,5425,5457,6048,6111,6256],{"_uid":718,"link":4896,"image":4897,"title":722,"component":723,"media_type":724,"description":4899},[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":284,"meta_data":4898},{},{"type":12,"content":4900},[4901],{"type":15,"attrs":4902,"content":4903},{"textAlign":53},[4904],{"text":4905,"type":295},"To decrease the morbidity and mortality from sepsis and to prevent nosocomial sepsis in the hospitalized pediatric and adult population.",{"_uid":1802,"content":4907,"component":633},[4908],{"_uid":1805,"content":4909,"component":632},{"type":12,"content":4910},[4911,4915,4926,4931,4936,4941,4946,4951,4956,5035,5039,5044,5049,5061,5066],{"type":406,"attrs":4912,"content":4913},{"level":408,"textAlign":53},[4914],{"text":743,"type":295},{"type":15,"attrs":4916,"content":4917},{"textAlign":53},[4918,4919,4925],{"text":748,"type":295},{"text":455,"type":295,"marks":4920},[4921],{"type":371,"attrs":4922},{"href":459,"uuid":460,"anchor":53,"custom":4923,"target":462,"linktype":463,"story":4924},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":756,"type":295},{"type":15,"attrs":4927,"content":4928},{"textAlign":53},[4929],{"text":4930,"type":295},"Healthcare-associated infections (HAIs) can lead to sepsis and its deleterious outcomes (Riley & Wheeler, 2012). Failure to comply with evidence-based infection preventive practices for HAIs increases the incidence of hospital-acquired sepsis.",{"type":15,"attrs":4932,"content":4933},{"textAlign":53},[4934],{"text":4935,"type":295},"HAIs account for a large proportion of patient safety incidents in Canada. Every year, it is estimated that 220,000 Canadian patients (approximately one in nine) will develop an infection during their stay in hospital. Complicating the problem is the fact that many HAIs are caused by antimicrobial-resistant organisms (AROs), which make them difficult to treat. Although progress has been made to prevent and control ARO-related HAIs, much work remains to be done. Globally and in Canada, the steps taken to mitigate antimicrobial resistance (AMR) are relatively limited (MacLaurin et al., 2020). The Public Health Agency of Canada (PHAC) estimates that approximately two per cent of patients admitted to large, academic Canadian hospitals will have acquired an infection with an ARO during the course of their hospital stay (Mitchell et al., 2019) and that at any given time, three to 10 per cent of patients who are hospitalized in Canada will either be infected or be a carrier of an ARO (Martin et al., 2019).",{"type":15,"attrs":4937,"content":4938},{"textAlign":53},[4939],{"text":4940,"type":295},"Canada continues to lag behind other OECD countries on sepsis following abdominal surgery (CIHI, 2019b). In 2019, the Canadian in-hospital sepsis rate was 3.9 per 1,000 patients (CIHI, 2019a).  Sepsis affects approximately 1.7 million adults in the United States each year and potentially contributes to more than 250,000 deaths. Various studies estimate that sepsis is present in 30 to 50 per cent of hospitalizations that culminate in death. The high burden of sepsis and the perception that most sepsis-associated deaths are preventable with better care has catalyzed numerous sepsis performance improvement initiatives in hospitals around the world (Rhee et al., 2019).  ",{"type":15,"attrs":4942,"content":4943},{"textAlign":53},[4944],{"text":4945,"type":295},"It has been reported in a recent study that hospital-onset sepsis preferentially afflicted ill patients but even after risk-adjustment, they were twice as likely to die as community-onset sepsis patients; in patients admitted without sepsis, hospital-onset sepsis tripled the risk of death. Hospital-onset sepsis is an important target for surveillance, prevention, and quality improvement initiatives (Rhee et al., 2019).",{"type":15,"attrs":4947,"content":4948},{"textAlign":53},[4949],{"text":4950,"type":295},"Recommendations for guiding care for adults with critical or severe Coronavirus associated sepsis have been developed by the Surviving Sepsis Campaign Coronavirus Disease 2019 panel and will be updated as necessary (Alhazzani et al., 2020). ",{"type":406,"attrs":4952,"content":4953},{"level":773,"textAlign":53},[4954],{"text":4955,"type":295},"Risk Factors",{"type":499,"content":4957},[4958,4965,4972,4979,4986,4993,5000,5007,5014,5021,5028],{"type":440,"content":4959},[4960],{"type":15,"attrs":4961,"content":4962},{"textAlign":53},[4963],{"text":4964,"type":295},"Examples of risk factors are:",{"type":440,"content":4966},[4967],{"type":15,"attrs":4968,"content":4969},{"textAlign":53},[4970],{"text":4971,"type":295},"Age (higher risk in neonates and elderly persons than in other age groups).",{"type":440,"content":4973},[4974],{"type":15,"attrs":4975,"content":4976},{"textAlign":53},[4977],{"text":4978,"type":295},"Chronic diseases with/without severe organ dysfunction.",{"type":440,"content":4980},[4981],{"type":15,"attrs":4982,"content":4983},{"textAlign":53},[4984],{"text":4985,"type":295},"Immunodeficiency.",{"type":440,"content":4987},[4988],{"type":15,"attrs":4989,"content":4990},{"textAlign":53},[4991],{"text":4992,"type":295},"Immunosuppressive agents.",{"type":440,"content":4994},[4995],{"type":15,"attrs":4996,"content":4997},{"textAlign":53},[4998],{"text":4999,"type":295},"Inappropriate use of antibiotics.",{"type":440,"content":5001},[5002],{"type":15,"attrs":5003,"content":5004},{"textAlign":53},[5005],{"text":5006,"type":295},"The presence of implanted medical devices (intravascular or other).",{"type":440,"content":5008},[5009],{"type":15,"attrs":5010,"content":5011},{"textAlign":53},[5012],{"text":5013,"type":295},"Pregnancy.",{"type":440,"content":5015},[5016],{"type":15,"attrs":5017,"content":5018},{"textAlign":53},[5019],{"text":5020,"type":295},"Prematurity.",{"type":440,"content":5022},[5023],{"type":15,"attrs":5024,"content":5025},{"textAlign":53},[5026],{"text":5027,"type":295},"Infection is more likely to occur when the normal anatomy is altered by a process – benign or malignant - that either obstructs a normal passage (e.g., calculous cholecystitis, prostatitis) or breaks and enters a previously sterile system (e.g., skin breakdown by trauma, dermatological conditions).",{"type":440,"content":5029},[5030],{"type":15,"attrs":5031,"content":5032},{"textAlign":53},[5033],{"text":5034,"type":295},"Patients unable to communicate their symptoms often present later in their illness (i.e., often with sepsis) (CPSI et al., 2015).",{"type":406,"attrs":5036,"content":5037},{"level":408,"textAlign":53},[5038],{"text":860,"type":295},{"type":406,"attrs":5040,"content":5041},{"level":773,"textAlign":53},[5042],{"text":5043,"type":295},"Patient Stories",{"type":406,"attrs":5045,"content":5046},{"level":3698,"textAlign":53},[5047],{"text":5048,"type":295},"Julie's Story",{"type":15,"attrs":5050,"content":5051},{"textAlign":53},[5052,5054,5059],{"text":5053,"type":295},"This short documentary accompanies \"",{"text":5048,"type":295,"marks":5055},[5056],{"type":371,"attrs":5057},{"href":5058,"uuid":53,"anchor":53,"custom":753,"target":374,"linktype":375},"https://www.patientstories.org.uk/recent-posts/julies-story-now-available/",{"text":5060,"type":295},"\". In 2008, Julie Carman was involved in a road traffic accident whilst on a cycling holiday. She suffered injuries to her face, jaw and legs but made a good initial recovery and expected to be back at work within three months. Three years later she was still having treatment having experienced two further emergency admissions to hospital due to acute cellulitis and sepsis. In this short film, Julie explains how a series of \"everyday\" communication failures conspired to create delays in her receiving effective treatment (Patient Stories, 2013).",{"type":406,"attrs":5062,"content":5063},{"level":3698,"textAlign":53},[5064],{"text":5065,"type":295},"Additional Sepsis Survival Stories",{"type":15,"attrs":5067,"content":5068},{"textAlign":53},[5069],{"text":5070,"type":295,"marks":5071},"https://bcpsqc.ca/improve-care/sepsis/sepsis-survival-stories/",[5072],{"type":371,"attrs":5073},{"href":5074,"uuid":53,"anchor":53,"custom":753,"target":374,"linktype":375},"https://healthqualitybc.ca/improve-care/sepsis/sepsis-survival-stories/",{"_uid":891,"items":5076,"title":1457,"component":1458,"description":5384},[5077],{"_uid":894,"title":895,"ctaLeft":5078,"ctaRight":5079,"component":898,"columnLeft":5080,"columnRight":5101},[],[],{"type":12,"content":5081},[5082],{"type":15,"attrs":5083,"content":5084},{"textAlign":53},[5085,5089,5097],{"text":2130,"type":295,"marks":5086},[5087],{"type":298,"attrs":5088},{"color":300},{"text":2135,"type":295,"marks":5090},[5091,5095],{"type":371,"attrs":5092},{"href":459,"uuid":460,"anchor":53,"custom":5093,"target":462,"linktype":463,"story":5094},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"type":5096},"underline",{"text":540,"type":295,"marks":5098},[5099],{"type":298,"attrs":5100},{"color":300},{"type":12,"content":5102},[5103,5115,5120,5336,5343],{"type":15,"attrs":5104,"content":5105},{"textAlign":53},[5106,5107,5113],{"text":905,"type":295},{"text":907,"type":295,"marks":5108},[5109],{"type":371,"attrs":5110},{"href":459,"uuid":460,"anchor":53,"custom":5111,"target":462,"linktype":463,"story":5112},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":5114,"type":295},". ",{"type":15,"attrs":5116,"content":5117},{"textAlign":53},[5118],{"text":5119,"type":295},"If your review reveals that your cases of Sepsis are linked to specific processes or procedures, you may find these resources helpful:",{"type":499,"content":5121},[5122,5135,5148,5161,5168,5175,5182,5195,5207,5220,5232,5245,5258,5271,5284,5297,5310,5323],{"type":440,"content":5123},[5124],{"type":15,"attrs":5125,"content":5126},{"textAlign":53},[5127,5129],{"text":5128,"type":295},"BC Patient Safety and Quality Council ",{"text":5130,"type":295,"marks":5131},"https://bcpsqc.ca/",[5132],{"type":371,"attrs":5133},{"href":5130,"uuid":53,"anchor":53,"custom":5134,"target":374,"linktype":375},{},{"type":440,"content":5136},[5137],{"type":15,"attrs":5138,"content":5139},{"textAlign":53},[5140,5142],{"text":5141,"type":295},"BC Patient Safety & Quality Council. BC Sepsis Network. BC Patient Safety & Quality Council. ",{"text":5143,"type":295,"marks":5144},"https://bcpsqc.ca/improve-care/bc-sepsis-network/",[5145],{"type":371,"attrs":5146},{"href":5143,"uuid":53,"anchor":53,"custom":5147,"target":374,"linktype":375},{},{"type":440,"content":5149},[5150],{"type":15,"attrs":5151,"content":5152},{"textAlign":53},[5153,5155],{"text":5154,"type":295},"Canadian Patient Safety Institute (CPSI) ",{"text":5156,"type":295,"marks":5157},"https://www.patientsafetyinstitute.ca/en/toolsResources/Hospital-Harm-Measure/Improvement-Resources/Pages/default.aspx",[5158],{"type":371,"attrs":5159},{"href":5156,"uuid":53,"anchor":53,"custom":5160,"target":374,"linktype":375},{},{"type":440,"content":5162},[5163],{"type":15,"attrs":5164,"content":5165},{"textAlign":53},[5166],{"text":5167,"type":295},"Hospital Harm Improvement Resource – Infections due to C.diff, MRSA, VRE",{"type":440,"content":5169},[5170],{"type":15,"attrs":5171,"content":5172},{"textAlign":53},[5173],{"text":5174,"type":295},"Hospital Harm Improvement Resource – Pneumonia",{"type":440,"content":5176},[5177],{"type":15,"attrs":5178,"content":5179},{"textAlign":53},[5180],{"text":5181,"type":295},"Hospital Harm Improvement Resource – Post-Procedure Infections",{"type":440,"content":5183},[5184],{"type":15,"attrs":5185,"content":5186},{"textAlign":53},[5187],{"text":5188,"type":295,"marks":5189},"Hospital Harm Improvement Resource – UTI",[5190],{"type":371,"attrs":5191},{"href":5192,"uuid":685,"anchor":53,"custom":5193,"target":462,"linktype":463,"story":5194},"/resources/uti",{},{"name":680,"id":684,"uuid":685,"slug":1745,"url":1746,"full_slug":1746,"_stopResolving":301},{"type":440,"content":5196},[5197],{"type":15,"attrs":5198,"content":5199},{"textAlign":53},[5200,5202],{"text":5201,"type":295},"Centers for Disease Control and Prevention ",{"text":1072,"type":295,"marks":5203},[5204],{"type":371,"attrs":5205},{"href":1072,"uuid":53,"anchor":53,"custom":5206,"target":374,"linktype":375},{},{"type":440,"content":5208},[5209],{"type":15,"attrs":5210,"content":5211},{"textAlign":53},[5212,5214],{"text":5213,"type":295},"Centers for Disease Control and Prevention. Sepsis: Clinical Information. Clinical Resources. Published December 7, 2020. Accessed March 2021. ",{"text":5215,"type":295,"marks":5216},"https://www.cdc.gov/sepsis/clinicaltools/index.html",[5217],{"type":371,"attrs":5218},{"href":5215,"uuid":53,"anchor":53,"custom":5219,"target":374,"linktype":375},{},{"type":440,"content":5221},[5222],{"type":15,"attrs":5223,"content":5224},{"textAlign":53},[5225,5227],{"text":5226,"type":295},"Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, Healthcare Infection Control Practices Advisory Committee (HICPAC). Guideline for prevention of catheter-associated urinary tract infections 2009. Infection Control Hospital Epidemiology. 2010;31(4):319-326. ",{"text":1112,"type":295,"marks":5228},[5229],{"type":371,"attrs":5230},{"href":1112,"uuid":53,"anchor":53,"custom":5231,"target":374,"linktype":375},{},{"type":440,"content":5233},[5234],{"type":15,"attrs":5235,"content":5236},{"textAlign":53},[5237,5239],{"text":5238,"type":295},"Novosad SA, Sapiano MRP, Grigg C, et al. Vital Signs: Epidemiology of Sepsis: Prevalence of Health Care Factors and Opportunities for Prevention. Morbidity and Mortality Weekly Report. 2016;65(33):864-869. ",{"text":5240,"type":295,"marks":5241},"http://dx.doi.org/10.15585/mmwr.mm6533e1",[5242],{"type":371,"attrs":5243},{"href":5240,"uuid":53,"anchor":53,"custom":5244,"target":374,"linktype":375},{},{"type":440,"content":5246},[5247],{"type":15,"attrs":5248,"content":5249},{"textAlign":53},[5250,5252],{"text":5251,"type":295},"Tumpey A. Empowering Nurses for Early Sepsis Recognition; 2016. Accessed March 2021. ",{"text":5253,"type":295,"marks":5254},"https://www.youtube.com/watch?v=s687VMj6iwo",[5255],{"type":371,"attrs":5256},{"href":5253,"uuid":53,"anchor":53,"custom":5257,"target":374,"linktype":375},{},{"type":440,"content":5259},[5260],{"type":15,"attrs":5261,"content":5262},{"textAlign":53},[5263,5265],{"text":5264,"type":295},"Tumpey A. Sepsis Standard Work: Improving Compliance with Early Recognition and Management of Perinatal Sepsis; 2017. ",{"text":5266,"type":295,"marks":5267},"https://www.youtube.com/watch?v=BUuFfwsj1W4",[5268],{"type":371,"attrs":5269},{"href":5266,"uuid":53,"anchor":53,"custom":5270,"target":374,"linktype":375},{},{"type":440,"content":5272},[5273],{"type":15,"attrs":5274,"content":5275},{"textAlign":53},[5276,5278],{"text":5277,"type":295},"Tumpey A. Advances in Sepsis: Protecting Patients Throughout the Lifespan; 2016. Accessed March 23, 2021. ",{"text":5279,"type":295,"marks":5280},"https://www.youtube.com/watch?v=EASYi4-_bv4",[5281],{"type":371,"attrs":5282},{"href":5279,"uuid":53,"anchor":53,"custom":5283,"target":374,"linktype":375},{},{"type":440,"content":5285},[5286],{"type":15,"attrs":5287,"content":5288},{"textAlign":53},[5289,5291],{"text":5290,"type":295},"Global Sepsis Alliance ",{"text":5292,"type":295,"marks":5293},"www.global-sepsis-alliance.org",[5294],{"type":371,"attrs":5295},{"href":5292,"uuid":53,"anchor":53,"custom":5296,"target":374,"linktype":375},{},{"type":440,"content":5298},[5299],{"type":15,"attrs":5300,"content":5301},{"textAlign":53},[5302,5304],{"text":5303,"type":295},"Infection Prevention and Control Canada ",{"text":5305,"type":295,"marks":5306},"www.ipac-canada.org",[5307],{"type":371,"attrs":5308},{"href":5305,"uuid":53,"anchor":53,"custom":5309,"target":374,"linktype":375},{},{"type":440,"content":5311},[5312],{"type":15,"attrs":5313,"content":5314},{"textAlign":53},[5315,5317],{"text":5316,"type":295},"Society of Critical Care Medicine ",{"text":5318,"type":295,"marks":5319},"https://www.sccm.org",[5320],{"type":371,"attrs":5321},{"href":5318,"uuid":53,"anchor":53,"custom":5322,"target":374,"linktype":375},{},{"type":440,"content":5324},[5325],{"type":15,"attrs":5326,"content":5327},{"textAlign":53},[5328,5330],{"text":5329,"type":295},"Surviving Sepsis Campaign ",{"text":5331,"type":295,"marks":5332},"https://www.sccm.org/SurvivingSepsisCampaign/Home",[5333],{"type":371,"attrs":5334},{"href":5331,"uuid":53,"anchor":53,"custom":5335,"target":374,"linktype":375},{},{"type":15,"attrs":5337,"content":5338},{"textAlign":53},[5339],{"text":5340,"type":295,"marks":5341},"Guidelines and Bundles",[5342],{"type":487},{"type":499,"content":5344},[5345,5358,5371],{"type":440,"content":5346},[5347],{"type":15,"attrs":5348,"content":5349},{"textAlign":53},[5350,5352],{"text":5351,"type":295},"Covid-19 Guideline ",{"text":5353,"type":295,"marks":5354},"https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/COVID-19",[5355],{"type":371,"attrs":5356},{"href":5353,"uuid":53,"anchor":53,"custom":5357,"target":374,"linktype":375},{},{"type":440,"content":5359},[5360],{"type":15,"attrs":5361,"content":5362},{"textAlign":53},[5363,5365],{"text":5364,"type":295},"Adult Patients ",{"text":5366,"type":295,"marks":5367},"https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/Adult-Patients",[5368],{"type":371,"attrs":5369},{"href":5366,"uuid":53,"anchor":53,"custom":5370,"target":374,"linktype":375},{},{"type":440,"content":5372},[5373],{"type":15,"attrs":5374,"content":5375},{"textAlign":53},[5376,5378],{"text":5377,"type":295},"Pediatric Patients ",{"text":5379,"type":295,"marks":5380},"https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/Pediatric-Patients",[5381],{"type":371,"attrs":5382},{"href":5379,"uuid":53,"anchor":53,"custom":5383,"target":374,"linktype":375},{},{"type":12,"content":5385},[5386,5394,5398],{"type":15,"attrs":5387,"content":5388},{"textAlign":53},[5389,5390,5393],{"text":2529,"type":295},{"text":4864,"type":295,"marks":5391},[5392],{"type":402},{"text":2535,"type":295},{"type":15,"attrs":5395,"content":5396},{"textAlign":868},[5397],{"text":1470,"type":295},{"type":435,"attrs":5399,"content":5400},{"order":437},[5401,5407,5413,5419],{"type":440,"content":5402},[5403],{"type":15,"attrs":5404,"content":5405},{"textAlign":53},[5406],{"text":1480,"type":295},{"type":440,"content":5408},[5409],{"type":15,"attrs":5410,"content":5411},{"textAlign":53},[5412],{"text":1487,"type":295},{"type":440,"content":5414},[5415],{"type":15,"attrs":5416,"content":5417},{"textAlign":53},[5418],{"text":1494,"type":295},{"type":440,"content":5420},[5421],{"type":15,"attrs":5422,"content":5423},{"textAlign":53},[5424],{"text":1501,"type":295},{"_uid":1503,"items":5426,"title":1548,"component":1549,"description":5451},[5427,5433,5439,5445],{"_uid":1506,"image":5428,"title":2572,"component":1512,"description":5430},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":5429,"is_external_url":286},{},{"type":12,"content":5431},[5432],{"type":15},{"_uid":1517,"image":5434,"title":2579,"component":1512,"description":5436},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":5435,"is_external_url":286},{},{"type":12,"content":5437},[5438],{"type":15},{"_uid":1525,"image":5440,"title":1511,"component":1512,"description":5442},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":5441,"is_external_url":286},{},{"type":12,"content":5443},[5444],{"type":15},{"_uid":1533,"image":5446,"title":1528,"component":1512,"description":5448},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":5447,"is_external_url":286},{},{"type":12,"content":5449},[5450],{"type":15},{"type":12,"content":5452},[5453],{"type":15,"attrs":5454,"content":5455},{"textAlign":53},[5456],{"text":2601,"type":295},{"_uid":1563,"items":5458,"title":1680,"component":1458,"description":6026},[5459,5608,5766,5911],{"_uid":1566,"title":1567,"ctaLeft":5460,"ctaRight":5461,"component":898,"columnLeft":5462,"columnRight":5521},[],[],{"type":12,"content":5463},[5464,5470,5500,5516],{"type":15,"attrs":5465,"content":5466},{"textAlign":53},[5467],{"text":1630,"type":295,"marks":5468},[5469],{"type":487},{"type":435,"attrs":5471,"content":5472},{"order":437},[5473,5480,5486,5493],{"type":440,"content":5474},[5475],{"type":15,"attrs":5476,"content":5477},{"textAlign":53},[5478],{"text":5479,"type":295},"Abstracts with age on admission less than 1 year.",{"type":440,"content":5481},[5482],{"type":15,"attrs":5483,"content":5484},{"textAlign":53},[5485],{"text":1639,"type":295},{"type":440,"content":5487},[5488],{"type":15,"attrs":5489,"content":5490},{"textAlign":53},[5491],{"text":5492,"type":295},"Abstracts with a most responsible diagnosis of palliative care (ICD-10-CA: Z51:5)",{"type":440,"content":5494},[5495],{"type":15,"attrs":5496,"content":5497},{"textAlign":53},[5498],{"text":5499,"type":295},"Abstracts where sepsis is also identified as a pre-admit condition are excluded from the numerator:",{"type":499,"content":5501},[5502,5509],{"type":440,"content":5503},[5504],{"type":15,"attrs":5505,"content":5506},{"textAlign":53},[5507],{"text":5508,"type":295},"Abstracts with sepsis codes (ICD-10-CA: A40.–, A41.–, B37.7, R65.1, R57.2) or the associated post-procedural complication codes (ICD-10-CA: T80.2, T81.1, T81.4, T82.6, T82.7–, T83.5, T83.6, T84.5–, T84.6–, T84.7, T85.7, T88.0) identified as pre-admit [type (M), (1), (W), (X) or (Y)]",{"type":440,"content":5510},[5511],{"type":15,"attrs":5512,"content":5513},{"textAlign":53},[5514],{"text":5515,"type":295},"Abstract with sepsis in obstetric patients where the puerperal sepsis code or the associated obstetric infection code is identified as pre-admit [ICD-10-CA: O85.004, O85.009, O98.501, O98.503, O98.504, O98.509, O98.801, O98.803, O98.804, O98.809 — any diagnosis type or O03.0, O03.5, O04.0, O04.5, O05.0, O05.5, O07.3, O08.0 as type (M), (1), (W), (X) or (Y)]",{"type":15,"attrs":5517,"content":5518},{"textAlign":53},[5519],{"text":5520,"type":295},"As an exception, sepsis is not considered as a pre-admit condition when the above codes identified as type (M), (W), (X) or (Y) also appear as type (2) or within a post-admit sepsis coding scenario (sepsis code as type (2); sepsis code as type (3) or an associated infection code as type (2) in sepsis as post-procedural or obstetric complications",{"type":12,"content":5522},[5523,5531,5545,5552,5560,5567,5575,5582,5590,5599],{"type":15,"attrs":5524,"content":5525},{"textAlign":53},[5526,5529],{"text":2613,"type":295,"marks":5527},[5528],{"type":487},{"text":5530,"type":295},": Condition",{"type":15,"attrs":5532,"content":5533},{"textAlign":53},[5534,5540],{"text":5535,"type":295,"marks":5536},"A40.–, A41.–, B37.7, R57.2, R65.1",[5537,5539],{"type":298,"attrs":5538},{"color":2834},{"type":487},{"text":5541,"type":295,"marks":5542},": Identified as diagnosis type (2)",[5543],{"type":298,"attrs":5544},{"color":2834},{"type":15,"attrs":5546,"content":5547},{"textAlign":53},[5548],{"text":1596,"type":295,"marks":5549},[5550],{"type":298,"attrs":5551},{"color":2834},{"type":15,"attrs":5553,"content":5554},{"textAlign":53},[5555],{"text":5556,"type":295,"marks":5557},"Identified as diagnosis type (3) AND T80.2, T81.4, T82.6,   T82.7–, T83.5, T83.6, T84.5–, T84.6–, T84.7, T85.7 or T88.0 as diagnosis type (2) AND Y60–Y84 in the same diagnosis cluster",[5558],{"type":298,"attrs":5559},{"color":2834},{"type":15,"attrs":5561,"content":5562},{"textAlign":53},[5563],{"text":1596,"type":295,"marks":5564},[5565],{"type":298,"attrs":5566},{"color":2834},{"type":15,"attrs":5568,"content":5569},{"textAlign":53},[5570],{"text":5571,"type":295,"marks":5572},"Identified as diagnosis type (3) AND O03.0, O03.5, O04.0, O04.5, O05.0, O05.5, O07.3 or O08.0– as diagnosis type (2) on the same abstract",[5573],{"type":298,"attrs":5574},{"color":2834},{"type":15,"attrs":5576,"content":5577},{"textAlign":53},[5578],{"text":1596,"type":295,"marks":5579},[5580],{"type":298,"attrs":5581},{"color":2834},{"type":15,"attrs":5583,"content":5584},{"textAlign":53},[5585],{"text":5586,"type":295,"marks":5587},"Identified as diagnosis type (3) AND O98.502 or O98.802 as diagnosis type (M), (1), (2), (W), (X) or (Y) on the same abstract",[5588],{"type":298,"attrs":5589},{"color":2834},{"type":15,"attrs":5591,"content":5592},{"textAlign":53},[5593,5597],{"text":5594,"type":295,"marks":5595},"O85.002",[5596],{"type":487},{"text":5598,"type":295},": Identified as diagnosis type (M), (1), (2), (W), (X) or (Y)",{"type":15,"attrs":5600,"content":5601},{"textAlign":53},[5602,5606],{"text":5603,"type":295,"marks":5604},"R57.2",[5605],{"type":487},{"text":5607,"type":295},": Identified as diagnosis type (3) AND T81.1 as diagnosis type (2) AND Y60–Y84 in the same diagnosis cluster",{"_uid":2668,"title":2669,"ctaLeft":5609,"ctaRight":5610,"component":898,"columnLeft":5611,"columnRight":5615},[],[],{"type":12,"content":5612},[5613],{"type":15,"attrs":5614},{"textAlign":53},{"type":12,"content":5616},[5617,5624,5633,5642,5651,5660,5669,5678,5687,5696,5705,5714,5723,5731,5740,5749,5757],{"type":15,"attrs":5618,"content":5619},{"textAlign":53},[5620,5623],{"text":2613,"type":295,"marks":5621},[5622],{"type":487},{"text":2685,"type":295},{"type":15,"attrs":5625,"content":5626},{"textAlign":53},[5627,5631],{"text":5628,"type":295,"marks":5629},"A40",[5630],{"type":487},{"text":5632,"type":295},": Streptococcal sepsis",{"type":15,"attrs":5634,"content":5635},{"textAlign":53},[5636,5640],{"text":5637,"type":295,"marks":5638},"A41",[5639],{"type":487},{"text":5641,"type":295},".–: Other sepsis",{"type":15,"attrs":5643,"content":5644},{"textAlign":53},[5645,5649],{"text":5646,"type":295,"marks":5647},"B37.7",[5648],{"type":487},{"text":5650,"type":295},": Candidal sepsis",{"type":15,"attrs":5652,"content":5653},{"textAlign":53},[5654,5658],{"text":5655,"type":295,"marks":5656},"O03.0",[5657],{"type":487},{"text":5659,"type":295},": Spontaneous abortion, incomplete, complicated by genital tract and pelvic infection",{"type":15,"attrs":5661,"content":5662},{"textAlign":53},[5663,5667],{"text":5664,"type":295,"marks":5665},"O03.5",[5666],{"type":487},{"text":5668,"type":295},": Spontaneous abortion, complete or unspecified, complicated by genital tract and pelvic infection",{"type":15,"attrs":5670,"content":5671},{"textAlign":53},[5672,5676],{"text":5673,"type":295,"marks":5674},"O04.0",[5675],{"type":487},{"text":5677,"type":295},": Medical abortion, incomplete, complicated by genital tract and pelvic infection",{"type":15,"attrs":5679,"content":5680},{"textAlign":53},[5681,5685],{"text":5682,"type":295,"marks":5683},"O04.5",[5684],{"type":487},{"text":5686,"type":295},": Medical abortion, complete or unspecified, complicated by genital tract and pelvic infection",{"type":15,"attrs":5688,"content":5689},{"textAlign":53},[5690,5694],{"text":5691,"type":295,"marks":5692},"O05.0",[5693],{"type":487},{"text":5695,"type":295},": Other abortion, incomplete, complicated by genital tract and pelvic infection",{"type":15,"attrs":5697,"content":5698},{"textAlign":53},[5699,5703],{"text":5700,"type":295,"marks":5701},"O05.5",[5702],{"type":487},{"text":5704,"type":295},": Other abortion, complete or unspecified, complicated by genital tract and pelvic infection",{"type":15,"attrs":5706,"content":5707},{"textAlign":53},[5708,5712],{"text":5709,"type":295,"marks":5710},"O07.3",[5711],{"type":487},{"text":5713,"type":295},": Failed attempted abortion, complicated",{"type":15,"attrs":5715,"content":5716},{"textAlign":53},[5717,5721],{"text":5718,"type":295,"marks":5719},"O08.0–",[5720],{"type":487},{"text":5722,"type":295},": Complications following abortion and ectopic and molar pregnancy; genital tract and pelvic infection",{"type":15,"attrs":5724,"content":5725},{"textAlign":53},[5726,5729],{"text":5594,"type":295,"marks":5727},[5728],{"type":487},{"text":5730,"type":295},": Puerperal sepsis, delivered with mention of postpartum complication",{"type":15,"attrs":5732,"content":5733},{"textAlign":53},[5734,5738],{"text":5735,"type":295,"marks":5736},"O98.502",[5737],{"type":487},{"text":5739,"type":295},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; delivered with mention of postpartum complication",{"type":15,"attrs":5741,"content":5742},{"textAlign":53},[5743,5747],{"text":5744,"type":295,"marks":5745},"O98.802",[5746],{"type":487},{"text":5748,"type":295},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; delivered with mention of postpartum complication",{"type":15,"attrs":5750,"content":5751},{"textAlign":53},[5752,5755],{"text":5603,"type":295,"marks":5753},[5754],{"type":487},{"text":5756,"type":295},": Septic shock",{"type":15,"attrs":5758,"content":5759},{"textAlign":53},[5760,5764],{"text":5761,"type":295,"marks":5762},"R65.1",[5763],{"type":487},{"text":5765,"type":295},": Systemic inflammatory response syndrome of infectious origin with acute organ failure",{"_uid":5767,"title":1654,"ctaLeft":5768,"ctaRight":5769,"component":898,"columnLeft":5770,"columnRight":5774},"298700c3-a866-4c7b-9c20-e87c98c04dea",[],[],{"type":12,"content":5771},[5772],{"type":15,"attrs":5773},{"textAlign":53},{"type":12,"content":5775},[5776,5783,5797,5806,5815,5824,5833,5842,5851,5860,5869,5878,5887,5896],{"type":15,"attrs":5777,"content":5778},{"textAlign":53},[5779,5782],{"text":2613,"type":295,"marks":5780},[5781],{"type":487},{"text":2685,"type":295},{"type":15,"attrs":5784,"content":5785},{"textAlign":53},[5786,5792],{"text":5787,"type":295,"marks":5788},"T80.2",[5789,5791],{"type":298,"attrs":5790},{"color":2834},{"type":487},{"text":5793,"type":295,"marks":5794},": Infections following infusion, transfusion, and therapeutic injection",[5795],{"type":298,"attrs":5796},{"color":2834},{"type":15,"attrs":5798,"content":5799},{"textAlign":53},[5800,5804],{"text":5801,"type":295,"marks":5802},"T81.4",[5803],{"type":487},{"text":5805,"type":295},": Infection following a procedure, not elsewhere classified",{"type":15,"attrs":5807,"content":5808},{"textAlign":53},[5809,5813],{"text":5810,"type":295,"marks":5811},"T81.1",[5812],{"type":487},{"text":5814,"type":295},": Shock during or resulting from a procedure, not elsewhere classified",{"type":15,"attrs":5816,"content":5817},{"textAlign":53},[5818,5822],{"text":5819,"type":295,"marks":5820},"T82.6",[5821],{"type":487},{"text":5823,"type":295},": Infection and inflammatory reaction due to cardiac valve prosthesis",{"type":15,"attrs":5825,"content":5826},{"textAlign":53},[5827,5831],{"text":5828,"type":295,"marks":5829},"T82.7",[5830],{"type":487},{"text":5832,"type":295},": Infection and inflammatory reaction due to other cardiac and vascular devices, implants, and grafts",{"type":15,"attrs":5834,"content":5835},{"textAlign":53},[5836,5840],{"text":5837,"type":295,"marks":5838},"T83.5",[5839],{"type":487},{"text":5841,"type":295},": Infection and inflammatory reaction due to prosthetic device, implant, and graft in urinary system",{"type":15,"attrs":5843,"content":5844},{"textAlign":53},[5845,5849],{"text":5846,"type":295,"marks":5847},"T83.6",[5848],{"type":487},{"text":5850,"type":295},": Infection and inflammatory reaction due to prosthetic device, implant, and graft in genital tract",{"type":15,"attrs":5852,"content":5853},{"textAlign":53},[5854,5858],{"text":5855,"type":295,"marks":5856},"T84.5–",[5857],{"type":487},{"text":5859,"type":295},": Infection and inflammatory reaction due to internal joint prosthesis",{"type":15,"attrs":5861,"content":5862},{"textAlign":53},[5863,5867],{"text":5864,"type":295,"marks":5865},"T84.6–",[5866],{"type":487},{"text":5868,"type":295},": Infection and inflammatory reaction due to internal fixation device (any site)",{"type":15,"attrs":5870,"content":5871},{"textAlign":53},[5872,5876],{"text":5873,"type":295,"marks":5874},"T84.7",[5875],{"type":487},{"text":5877,"type":295},": Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants, and grafts",{"type":15,"attrs":5879,"content":5880},{"textAlign":53},[5881,5885],{"text":5882,"type":295,"marks":5883},"T85.7",[5884],{"type":487},{"text":5886,"type":295},": Infection and inflammatory reaction due to other internal prosthetic devices, implants, and grafts",{"type":15,"attrs":5888,"content":5889},{"textAlign":53},[5890,5894],{"text":5891,"type":295,"marks":5892},"T88.0",[5893],{"type":487},{"text":5895,"type":295},": Infection following immunization",{"type":15,"attrs":5897,"content":5898},{"textAlign":53},[5899,5902,5904,5910],{"text":1614,"type":295,"marks":5900},[5901],{"type":487},{"text":5903,"type":295},": Complications of medical and surgical care (refer to Appendix A of the ",{"text":1674,"type":295,"marks":5905},[5906],{"type":371,"attrs":5907},{"href":5908,"uuid":53,"anchor":53,"custom":5909,"target":374,"linktype":375},"https://www.cihi.ca/display/HSPIL/Hospital+Harm?preview=%5c10453027%5c15564910%5cHospital%20Harm%20Indicator%20General%20Methodology%20Notes.pdf",{},{"text":999,"type":295},{"_uid":1629,"title":2741,"ctaLeft":5912,"ctaRight":5913,"component":898,"columnLeft":5914,"columnRight":5918},[],[],{"type":12,"content":5915},[5916],{"type":15,"attrs":5917},{"textAlign":53},{"type":12,"content":5919},[5920,5927,5936,5945,5954,5963,5972,5981,5990,5999,6008,6017],{"type":15,"attrs":5921,"content":5922},{"textAlign":53},[5923,5926],{"text":2613,"type":295,"marks":5924},[5925],{"type":487},{"text":2685,"type":295},{"type":15,"attrs":5928,"content":5929},{"textAlign":53},[5930,5934],{"text":5931,"type":295,"marks":5932},"O85.004",[5933],{"type":487},{"text":5935,"type":295},": Puerperal sepsis, postpartum condition, or complication",{"type":15,"attrs":5937,"content":5938},{"textAlign":53},[5939,5943],{"text":5940,"type":295,"marks":5941},"O85.009",[5942],{"type":487},{"text":5944,"type":295},": Puerperal sepsis, unspecified as to episode of care, or not applicable",{"type":15,"attrs":5946,"content":5947},{"textAlign":53},[5948,5952],{"text":5949,"type":295,"marks":5950},"O98.501",[5951],{"type":487},{"text":5953,"type":295},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; delivered with or without mention of antepartum condition",{"type":15,"attrs":5955,"content":5956},{"textAlign":53},[5957,5961],{"text":5958,"type":295,"marks":5959},"O98.503",[5960],{"type":487},{"text":5962,"type":295},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; antepartum condition or complication",{"type":15,"attrs":5964,"content":5965},{"textAlign":53},[5966,5970],{"text":5967,"type":295,"marks":5968},"O98.504",[5969],{"type":487},{"text":5971,"type":295},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; postpartum condition or complication",{"type":15,"attrs":5973,"content":5974},{"textAlign":53},[5975,5979],{"text":5976,"type":295,"marks":5977},"O98.509",[5978],{"type":487},{"text":5980,"type":295},": Other viral diseases complicating pregnancy, childbirth, and the puerperium; unspecified as to episode of care, or not applicable",{"type":15,"attrs":5982,"content":5983},{"textAlign":53},[5984,5988],{"text":5985,"type":295,"marks":5986},"O98.801",[5987],{"type":487},{"text":5989,"type":295},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; delivered with or without mention of antepartum condition",{"type":15,"attrs":5991,"content":5992},{"textAlign":53},[5993,5997],{"text":5994,"type":295,"marks":5995},"O98.803",[5996],{"type":487},{"text":5998,"type":295},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; antepartum condition or complication",{"type":15,"attrs":6000,"content":6001},{"textAlign":53},[6002,6006],{"text":6003,"type":295,"marks":6004},"O98.804",[6005],{"type":487},{"text":6007,"type":295},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; postpartum condition or complication",{"type":15,"attrs":6009,"content":6010},{"textAlign":53},[6011,6015],{"text":6012,"type":295,"marks":6013},"O98.809",[6014],{"type":487},{"text":6016,"type":295},": Other maternal infectious and parasitic diseases complicating pregnancy, childbirth, and the puerperium; unspecified as to episode of care, or not applicable",{"type":15,"attrs":6018,"content":6019},{"textAlign":53},[6020,6024],{"text":6021,"type":295,"marks":6022},"Z51.5",[6023],{"type":487},{"text":6025,"type":295},": Palliative care",{"type":12,"content":6027},[6028,6038,6043],{"type":15,"attrs":6029,"content":6030},{"textAlign":53},[6031,6032],{"text":2985,"type":295},{"text":6033,"type":295,"marks":6034},"B17: Sepsis",[6035,6037],{"type":298,"attrs":6036},{"color":2834},{"type":487},{"type":15,"attrs":6039,"content":6040},{"textAlign":53},[6041],{"text":6042,"type":295},"Concept: Sepsis identified during a hospital stay, excluding neonatal sepsis.",{"type":15,"attrs":6044,"content":6045},{"textAlign":53},[6046],{"text":6047,"type":295},"Notes: This clinical group includes an episode of sepsis that developed in hospital; however, the infection which led to sepsis might have been acquired in the community or hospital.",{"_uid":6049,"content":6050,"component":633},"6228c795-3291-4108-81fd-95c44b54c84a",[6051],{"_uid":6052,"content":6053,"component":632},"c08cb049-afe3-48fb-9071-3eaa4b8d0212",{"type":12,"content":6054},[6055,6060,6074,6086,6100],{"type":406,"attrs":6056,"content":6057},{"level":408,"textAlign":53},[6058],{"text":6059,"type":295},"Success Stories ",{"type":499,"content":6061},[6062],{"type":440,"content":6063},[6064],{"type":15,"attrs":6065,"content":6066},{"textAlign":53},[6067],{"text":6068,"type":295,"marks":6069},"Surviving Sepsis: A Human Factors Approach",[6070],{"type":371,"attrs":6071},{"href":6072,"uuid":53,"anchor":53,"custom":6073,"target":374,"linktype":375},"https://www.patientstories.org.uk/recent-posts/surviving-sepsis-a-human-factors-approach/",{},{"type":15,"attrs":6075,"content":6076},{"textAlign":53},[6077,6079,6084],{"text":6078,"type":295},"PatientStories.org and the Winchester and Eastleigh Healthcare NHS Trust in the UK have created ",{"text":6068,"type":295,"marks":6080},[6081],{"type":371,"attrs":6082},{"href":6072,"uuid":53,"anchor":53,"custom":6083,"target":374,"linktype":375},{},{"text":6085,"type":295},", a short film documenting their innovative human factors approach to identify and manage sepsis (Patient Stories, 2013).",{"type":499,"content":6087},[6088],{"type":440,"content":6089},[6090],{"type":15,"attrs":6091,"content":6092},{"textAlign":53},[6093],{"text":6094,"type":295,"marks":6095},"World Sepsis Declaration",[6096],{"type":371,"attrs":6097},{"href":6098,"uuid":53,"anchor":53,"custom":6099,"target":374,"linktype":375},"https://www.worldsepsisday.org/?MET=HOME&vLANGUAGE=EN",{},{"type":15,"attrs":6101,"content":6102},{"textAlign":53},[6103,6104,6109],{"text":382,"type":295},{"text":6094,"type":295,"marks":6105},[6106],{"type":371,"attrs":6107},{"href":6098,"uuid":53,"anchor":53,"custom":6108,"target":374,"linktype":375},{},{"text":6110,"type":295}," is a call to action: To reduce sepsis incidence by 20 per cent by 2020. Internationally, over 4,200 organizations and individuals have signed this declaration to show their support. This includes organizations and individuals from across Canada. The pledge supports increasing awareness, implementing best practice, and tracking the positive impact of sepsis care and management.",{"_uid":3408,"items":6112,"title":3523,"component":1458,"description":6253},[6113],{"_uid":3411,"title":3412,"ctaLeft":6114,"ctaRight":6115,"component":898,"columnLeft":6116,"columnRight":6120},[],[],{"type":12,"content":6117},[6118],{"type":15,"attrs":6119},{"textAlign":53},{"type":12,"content":6121},[6122,6127,6139,6151,6162,6173,6185,6197,6202,6207,6212,6217,6227,6238,6243,6248],{"type":15,"attrs":6123,"content":6124},{"textAlign":53},[6125],{"text":6126,"type":295},"Alhazzani W, Møller MH, Arabi YM, et al. Surviving Sepsis Campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Medicine. 2020;46(5):854-887. doi:10.1007/s00134-020-06022-5",{"type":15,"attrs":6128,"content":6129},{"textAlign":53},[6130,6132],{"text":6131,"type":295},"Canadian Institute for Health Information. In Depth Bar Graph Data Export: In-Hospital Sepsis. CIHI Your Health System. Published 2019a. Accessed March 2021.",{"text":6133,"type":295,"marks":6134}," https://yourhealthsystem.cihi.ca/hsp/indepth?lang=en#/indicator/016/2/C300/",[6135],{"type":371,"attrs":6136},{"href":6137,"uuid":53,"anchor":53,"custom":6138,"target":374,"linktype":375},"https://www.cihi.ca/en/your-health-system-yhs-and-health-indicators-e-publication-epub-are-transitioning-to-serve-you?lang=en#/indicator/016/2/C300/",{},{"type":15,"attrs":6140,"content":6141},{"textAlign":53},[6142,6144],{"text":6143,"type":295},"Canadian Institute for Health Information. OECD Interactive Tool: International Comparisons - Patient Safety. Canadian Institute for Health Information. Published 2019b. Accessed March 2021. ",{"text":6145,"type":295,"marks":6146},"https://www.cihi.ca/en/oecd-interactive-tool-international-comparisons-patient-safety",[6147],{"type":371,"attrs":6148},{"href":6149,"uuid":53,"anchor":53,"custom":6150,"target":374,"linktype":375},"https://www.cihi.ca/en/organisation-for-economic-co-operation-and-development-oecd-health-statistics",{},{"type":15,"attrs":6152,"content":6153},{"textAlign":53},[6154,6156],{"text":6155,"type":295},"Canadian Institute for Health Information. Appendix A. In: Hospital Harm Indicator: General Methodology Notes. Canadian Institute for Health Information; 2019c. ",{"text":6157,"type":295,"marks":6158},"https://www.cihi.ca/sites/default/files/document/hospital-harm-indicator-general-methodology-notes.pdf",[6159],{"type":371,"attrs":6160},{"href":6157,"uuid":53,"anchor":53,"custom":6161,"target":374,"linktype":375},{},{"type":15,"attrs":6163,"content":6164},{"textAlign":53},[6165,6167],{"text":6166,"type":295},"Canadian Patient Safety Institute. Hospital Harm Improvement Resource. Published 2018. ",{"text":455,"type":295,"marks":6168},[6169],{"type":371,"attrs":6170},{"href":459,"uuid":460,"anchor":53,"custom":6171,"target":462,"linktype":463,"story":6172},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"type":15,"attrs":6174,"content":6175},{"textAlign":53},[6176,6178],{"text":6177,"type":295},"Canadian Patient Safety Institute, Bernier P, Boiteau P, et al. Sepsis: Prevention, Early Identification and Response: Getting Started Kit. Canadian Patient Safety Institute; 2015. ",{"text":6179,"type":295,"marks":6180},"https://doi.org/10.7939/r3-qs6h-nd54",[6181],{"type":371,"attrs":6182},{"href":6183,"uuid":53,"anchor":53,"custom":6184,"target":374,"linktype":375},"https://ualberta.scholaris.ca/items/0fc3b1a6-a5cc-485e-a6c1-3bd12a7304fb",{},{"type":15,"attrs":6186,"content":6187},{"textAlign":53},[6188,6190],{"text":6189,"type":295},"Escobar MF, Echavarría MP, Zambrano MA, Ramos I, Kusanovic JP. Maternal sepsis. American Journal of Obstetrics & Gynecology MFM. 2020;2(3). doi:",{"text":6191,"type":295,"marks":6192},"10.1016/j.ajogmf.2020.100149",[6193],{"type":371,"attrs":6194},{"href":6195,"uuid":53,"anchor":53,"custom":6196,"target":374,"linktype":375},"https://linkinghub.elsevier.com/retrieve/pii/S2589933320300938",{},{"type":15,"attrs":6198,"content":6199},{"textAlign":53},[6200],{"text":6201,"type":295},"Institute for Healthcare Improvement (IHI). How-to Guide: Prevent surgical site infections. Cambridge, MA: IHI; 2012. http://www.ihi.org/resources/pages/tools/howtoguidepreventsurgicalsiteinfection.aspx",{"type":15,"attrs":6203,"content":6204},{"textAlign":53},[6205],{"text":6206,"type":295},"MacLaurin A, Amaratunga K, Couris C, et al. Measuring and Monitoring Healthcare-Associated Infections: A Canadian Collaboration to Better Understand the Magnitude of the Problem. Healthcare Quarterly. 2020;22(SP):116-128. doi:10.12927/hcq.2020.26040",{"type":15,"attrs":6208,"content":6209},{"textAlign":53},[6210],{"text":6211,"type":295},"Martin P, Abou Chakra CN, Williams V, et al. Prevalence of antibiotic-resistant organisms in Canadian Hospitals. Comparison of point-prevalence survey results from 2010, 2012, and 2016. Infection Control & Hospital Epidemiology. 2019;40(1):53-59. doi:10.1017/ice.2018.279",{"type":15,"attrs":6213,"content":6214},{"textAlign":53},[6215],{"text":6216,"type":295},"Mitchell R, Taylor G, Rudnick W, et al. Trends in health care–associated infections in acute care hospitals in Canada: an analysis of repeated point-prevalence surveys. CMAJ. 2019;191(36):E981. doi:10.1503/cmaj.190361",{"type":15,"attrs":6218,"content":6219},{"textAlign":53},[6220,6222],{"text":6221,"type":295},"Patient Stories. Julie's Story; 2013. Accessed March 23, 2021. ",{"text":5058,"type":295,"marks":6223},[6224],{"type":371,"attrs":6225},{"href":5058,"uuid":53,"anchor":53,"custom":6226,"target":374,"linktype":375},{},{"type":15,"attrs":6228,"content":6229},{"textAlign":53},[6230,6232],{"text":6231,"type":295},"Patient Stories. Surviving Sepsis; 2010. Accessed March 23, 2021.",{"text":6233,"type":295,"marks":6234}," https://www.patientstories.org.uk/recent-posts/surviving-sepsis-a-human-factors-approach/",[6235],{"type":371,"attrs":6236},{"href":6072,"uuid":53,"anchor":53,"custom":6237,"target":374,"linktype":375},{},{"type":15,"attrs":6239,"content":6240},{"textAlign":53},[6241],{"text":6242,"type":295},"Rhee C, Jones TM, Hamad Y, et al. Prevalence, Underlying Causes, and Preventability of Sepsis-Associated Mortality in US Acute Care Hospitals. JAMA Network Open. 2019;2(2):e187571-e187571. doi:10.1001/jamanetworkopen.2018.7571",{"type":15,"attrs":6244,"content":6245},{"textAlign":53},[6246],{"text":6247,"type":295},"Riley C, Wheeler DS. Prevention of sepsis in children: a new paradigm for public policy. Crit Care Res Pract. 2012;2012:437139-437139. doi:10.1155/2012/437139",{"type":15,"attrs":6249,"content":6250},{"textAlign":53},[6251],{"text":6252,"type":295},"Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-810. doi:10.1001/jama.2016.0287",{"type":12,"content":6254},[6255],{"type":15},{"id":16,"_uid":6257,"items":6258,"component":659},"3232811b-05e5-479b-9e6c-665a88720966",[6259],{"_uid":6260,"link":6261,"image":6266,"title":651,"component":652,"description":6268},"23611e6c-ad93-4f48-a4de-8720b1179679",[6262],{"_uid":6263,"link":6264,"label":645,"component":646},"a8a2c546-f504-48a1-94c9-0a04e7154602",{"id":275,"url":16,"linktype":463,"fieldtype":643,"cached_url":303,"story":6265},{"name":270,"id":274,"uuid":275,"slug":9,"url":303,"full_slug":303,"_stopResolving":301},{"id":648,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":649,"copyright":16,"fieldtype":284,"meta_data":6267,"is_external_url":286},{},{"type":12,"content":6269},[6270],{"type":15,"attrs":6271,"content":6272},{"textAlign":53},[6273],{"text":294,"type":295},[129,150,136,122,143,115,157],[185,192,200],"sepsis","resources/sepsis",-18630,[],"b1b1354c-2415-4bdc-8e10-792767f9a80b","2025-12-08T23:10:07.863Z",[],[6284],{"path":6285,"name":6276,"lang":315,"published":301},"ressources/la-septicemie",{"name":6287,"created_at":6288,"published_at":6289,"updated_at":6290,"id":6291,"uuid":6292,"content":6293,"slug":7668,"full_slug":7669,"sort_by_date":53,"position":7670,"tag_list":7671,"is_startpage":286,"parent_id":667,"meta_data":53,"group_id":7672,"first_published_at":7673,"release_id":53,"lang":309,"path":53,"alternates":7674,"default_full_slug":7669,"translated_slugs":7675},"Wound Disruption","2025-12-09T20:52:36.308Z","2026-03-10T16:38:42.469Z","2026-03-10T16:38:42.575Z",121339725112122,"2edb0313-04e0-47a0-9df0-f75a8f021746",{"new":286,"seo":6294,"_uid":690,"hero":6295,"type":174,"topics":6316,"Noindex":286,"content":6317,"audience":7666,"duration":16,"regional":7667,"component":662},{"_uid":688,"title":6287,"plugin":339,"og_image":16,"og_title":16,"description":1766,"twitter_image":16,"twitter_title":16,"og_description":16,"twitter_description":16},[6296],{"_uid":693,"image":6297,"title":6299,"format":6300,"component":351,"description":6303,"key_learning":6310,"prerequisite":6313},{"id":695,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":696,"copyright":16,"fieldtype":284,"meta_data":6298,"is_external_url":286},{"alt":16,"title":16,"source":16,"copyright":16},"Hospital Harm: Wound Disruption",{"type":12,"content":6301},[6302],{"type":15},{"type":12,"content":6304},[6305],{"type":15,"attrs":6306,"content":6307},{"textAlign":53},[6308],{"text":6309,"type":295},"Wound healing is a critical outcome in surgery, and postoperative wound disruption is a serious complication. Surgical incisions are acute wounds that activate the healing process. ",{"type":12,"content":6311},[6312],{"type":15},{"type":12,"content":6314},[6315],{"type":15},[76,8],[6318,6329,6586,6661,7119,7151,7340,7411,7648],{"_uid":718,"link":6319,"image":6320,"title":722,"component":723,"media_type":724,"description":6322},[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":284,"meta_data":6321},{},{"type":12,"content":6323},[6324],{"type":15,"attrs":6325,"content":6326},{"textAlign":53},[6327],{"text":6328,"type":295},"Reduce the incidence of wound disruption in surgical and obstetrical patients by assessing risk, implementing risk factor modifications prior to surgery and instituting good wound care management.",{"_uid":1802,"content":6330,"component":633},[6331],{"_uid":1805,"content":6332,"component":632},{"type":12,"content":6333},[6334,6338,6349,6354,6359,6364,6369,6373,6378,6538,6543],{"type":406,"attrs":6335,"content":6336},{"level":408,"textAlign":53},[6337],{"text":743,"type":295},{"type":15,"attrs":6339,"content":6340},{"textAlign":53},[6341,6342,6348],{"text":748,"type":295},{"text":455,"type":295,"marks":6343},[6344],{"type":371,"attrs":6345},{"href":459,"uuid":460,"anchor":53,"custom":6346,"target":462,"linktype":463,"story":6347},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":756,"type":295},{"type":15,"attrs":6350,"content":6351},{"textAlign":53},[6352],{"text":6353,"type":295},"The healing process has four identified stages, namely: coagulation, inflammation, proliferative phase/granulation tissue formation and the remodeling phase, in reality it is a complex, continuous process (Demidova-Rice et al., 2012). Surgical wound dehiscence (SWD) has been defined as the separation of the margins of a closed surgical incision that has been made in skin, with or without exposure or protrusion of underlying tissue, organs, or implants. Separation may occur at single or multiple regions, or involve the full length of the incision, and may affect some or all tissue layers. A dehisced incision may, or may not, display clinical signs and symptoms of infection (Ousey,2018).",{"type":15,"attrs":6355,"content":6356},{"textAlign":53},[6357],{"text":6358,"type":295},"Despite improvements in contemporary preoperative care and suture materials, the rate of surgical wound disruption has not decreased in recent years (Sorensen et al., 2005). CIHI's Hospital Harm Results reports the number of preventable, unintended harm due to wound disruption as ranged from 3,581 events in fiscal 2014, to 5,435 events in fiscal 2019 (CIHI, 2020). This may be attributable to the increasing incidence of risk factors within the patient population outweighing the benefits of technical achievements (Sorensen et al., 2005).",{"type":15,"attrs":6360,"content":6361},{"textAlign":53},[6362],{"text":6363,"type":295},"The causes of SWD can be categorized as: technical issues with the closure of the incision (e.g., unravelling of suture knots); mechanical stress (e.g., coughing can cause breakage of the sutures or rupture of the healing incision after suture or clip removal/reabsorption); and disrupted healing (e.g., due to comorbidities or treatments that hamper healing, or as a result of a surgical site infection [SSI]) (Ousey, 2018). However, overall SSI is the strongest predictor of wound disruption (Moghadamyeghaneh et al., 2015). Abdominal wound disruption typically occurs at 10 +/- 6.5 days (median eight days) after surgery (Kenig et al., 2014). Hospital stay is significantly longer for patients with wound disruption, with a median of 36 days, compared to 16 days in a control group (van Ramshorst et al., 2010).",{"type":15,"attrs":6365,"content":6366},{"textAlign":53},[6367],{"text":6368,"type":295},"The prevention and management of surgical wound complications is a growing area of concern for patients, healthcare professionals, and administrators alike. In these times of rationalization of healthcare dollars, it is important to ensure that patients receive appropriate screening and care, beginning at the pre-operative assessment and continuing through to post-operative care and monitoring in the community. Best practice recommendations when combined with evidence-informed interventions should help clinicians develop the skills and tools needed to identify those at risk for complications and develop plans in collaboration with their patients to ensure a best practice approach (Harris, 2017).",{"type":406,"attrs":6370,"content":6371},{"level":773,"textAlign":53},[6372],{"text":4955,"type":295},{"type":15,"attrs":6374,"content":6375},{"textAlign":53},[6376],{"text":6377,"type":295},"Factors that could increase the risk of postoperative wound dehiscence (AHRQ-PDI 14, 2016, *Kamel & Khaled, 2014): ",{"type":499,"content":6379},[6380,6508],{"type":440,"content":6381},[6382,6387],{"type":15,"attrs":6383,"content":6384},{"textAlign":53},[6385],{"text":6386,"type":295},"Adult Patient related:",{"type":499,"content":6388},[6389,6396,6403,6410,6417,6424,6431,6438,6445,6452,6459,6466,6473,6480,6487,6494,6501],{"type":440,"content":6390},[6391],{"type":15,"attrs":6392,"content":6393},{"textAlign":53},[6394],{"text":6395,"type":295},"Anemia",{"type":440,"content":6397},[6398],{"type":15,"attrs":6399,"content":6400},{"textAlign":53},[6401],{"text":6402,"type":295},"Hypoproteinemia",{"type":440,"content":6404},[6405],{"type":15,"attrs":6406,"content":6407},{"textAlign":53},[6408],{"text":6409,"type":295},"Jaundice",{"type":440,"content":6411},[6412],{"type":15,"attrs":6413,"content":6414},{"textAlign":53},[6415],{"text":6416,"type":295},"Male gender",{"type":440,"content":6418},[6419],{"type":15,"attrs":6420,"content":6421},{"textAlign":53},[6422],{"text":6423,"type":295},"Overweight",{"type":440,"content":6425},[6426],{"type":15,"attrs":6427,"content":6428},{"textAlign":53},[6429],{"text":6430,"type":295},"Increasing age",{"type":440,"content":6432},[6433],{"type":15,"attrs":6434,"content":6435},{"textAlign":53},[6436],{"text":6437,"type":295},"Infection",{"type":440,"content":6439},[6440],{"type":15,"attrs":6441,"content":6442},{"textAlign":53},[6443],{"text":6444,"type":295},"Episiotomy*",{"type":440,"content":6446},[6447],{"type":15,"attrs":6448,"content":6449},{"textAlign":53},[6450],{"text":6451,"type":295},"Poor nutrition",{"type":440,"content":6453},[6454],{"type":15,"attrs":6455,"content":6456},{"textAlign":53},[6457],{"text":6458,"type":295},"Diabetes",{"type":440,"content":6460},[6461],{"type":15,"attrs":6462,"content":6463},{"textAlign":53},[6464],{"text":6465,"type":295},"Smoking",{"type":440,"content":6467},[6468],{"type":15,"attrs":6469,"content":6470},{"textAlign":53},[6471],{"text":6472,"type":295},"Malignancy",{"type":440,"content":6474},[6475],{"type":15,"attrs":6476,"content":6477},{"textAlign":53},[6478],{"text":6479,"type":295},"Chronic pulmonary disease",{"type":440,"content":6481},[6482],{"type":15,"attrs":6483,"content":6484},{"textAlign":53},[6485],{"text":6486,"type":295},"Presence of prior scar or radiation at the incision site",{"type":440,"content":6488},[6489],{"type":15,"attrs":6490,"content":6491},{"textAlign":53},[6492],{"text":6493,"type":295},"Non-compliance with postoperative instructions (such as early excessive exercise or lifting heavy objects)",{"type":440,"content":6495},[6496],{"type":15,"attrs":6497,"content":6498},{"textAlign":53},[6499],{"text":6500,"type":295},"Increased pressure within the abdomen due to fluid accumulation (ascites); inflamed bowel; severe coughing, straining, or vomiting",{"type":440,"content":6502},[6503],{"type":15,"attrs":6504,"content":6505},{"textAlign":53},[6506],{"text":6507,"type":295},"Long-term use of corticosteroid medications",{"type":440,"content":6509},[6510,6515],{"type":15,"attrs":6511,"content":6512},{"textAlign":53},[6513],{"text":6514,"type":295},"Procedure related:",{"type":499,"content":6516},[6517,6524,6531],{"type":440,"content":6518},[6519],{"type":15,"attrs":6520,"content":6521},{"textAlign":53},[6522],{"text":6523,"type":295},"Emergency surgery",{"type":440,"content":6525},[6526],{"type":15,"attrs":6527,"content":6528},{"textAlign":53},[6529],{"text":6530,"type":295},"Types of surgery (clean vs. contaminated)",{"type":440,"content":6532},[6533],{"type":15,"attrs":6534,"content":6535},{"textAlign":53},[6536],{"text":6537,"type":295},"Surgical error",{"type":15,"attrs":6539,"content":6540},{"textAlign":53},[6541],{"text":6542,"type":295},"Factors that could increase the risk of postoperative wound dehiscence in the pediatric population (AHRQ PSI 11, 2016):",{"type":499,"content":6544},[6545,6552,6559,6565,6572,6579],{"type":440,"content":6546},[6547],{"type":15,"attrs":6548,"content":6549},{"textAlign":53},[6550],{"text":6551,"type":295},"Wound infections",{"type":440,"content":6553},[6554],{"type":15,"attrs":6555,"content":6556},{"textAlign":53},[6557],{"text":6558,"type":295},"Age \u003C1 year",{"type":440,"content":6560},[6561],{"type":15,"attrs":6562,"content":6563},{"textAlign":53},[6564],{"text":6523,"type":295},{"type":440,"content":6566},[6567],{"type":15,"attrs":6568,"content":6569},{"textAlign":53},[6570],{"text":6571,"type":295},"Mechanical ventilation",{"type":440,"content":6573},[6574],{"type":15,"attrs":6575,"content":6576},{"textAlign":53},[6577],{"text":6578,"type":295},"Median or vertical incisions",{"type":440,"content":6580},[6581],{"type":15,"attrs":6582,"content":6583},{"textAlign":53},[6584],{"text":6585,"type":295},"Malnutrition",{"_uid":4401,"items":6587,"title":860,"component":1458,"description":6654},[6588,6608,6631],{"_uid":4404,"title":6589,"ctaLeft":6590,"ctaRight":6591,"component":898,"columnLeft":6597,"columnRight":6601},"Regina's Story",[],[6592],{"_uid":6593,"link":6594,"label":6596,"component":4028},"b1ad4fce-524e-456c-aad0-a495546eb4f4",{"id":16,"url":6595,"target":374,"linktype":375,"fieldtype":643,"cached_url":6595},"https://www.youtube.com/watch?v=U8S3MJpUAYY","Watch the video",{"type":12,"content":6598},[6599],{"type":15,"attrs":6600},{"textAlign":53},{"type":12,"content":6602},[6603],{"type":15,"attrs":6604,"content":6605},{"textAlign":53},[6606],{"text":6607,"type":295},"Here is a patient story about a 75-year-old lady named Regina from Tasmania.",{"_uid":6609,"title":6610,"ctaLeft":6611,"ctaRight":6612,"component":898,"columnLeft":6617,"columnRight":6621},"9f7286e6-4a86-4f37-a7cc-3c9b8b5de7aa","David's Story",[],[6613],{"_uid":6614,"link":6615,"label":6596,"component":4028},"fdffbf3a-dcab-4615-a29d-17f27e2c78b2",{"id":16,"url":6616,"target":374,"linktype":375,"fieldtype":643,"cached_url":6616},"https://www.youtube.com/watch?v=zC3M7qN_uTQ",{"type":12,"content":6618},[6619],{"type":15,"attrs":6620},{"textAlign":53},{"type":12,"content":6622},[6623],{"type":15,"attrs":6624,"content":6625},{"textAlign":53},[6626],{"text":6627,"type":295,"marks":6628},"David from South Australia shares his experience of having diabetic ulcers.",[6629],{"type":298,"attrs":6630},{"color":2834},{"_uid":6632,"title":6633,"ctaLeft":6634,"ctaRight":6635,"component":898,"columnLeft":6640,"columnRight":6644},"31006807-3bbb-4a1a-a937-66555819311a","Daniela's Story",[],[6636],{"_uid":6637,"link":6638,"label":6596,"component":4028},"940ba90a-8112-4fed-92f8-9a9c5a8a08d4",{"id":16,"url":6639,"target":374,"linktype":375,"fieldtype":643,"cached_url":6639},"https://www.youtube.com/watch?v=E_tOg7IaVDs",{"type":12,"content":6641},[6642],{"type":15,"attrs":6643},{"textAlign":53},{"type":12,"content":6645},[6646],{"type":15,"attrs":6647,"content":6648},{"textAlign":53},[6649],{"text":6650,"type":295,"marks":6651},"Daniela, a dental nurse, and mother from Victoria, Australia, was told she needed amputation after a wound developed so large that it exposed her Achilles tendon. Hear her story of overcoming this difficult situation. ",[6652],{"type":298,"attrs":6653},{"color":2834},{"type":12,"content":6655},[6656],{"type":15,"attrs":6657,"content":6658},{"textAlign":53},[6659],{"text":6660,"type":295},"Wound complications are a burden for patients, their families, and the healthcare system (Butcher & White, 2014).  Poor healing can result in wound disruption which not only affects the patient's quality of life, but may also delay adjuvant therapies, increase post-operative discomfort, delay return to activity, and increase costs as a result of re-intervention, longer hospitalization and readmission. Pain, particularly during dressing change remains a significant factor. Apart from the distress caused, pain can lead to feelings of anxiety, anger, and depression (Woo, 2010). Accurate pain assessment and understanding of the type of pain, helps with decisions about when and how to give analgesia and what information needs to be shared with the multidisciplinary team (Taylor, 2010). Several risk factors can be mitigated before, during and after the operative period, suggesting that the risk of developing wound disruption in vulnerable patients also can be reduced.",{"_uid":891,"items":6662,"title":1457,"component":1458,"description":7079},[6663],{"_uid":894,"title":895,"ctaLeft":6664,"ctaRight":6665,"component":898,"columnLeft":6666,"columnRight":6685},[],[],{"type":12,"content":6667},[6668],{"type":15,"attrs":6669,"content":6670},{"textAlign":53},[6671,6675,6681],{"text":2130,"type":295,"marks":6672},[6673],{"type":298,"attrs":6674},{"color":300},{"text":2135,"type":295,"marks":6676},[6677],{"type":371,"attrs":6678},{"href":459,"uuid":460,"anchor":53,"custom":6679,"target":462,"linktype":463,"story":6680},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":540,"type":295,"marks":6682},[6683],{"type":298,"attrs":6684},{"color":300},{"type":12,"content":6686},[6687,6692],{"type":15,"attrs":6688,"content":6689},{"textAlign":53},[6690],{"text":6691,"type":295},"If your review reveals that your cases of wound disruption are linked to specific processes or procedures, you may find these resources helpful:",{"type":499,"content":6693},[6694,6750,6778,6806,6835,6862,6884,6911,6940,6967,6995,7037,7051],{"type":440,"content":6695},[6696,6708],{"type":15,"attrs":6697,"content":6698},{"textAlign":53},[6699,6701],{"text":6700,"type":295},"Agency for Healthcare Research and Quality (AHRQ) ",{"text":6702,"type":295,"marks":6703},"www.ahrq.gov",[6704],{"type":371,"attrs":6705},{"href":6706,"uuid":53,"anchor":53,"custom":6707,"target":374,"linktype":375},"http://www.ahrq.gov",{},{"type":499,"content":6709},[6710,6724,6737],{"type":440,"content":6711},[6712],{"type":15,"attrs":6713,"content":6714},{"textAlign":53},[6715,6717],{"text":6716,"type":295},"Selected Best Practices and Suggestions for Improvement PDI 11: Postoperative Wound Dehiscence [in children]. Toolkit for using the AHRQ quality indicators: How to Improve Hospital Quality and Safety. AHRQ, 2016 #5 ",{"text":6718,"type":295,"marks":6719},"Selected Best Practices and Suggestions for Improvement (ahrq.gov)",[6720],{"type":371,"attrs":6721},{"href":6722,"uuid":53,"anchor":53,"custom":6723,"target":374,"linktype":375},"https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4w_combo_pdi11-dehiscence-bestpractices.pdf",{},{"type":440,"content":6725},[6726],{"type":15,"attrs":6727,"content":6728},{"textAlign":53},[6729,6731],{"text":6730,"type":295},"Selected Best Practices and Suggestions for Improvement PSI 14: Postoperative Wound Dehiscence [in adults] Toolkit for using the AHRQ quality indicators: How to Improve Hospital Quality and Safety. AHRQ, 2016 #6. ",{"text":6732,"type":295,"marks":6733},"https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4k_combo_psi14-dehiscence-bestpractices.pdf",[6734],{"type":371,"attrs":6735},{"href":6732,"uuid":53,"anchor":53,"custom":6736,"target":374,"linktype":375},{},{"type":440,"content":6738},[6739],{"type":15,"attrs":6740,"content":6741},{"textAlign":53},[6742,6744],{"text":6743,"type":295},"Selected Best Practice and Suggestions for Improvement: PSI 14: Postoperative wound dehiscence. Toolkit for using the AHRQ quality indicators.  AHRQ; 2016. ",{"text":6745,"type":295,"marks":6746},"http://www.ahrq.gov/professionals/systems/hospital/qitoolkit/index.html",[6747],{"type":371,"attrs":6748},{"href":6745,"uuid":53,"anchor":53,"custom":6749,"target":374,"linktype":375},{},{"type":440,"content":6751},[6752,6763],{"type":15,"attrs":6753,"content":6754},{"textAlign":53},[6755,6757],{"text":6756,"type":295},"American Journal of Health-System Pharmacy ",{"text":6758,"type":295,"marks":6759},"https://academic.oup.com/ajhp",[6760],{"type":371,"attrs":6761},{"href":6758,"uuid":53,"anchor":53,"custom":6762,"target":374,"linktype":375},{},{"type":499,"content":6764},[6765],{"type":440,"content":6766},[6767],{"type":15,"attrs":6768,"content":6769},{"textAlign":53},[6770,6772],{"text":6771,"type":295},"Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195-283. doi:10.2146/ajhp120568 ",{"text":6773,"type":295,"marks":6774},"http://www.ajhp.org/content/70/3/195.long",[6775],{"type":371,"attrs":6776},{"href":6773,"uuid":53,"anchor":53,"custom":6777,"target":374,"linktype":375},{},{"type":440,"content":6779},[6780,6791],{"type":15,"attrs":6781,"content":6782},{"textAlign":53},[6783,6785],{"text":6784,"type":295},"Bone Joint ",{"text":6786,"type":295,"marks":6787},"https://online.boneandjoint.org.uk/loi/bjj",[6788],{"type":371,"attrs":6789},{"href":6786,"uuid":53,"anchor":53,"custom":6790,"target":374,"linktype":375},{},{"type":499,"content":6792},[6793],{"type":440,"content":6794},[6795],{"type":15,"attrs":6796,"content":6797},{"textAlign":53},[6798,6800],{"text":6799,"type":295},"Parvizi J, Gehrke T, Chen AF. Proceedings of the international consensus on periprosthetic joint infection. Bone Joint J. 2013; 95-B (11): 1450-1452. doi: 10.1302/0301-620X.95B11.33135. ",{"text":6801,"type":295,"marks":6802},"https://online.boneandjoint.org.uk/doi/full/10.1302/0301-620X.95B11.33135",[6803],{"type":371,"attrs":6804},{"href":6801,"uuid":53,"anchor":53,"custom":6805,"target":374,"linktype":375},{},{"type":440,"content":6807},[6808,6819],{"type":15,"attrs":6809,"content":6810},{"textAlign":53},[6811,6813],{"text":6812,"type":295},"Canadian Journal of Infectious Diseases and Medical Microbiology ",{"text":6814,"type":295,"marks":6815},"https://www.hindawi.com/journals/cjidmm",[6816],{"type":371,"attrs":6817},{"href":6814,"uuid":53,"anchor":53,"custom":6818,"target":374,"linktype":375},{},{"type":499,"content":6820},[6821],{"type":440,"content":6822},[6823],{"type":15,"attrs":6824,"content":6825},{"textAlign":53},[6826,6828],{"text":6827,"type":295},"Chow AW, Evans GA, Nathens AB, et al. Canadian practice guidelines for surgical intra-abdominal infections. Can J Infect Dis Med Microbiol J Can Mal Infect Microbiol Medicale. 2010;21(1):11-37. doi:10.1155/2010/580340 ",{"text":6829,"type":295,"marks":6830},"Canadian Practice Guidelines for Surgical Intra-Abdominal Infections (hindawi.com)",[6831],{"type":371,"attrs":6832},{"href":6833,"uuid":53,"anchor":53,"custom":6834,"target":374,"linktype":375},"https://www.hindawi.com/journals/cjidmm/2010/580340/",{},{"type":440,"content":6836},[6837,6847],{"type":15,"attrs":6838,"content":6839},{"textAlign":53},[6840,6841],{"text":5201,"type":295},{"text":1072,"type":295,"marks":6842},[6843],{"type":371,"attrs":6844},{"href":6845,"uuid":53,"anchor":53,"custom":6846,"target":374,"linktype":375},"http://www.cdc.gov",{},{"type":499,"content":6848},[6849],{"type":440,"content":6850},[6851],{"type":15,"attrs":6852,"content":6853},{"textAlign":53},[6854,6856],{"text":6855,"type":295},"Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection. JAMA Surg. 2017;152(8):784-791. doi:10.1001/jamasurg.2017.0904 ",{"text":6857,"type":295,"marks":6858},"https://www.cdc.gov/infectioncontrol/guidelines/ssi/index.html",[6859],{"type":371,"attrs":6860},{"href":6857,"uuid":53,"anchor":53,"custom":6861,"target":374,"linktype":375},{},{"type":440,"content":6863},[6864,6869],{"type":15,"attrs":6865,"content":6866},{"textAlign":53},[6867],{"text":6868,"type":295},"Diabetes Care",{"type":499,"content":6870},[6871],{"type":440,"content":6872},[6873],{"type":15,"attrs":6874,"content":6875},{"textAlign":53},[6876,6878],{"text":6877,"type":295},"Moghissi ES, Korytkowski MT, DiNardo M, et al. American Association of Clinical Endocrinologist and American Diabetes Association consensus statement on inpatient glycemic control. Diabetes Care. 2009; 32 (6):1119-1129. doi: 10.2337/dc09-9029. ",{"text":6879,"type":295,"marks":6880},"http://care.diabetesjournals.org/content/32/6/1119",[6881],{"type":371,"attrs":6882},{"href":6879,"uuid":53,"anchor":53,"custom":6883,"target":374,"linktype":375},{},{"type":440,"content":6885},[6886,6896],{"type":15,"attrs":6887,"content":6888},{"textAlign":53},[6889,6890],{"text":1248,"type":295},{"text":1250,"type":295,"marks":6891},[6892],{"type":371,"attrs":6893},{"href":6894,"uuid":53,"anchor":53,"custom":6895,"target":374,"linktype":375},"http://www.ihi.org",{},{"type":499,"content":6897},[6898],{"type":440,"content":6899},[6900],{"type":15,"attrs":6901,"content":6902},{"textAlign":53},[6903,6905],{"text":6904,"type":295},"Institute for Healthcare Improvement. How-to Guide: Prevent Surgical Site Infections. IHI; 2012. ",{"text":6906,"type":295,"marks":6907},"http://www.ihi.org/resources/pages/tools/howtoguidepreventsurgicalsiteinfection.aspx",[6908],{"type":371,"attrs":6909},{"href":6906,"uuid":53,"anchor":53,"custom":6910,"target":374,"linktype":375},{},{"type":440,"content":6912},[6913,6925],{"type":15,"attrs":6914,"content":6915},{"textAlign":53},[6916,6918],{"text":6917,"type":295},"National Institute for Health and Care Excellence (NICE) ",{"text":6919,"type":295,"marks":6920},"www.nice.org.uk",[6921],{"type":371,"attrs":6922},{"href":6923,"uuid":53,"anchor":53,"custom":6924,"target":374,"linktype":375},"http://www.nice.org.uk",{},{"type":499,"content":6926},[6927],{"type":440,"content":6928},[6929],{"type":15,"attrs":6930,"content":6931},{"textAlign":53},[6932,6934],{"text":6933,"type":295},"National Institute for Health and Care Excellence (NICE). NICE Surgical Site Infections: Prevention and Treatment. NICE; 2019. ",{"text":6935,"type":295,"marks":6936},"https://www.nice.org.uk/guidance/ng125",[6937],{"type":371,"attrs":6938},{"href":6935,"uuid":53,"anchor":53,"custom":6939,"target":374,"linktype":375},{},{"type":440,"content":6941},[6942,6952],{"type":15,"attrs":6943,"content":6944},{"textAlign":53},[6945,6946],{"text":1376,"type":295},{"text":1378,"type":295,"marks":6947},[6948],{"type":371,"attrs":6949},{"href":6950,"uuid":53,"anchor":53,"custom":6951,"target":374,"linktype":375},"http://www.sogc.org",{},{"type":499,"content":6953},[6954],{"type":440,"content":6955},[6956],{"type":15,"attrs":6957,"content":6958},{"textAlign":53},[6959,6961],{"text":6960,"type":295},"Harvey MA, Pierce M, Alter JE, et al. SOGC Clinical Practice Guidelines. Obstetrical anal sphincter injuries (OASIS): Prevention, recognition, and repair. J Obstet Gynaecol Can. 2015; 37 (12): 1131-1148. ",{"text":6962,"type":295,"marks":6963},"https://www.jogc.com/action/showPdf?pii=S1701-2163%2816%2930081-0",[6964],{"type":371,"attrs":6965},{"href":6962,"uuid":53,"anchor":53,"custom":6966,"target":374,"linktype":375},{},{"type":440,"content":6968},[6969,6980],{"type":15,"attrs":6970,"content":6971},{"textAlign":53},[6972,6974],{"text":6973,"type":295},"The Society for Healthcare Epidemiology of America (SHEA) ",{"text":6975,"type":295,"marks":6976},"https://www.shea-online.org/",[6977],{"type":371,"attrs":6978},{"href":6975,"uuid":53,"anchor":53,"custom":6979,"target":374,"linktype":375},{},{"type":499,"content":6981},[6982],{"type":440,"content":6983},[6984],{"type":15,"attrs":6985,"content":6986},{"textAlign":53},[6987,6989],{"text":6988,"type":295},"Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(6):605-627. doi:10.1086/676022 ",{"text":6990,"type":295,"marks":6991},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267723/",[6992],{"type":371,"attrs":6993},{"href":6990,"uuid":53,"anchor":53,"custom":6994,"target":374,"linktype":375},{},{"type":440,"content":6996},[6997,7009],{"type":15,"attrs":6998,"content":6999},{"textAlign":53},[7000,7002],{"text":7001,"type":295},"Wound Care Canada ",{"text":7003,"type":295,"marks":7004},"www.woundscanada.ca",[7005],{"type":371,"attrs":7006},{"href":7007,"uuid":53,"anchor":53,"custom":7008,"target":374,"linktype":375},"http://www.woundscanada.ca",{},{"type":499,"content":7010},[7011,7024],{"type":440,"content":7012},[7013],{"type":15,"attrs":7014,"content":7015},{"textAlign":53},[7016,7018],{"text":7017,"type":295},"Orsted HL, Keast DH, Kuhnke J et al. Best practice recommendations for the prevention and management of open surgical wounds. Wound Care Canada. 2010; 8 (1): 6-34. ",{"text":7019,"type":295,"marks":7020},"https://www.woundscanada.ca/docman/public/wound-care-canada-magazine/2010-vol-8-no-1/362-wcc-2010-v8n1-best-practice-english/file",[7021],{"type":371,"attrs":7022},{"href":7019,"uuid":53,"anchor":53,"custom":7023,"target":374,"linktype":375},{},{"type":440,"content":7025},[7026],{"type":15,"attrs":7027,"content":7028},{"textAlign":53},[7029,7031],{"text":7030,"type":295},"Harris CL, Kuhnke J, Haley J, Cross K, Somayaji R, Dubois J, et al. Best practice recommendations for the prevention and management of surgical wound complications. In: Foundations of Best Practice for Skin and Wound Management. A supplement of Wound Care Canada; 2017. 66 pp. Retrieved from: ",{"text":7032,"type":295,"marks":7033},"https://www.woundscanada.ca/docman/public/health-care-professional/bpr-workshop/555-bpr-prevention-and-management-of-surgical-wound-complications-v2/file",[7034],{"type":371,"attrs":7035},{"href":7032,"uuid":53,"anchor":53,"custom":7036,"target":374,"linktype":375},{},{"type":440,"content":7038},[7039],{"type":15,"attrs":7040,"content":7041},{"textAlign":53},[7042,7044],{"text":7043,"type":295},"Wounds Australia: ",{"text":7045,"type":295,"marks":7046},"Wounds Australia Homepage - Healing Wounds Together",[7047],{"type":371,"attrs":7048},{"href":7049,"uuid":53,"anchor":53,"custom":7050,"target":374,"linktype":375},"https://www.woundsaustralia.com.au/",{},{"type":440,"content":7052},[7053,7064],{"type":15,"attrs":7054,"content":7055},{"textAlign":53},[7056,7058],{"text":7057,"type":295},"Wounds International ",{"text":7059,"type":295,"marks":7060},"www.woundsinternational.com",[7061],{"type":371,"attrs":7062},{"href":7063,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},"http://www.woundsinternational.com",{"type":499,"content":7065},[7066],{"type":440,"content":7067},[7068],{"type":15,"attrs":7069,"content":7070},{"textAlign":53},[7071,7073],{"text":7072,"type":295},"Ousey K, Djohan R, Dowsett C, Ferreira F, Hurd T, Romanelli M, Sandy-Hodgetts K. World Union of Wound Healing Societies (WUWHS) Consensus Document. Surgical wound dehiscence: improving prevention and outcomes. Wounds International, 2018. ",{"text":7074,"type":295,"marks":7075},"https://www.woundsinternational.com/download/resource/7394",[7076],{"type":371,"attrs":7077},{"href":7074,"uuid":53,"anchor":53,"custom":7078,"target":374,"linktype":375},{},{"type":12,"content":7080},[7081,7086,7090,7117],{"type":15,"attrs":7082,"content":7083},{"textAlign":53},[7084],{"text":7085,"type":295},"Given the broad range of potential causes of wound disruption, in addition to recommendations listed above, we recommend conducting clinical and system reviews to identify latent causes and determine appropriate recommendations.",{"type":15,"attrs":7087,"content":7088},{"textAlign":868},[7089],{"text":1470,"type":295},{"type":435,"attrs":7091,"content":7092},{"order":437},[7093,7099,7105,7111],{"type":440,"content":7094},[7095],{"type":15,"attrs":7096,"content":7097},{"textAlign":53},[7098],{"text":1480,"type":295},{"type":440,"content":7100},[7101],{"type":15,"attrs":7102,"content":7103},{"textAlign":53},[7104],{"text":1487,"type":295},{"type":440,"content":7106},[7107],{"type":15,"attrs":7108,"content":7109},{"textAlign":53},[7110],{"text":1494,"type":295},{"type":440,"content":7112},[7113],{"type":15,"attrs":7114,"content":7115},{"textAlign":53},[7116],{"text":1501,"type":295},{"type":15,"attrs":7118},{"textAlign":868},{"_uid":1503,"items":7120,"title":1548,"component":1549,"description":7145},[7121,7127,7133,7139],{"_uid":1506,"image":7122,"title":2572,"component":1512,"description":7124},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":7123,"is_external_url":286},{},{"type":12,"content":7125},[7126],{"type":15},{"_uid":1517,"image":7128,"title":2579,"component":1512,"description":7130},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":7129,"is_external_url":286},{},{"type":12,"content":7131},[7132],{"type":15},{"_uid":1525,"image":7134,"title":1511,"component":1512,"description":7136},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":7135,"is_external_url":286},{},{"type":12,"content":7137},[7138],{"type":15},{"_uid":1533,"image":7140,"title":1528,"component":1512,"description":7142},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":7141,"is_external_url":286},{},{"type":12,"content":7143},[7144],{"type":15},{"type":12,"content":7146},[7147],{"type":15,"attrs":7148,"content":7149},{"textAlign":53},[7150],{"text":2601,"type":295},{"_uid":1563,"items":7152,"title":1680,"component":1458,"description":7312},[7153,7215,7277],{"_uid":1566,"title":1567,"ctaLeft":7154,"ctaRight":7155,"component":898,"columnLeft":7156,"columnRight":7160},[],[],{"type":12,"content":7157},[7158],{"type":15,"attrs":7159},{"textAlign":53},{"type":12,"content":7161},[7162,7169],{"type":15,"attrs":7163,"content":7164},{"textAlign":53},[7165,7168],{"text":2613,"type":295,"marks":7166},[7167],{"type":487},{"text":5530,"type":295},{"type":499,"content":7170},[7171,7178,7185,7201],{"type":440,"content":7172},[7173],{"type":15,"attrs":7174,"content":7175},{"textAlign":53},[7176],{"text":7177,"type":295},"O90.002: Identified as diagnosis type (M), (1), (2), (W), (X) or (Y)",{"type":440,"content":7179},[7180],{"type":15,"attrs":7181,"content":7182},{"textAlign":53},[7183],{"text":7184,"type":295},"O90.102: Identified as diagnosis type (M), (1), (2), (W), (X) or (Y)",{"type":440,"content":7186},[7187],{"type":15,"attrs":7188,"content":7189},{"textAlign":53},[7190,7192,7195,7197],{"text":7191,"type":295},"T81.3: Identified as diagnosis type (2) ",{"text":1605,"type":295,"marks":7193},[7194],{"type":487},{"text":7196,"type":295},"Y60–Y84 ",{"text":7198,"type":295,"marks":7199},"in the same diagnosis cluster",[7200],{"type":487},{"type":440,"content":7202},[7203],{"type":15,"attrs":7204,"content":7205},{"textAlign":53},[7206,7208,7211,7212],{"text":7207,"type":295},"T81.83*: Identified as diagnosis type (2) ",{"text":1605,"type":295,"marks":7209},[7210],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":7213},[7214],{"type":487},{"_uid":2668,"title":2669,"ctaLeft":7216,"ctaRight":7217,"component":898,"columnLeft":7218,"columnRight":7222},[],[],{"type":12,"content":7219},[7220],{"type":15,"attrs":7221},{"textAlign":53},{"type":12,"content":7223},[7224,7231],{"type":15,"attrs":7225,"content":7226},{"textAlign":53},[7227,7230],{"text":2613,"type":295,"marks":7228},[7229],{"type":487},{"text":2685,"type":295},{"type":499,"content":7232},[7233,7244,7255,7266],{"type":440,"content":7234},[7235],{"type":15,"attrs":7236,"content":7237},{"textAlign":53},[7238,7242],{"text":7239,"type":295,"marks":7240},"O90.002",[7241],{"type":487},{"text":7243,"type":295},": Disruption of Caesarean section wound, delivered with mention of postpartum complication",{"type":440,"content":7245},[7246],{"type":15,"attrs":7247,"content":7248},{"textAlign":53},[7249,7253],{"text":7250,"type":295,"marks":7251},"O90.102",[7252],{"type":487},{"text":7254,"type":295},": Disruption of perineal obstetric wound, delivered with mention of postpartum complication",{"type":440,"content":7256},[7257],{"type":15,"attrs":7258,"content":7259},{"textAlign":53},[7260,7264],{"text":7261,"type":295,"marks":7262},"T81.3",[7263],{"type":487},{"text":7265,"type":295},": Disruption of operation wound, not elsewhere classified",{"type":440,"content":7267},[7268],{"type":15,"attrs":7269,"content":7270},{"textAlign":53},[7271,7275],{"text":7272,"type":295,"marks":7273},"T81.83*",[7274],{"type":487},{"text":7276,"type":295},": Postoperative leak",{"_uid":5767,"title":1654,"ctaLeft":7278,"ctaRight":7279,"component":898,"columnLeft":7280,"columnRight":7284},[],[],{"type":12,"content":7281},[7282],{"type":15,"attrs":7283},{"textAlign":53},{"type":12,"content":7285},[7286,7295,7310],{"type":15,"attrs":7287,"content":7288},{"textAlign":53},[7289,7293],{"text":7290,"type":295,"marks":7291},"Additional Codes",[7292],{"type":487},{"text":7294,"type":295},": Inclusions",{"type":499,"content":7296},[7297],{"type":440,"content":7298},[7299],{"type":15,"attrs":7300,"content":7301},{"textAlign":53},[7302,7304,7309],{"text":7303,"type":295},"Y60-Y84: Complications of medical and surgical care (refer to Appendix A) of the ",{"text":1674,"type":295,"marks":7305},[7306],{"type":371,"attrs":7307},{"href":1678,"uuid":53,"anchor":53,"custom":7308,"target":374,"linktype":375},{},{"text":1003,"type":295},{"type":15,"attrs":7311},{"textAlign":53},{"type":12,"content":7313},[7314,7318,7331],{"type":15,"attrs":7315,"content":7316},{"textAlign":53},[7317],{"text":2985,"type":295},{"type":499,"content":7319},[7320],{"type":440,"content":7321},[7322],{"type":15,"attrs":7323,"content":7324},{"textAlign":53},[7325,7329],{"text":7326,"type":295,"marks":7327},"D23",[7328],{"type":487},{"text":7330,"type":295},": Would Disruption",{"type":15,"attrs":7332,"content":7333},{"textAlign":53},[7334,7338],{"text":7335,"type":295,"marks":7336},"Concept",[7337],{"type":487},{"text":7339,"type":295},": Disruption of surgical wound during the same hospital stay or an obstetric wound during the delivery episode of care.",{"_uid":3987,"items":7341,"title":1709,"component":1458,"description":7407},[7342,7365,7387],{"_uid":3990,"title":7343,"ctaLeft":7344,"ctaRight":7345,"component":898,"columnLeft":7351,"columnRight":7358},"Wound Care Distance Consulting ",[],[7346],{"_uid":7347,"link":7348,"label":7350,"component":4028},"c1934137-2603-4787-928e-d9574e5a5961",{"id":16,"url":7349,"target":374,"linktype":375,"fieldtype":643,"cached_url":7349},"https://healthstandards.org/leading-practice/wound-care-distance-consulting/","Read the report",{"type":12,"content":7352},[7353],{"type":15,"attrs":7354,"content":7355},{"textAlign":53},[7356],{"text":7357,"type":295},"HSO Health Standards Organization, 2009",{"type":12,"content":7359},[7360],{"type":15,"attrs":7361,"content":7362},{"textAlign":53},[7363],{"text":7364,"type":295},"St. Adolphe Personal Care Home, a rural long-term care home, takes photos of difficult to heal wounds and e-mails them to a consulting dermatologist in the city. With this visual aid, the home's physician receives a more meaningful consult and has been successful in healing advanced ulcers. The consulting dermatologist has endorsed this practice and encourages other rural homes to adopt it. ",{"_uid":4021,"title":7366,"ctaLeft":7367,"ctaRight":7368,"component":898,"columnLeft":7373,"columnRight":7380},"Pixalere Incision Module",[],[7369],{"_uid":7370,"link":7371,"label":7350,"component":4028},"b4da11ed-d092-4ad4-979b-0d108375b2fc",{"id":16,"url":7372,"target":374,"linktype":375,"fieldtype":643,"cached_url":7372},"https://healthstandards.org/leading-practice/pixalere-incision-module/",{"type":12,"content":7374},[7375],{"type":15,"attrs":7376,"content":7377},{"textAlign":53},[7378],{"text":7379,"type":295},"HSO Health Standards Organization, 2010",{"type":12,"content":7381},[7382],{"type":15,"attrs":7383,"content":7384},{"textAlign":53},[7385],{"text":7386,"type":295},"Wound care is an ongoing, important issue with many home care clients. The efforts and resources provided by the home care staff using the Pixalere system, together with the support and consultation of RNs with specialized training in wound care management, have resulted in the Home Health program providing leading edge care. The ability to track a client's progress through a series of digital photos along with a clinical narrative allows staff to make appropriate and timely changes to care plans, helping to ensure quality patient outcomes.",{"_uid":7388,"title":7389,"ctaLeft":7390,"ctaRight":7391,"component":898,"columnLeft":7396,"columnRight":7400},"cc5a2cb9-4d7e-47e0-8384-4eb4c6086c14","Wounds Australia",[],[7392],{"_uid":7393,"link":7394,"label":6596,"component":4028},"ec2825d1-4e91-41b6-99a7-e03f53d976e3",{"id":16,"url":7395,"target":374,"linktype":375,"fieldtype":643,"cached_url":7395},"https://www.youtube.com/watch?v=Y0nDdcLVHdA",{"type":12,"content":7397},[7398],{"type":15,"attrs":7399},{"textAlign":53},{"type":12,"content":7401},[7402],{"type":15,"attrs":7403,"content":7404},{"textAlign":53},[7405],{"text":7406,"type":295},"Pharmacist describes his experience with a long-standing, chronic leg ulcer and eventually receiving a new approach to care that was successful. ",{"type":12,"content":7408},[7409],{"type":15,"attrs":7410},{"textAlign":53},{"_uid":3408,"items":7412,"title":3523,"component":1458,"description":7644},[7413],{"_uid":3411,"title":7414,"ctaLeft":7415,"ctaRight":7416,"component":898,"columnLeft":7417,"columnRight":7421},"Expand to see the full list of references",[],[],{"type":12,"content":7418},[7419],{"type":15,"attrs":7420},{"textAlign":53},{"type":12,"content":7422},[7423,7435,7446,7457,7471,7488,7505,7515,7525,7541,7552,7569,7580,7594,7611,7628],{"type":15,"attrs":7424,"content":7425},{"textAlign":53},[7426,7428,7430],{"text":7427,"type":295},"AHRQ PDI 11 - Selected Best Practices and Suggestions for Improvement PDI 11: Postoperative Wound Dehiscence [in children]. Toolkit for using the AHRQ quality indicators: How to Improve Hospital Quality and Safety. AHRQ, 2016 #5",{"type":7429},"hard_break",{"text":6722,"type":295,"marks":7431},[7432,7434],{"type":371,"attrs":7433},{"href":6722,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7436,"content":7437},{"textAlign":868},[7438,7440,7441],{"text":7439,"type":295},"AHRQ PSI 14 - Selected Best Practices and Suggestions for Improvement PSI 14: Postoperative Wound Dehiscence [in adults] Toolkit for using the AHRQ quality indicators: How to Improve Hospital Quality and Safety. AHRQ, 2016 #6. ",{"type":7429},{"text":6732,"type":295,"marks":7442},[7443,7445],{"type":371,"attrs":7444},{"href":6732,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7447,"content":7448},{"textAlign":868},[7449,7451,7455],{"text":7450,"type":295},"Butcher M, White R. Factors affecting cost-effectiveness in wound care decision making. ",{"text":7452,"type":295,"marks":7453},"Nurs Stand",[7454],{"type":402},{"text":7456,"type":295},". 2014; 28 (35): 51-58. doi: 10.7748/ns2014.04.28.35.51.e7671.",{"type":15,"attrs":7458,"content":7459},{"textAlign":868},[7460,7462,7469],{"text":7461,"type":295},"Canadian Institute for Health Information. ",{"text":7463,"type":295,"marks":7464},"Hospital Harm Results",[7465,7468],{"type":371,"attrs":7466},{"href":7467,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://www.cihi.ca/sites/default/files/document/hospital-harm-results-2014-2022-data-tables-en.xlsx",{"type":5096},{"text":7470,"type":295},", 2014–2015 to 2019–2020. Ottawa, ON: CIHI; 2020.",{"type":15,"attrs":7472,"content":7473},{"textAlign":868},[7474,7476,7480,7482],{"text":7475,"type":295},"Demidova-Rice T, Hamblin M, Herman IM. Acute and impaired wound healing: pathophysiology and current methods for drug delivery, part 1: normal and chronic wounds: biology, causes, and approaches to care. ",{"text":7477,"type":295,"marks":7478},"Adv Skin Wound Care",[7479],{"type":402},{"text":7481,"type":295},". 2012; 25 (7): 304-314. doi: 10.1097/01.ASW.0000416006.55218.d0. ",{"text":7483,"type":295,"marks":7484},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3428147/",[7485,7487],{"type":371,"attrs":7486},{"href":7483,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7489,"content":7490},{"textAlign":868},[7491,7493,7497,7499],{"text":7492,"type":295},"Harris CL, Kuhnke J, Haley J, Cross K, Somayaji R, Dubois J, et al. ",{"text":7494,"type":295,"marks":7495},"Best practice recommendations for the prevention and management of surgical wound complications. ",[7496],{"type":402},{"text":7498,"type":295},"In: Foundations of Best Practice for Skin and Wound Management. A supplement of Wound Care Canada; 2017. 66 pp. Retrieved from: ",{"text":7500,"type":295,"marks":7501},"www.woundscanada.ca/docman/public/health-care-professional/bpr-workshop/555-bpr-prevention-and-management-of-surgical-wound-complications-v2/file",[7502,7504],{"type":371,"attrs":7503},{"href":7032,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7506,"content":7507},{"textAlign":868},[7508,7510],{"text":7509,"type":295},"Health Standards Organization, 2009 , Leading Practices Library, Wound Care Distance Consulting. ",{"text":7349,"type":295,"marks":7511},[7512,7514],{"type":371,"attrs":7513},{"href":7349,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7516,"content":7517},{"textAlign":868},[7518,7520],{"text":7519,"type":295},"Health Standards Organization, 2010 , Leading Practices Library. Pixalere Incision Module. ",{"text":7372,"type":295,"marks":7521},[7522,7524],{"type":371,"attrs":7523},{"href":7372,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7526,"content":7527},{"textAlign":868},[7528,7530,7534,7536],{"text":7529,"type":295},"Institute for Healthcare Improvement (IHI). ",{"text":7531,"type":295,"marks":7532},"How-to Guide: Prevent surgical site infections.",[7533],{"type":402},{"text":7535,"type":295}," Cambridge, MA: IHI; 2012. ",{"text":6906,"type":295,"marks":7537},[7538,7540],{"type":371,"attrs":7539},{"href":6906,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7542,"content":7543},{"textAlign":868},[7544,7546,7550],{"text":7545,"type":295},"Kamel A, Khaled  M. Episiotomy, and obstetric perineal wound dehiscence: Beyond soreness. ",{"text":7547,"type":295,"marks":7548},"J Obstet Gynaecol",[7549],{"type":402},{"text":7551,"type":295},". 2014; 34 (3): 215-217. doi: 10.3109/01443615.2013.866080.",{"type":15,"attrs":7553,"content":7554},{"textAlign":868},[7555,7557,7561,7563],{"text":7556,"type":295},"Kenig J, Richer P, Lasek A, Zbierska K, Zurawska S. The efficacy of risk scores for predicting abdominal wound dehiscence: a case – controlled validation study. ",{"text":7558,"type":295,"marks":7559},"BMC Surg",[7560],{"type":402},{"text":7562,"type":295},". 2014; 14: 65. doi: 10.1186/1471-2482-14-65. ",{"text":7564,"type":295,"marks":7565},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159378/",[7566,7568],{"type":371,"attrs":7567},{"href":7564,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7570,"content":7571},{"textAlign":868},[7572,7574,7578],{"text":7573,"type":295},"Moghadamyeghaneh Z, Hanna MH, Carmichael JC, et al. Wound disruption following colorectal operations. ",{"text":7575,"type":295,"marks":7576},"World J Surg",[7577],{"type":402},{"text":7579,"type":295},". 2015; 39(12): 2999-3007. doi: 10.1007/s00268-015-3208-0.",{"type":15,"attrs":7581,"content":7582},{"textAlign":868},[7583,7585,7592],{"text":7584,"type":295},"Ousey K, Djohan R, Dowsett C, Ferreira F, Hurd T, Romanelli M, Sandy-Hodgetts K. World Union of Wound Healing Societies (WUWHS) Consensus Document. ",{"text":7586,"type":295,"marks":7587},"Surgical wound dehiscence: improving prevention and outcomes",[7588,7591],{"type":371,"attrs":7589},{"href":7590,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://woundsinternational.com/consensus-documents/surgical-wound-dehiscence-improving-prevention-and-outcomes/",{"type":5096},{"text":7593,"type":295},". Wounds International, 2018.",{"type":15,"attrs":7595,"content":7596},{"textAlign":868},[7597,7599,7603,7605],{"text":7598,"type":295},"Sorensen L, Hemmingsen U, Kallehave F, et al. Risk factors for tissue and wound complications in gastrointestinal surgery. ",{"text":7600,"type":295,"marks":7601},"Ann Surg",[7602],{"type":402},{"text":7604,"type":295},". 2005; 241 (4): 654-658. ",{"text":7606,"type":295,"marks":7607},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1357070/",[7608,7610],{"type":371,"attrs":7609},{"href":7606,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7612,"content":7613},{"textAlign":868},[7614,7616,7620,7622],{"text":7615,"type":295},"Taylor A. Principles of pain assessment. ",{"text":7617,"type":295,"marks":7618},"Wound Essentials",[7619],{"type":402},{"text":7621,"type":295},". 2010; 5: 104-110. ",{"text":7623,"type":295,"marks":7624},"https://www.wounds-uk.com/download/resource/1155",[7625,7627],{"type":371,"attrs":7626},{"href":7623,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":7629,"content":7630},{"textAlign":868},[7631,7633,7636,7638],{"text":7632,"type":295},"van Ramshorst G, Nieuwenhuizen J, Hop WC, et al. Abdominal wound dehiscence in adults: Development and validation of a risk model. ",{"text":7575,"type":295,"marks":7634},[7635],{"type":402},{"text":7637,"type":295},". 2010; 34 (1): 20-27. doi: 10.1007/s00268-009-0277-y. ",{"text":7639,"type":295,"marks":7640},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2795859/",[7641,7643],{"type":371,"attrs":7642},{"href":7639,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":12,"content":7645},[7646],{"type":15,"attrs":7647},{"textAlign":53},{"id":16,"_uid":7649,"items":7650,"component":659},"b2d6641a-1c3b-4864-ba6c-19ee346da1d3",[7651],{"_uid":7652,"link":7653,"image":7658,"title":651,"component":652,"description":7660},"c7cfed08-2efd-4485-aa1e-73f8e8102be3",[7654],{"_uid":7655,"link":7656,"label":645,"component":646},"9ad5d873-9318-46d0-a224-c392ff477445",{"id":275,"url":16,"linktype":463,"fieldtype":643,"cached_url":303,"story":7657},{"name":270,"id":274,"uuid":275,"slug":9,"url":303,"full_slug":303,"_stopResolving":301},{"id":648,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":649,"copyright":16,"fieldtype":284,"meta_data":7659,"is_external_url":286},{},{"type":12,"content":7661},[7662],{"type":15,"attrs":7663,"content":7664},{"textAlign":53},[7665],{"text":294,"type":295},[129,150,136,122,143,115,157],[185,192,200],"wound-disruption","resources/wound-disruption",-18650,[],"83a94f81-990a-4d3d-a6a6-aca10bb374b8","2025-12-09T21:48:41.399Z",[],[7676],{"path":7677,"name":7678,"lang":315,"published":301},"ressources/rupture-d-une-plaie","Rupture d’une plaie",{"name":7680,"created_at":7681,"published_at":7682,"updated_at":7683,"id":7684,"uuid":7685,"content":7686,"slug":8448,"full_slug":8449,"sort_by_date":53,"position":8450,"tag_list":8451,"is_startpage":286,"parent_id":667,"meta_data":53,"group_id":8452,"first_published_at":8453,"release_id":53,"lang":309,"path":53,"alternates":8454,"default_full_slug":8449,"translated_slugs":8455},"Pneumonia","2025-12-09T22:18:30.884Z","2026-03-10T16:37:55.403Z","2026-03-10T16:37:55.452Z",121360838247228,"56694c39-163e-4316-afc6-5453abb4f101",{"new":286,"seo":7687,"_uid":690,"hero":7688,"type":174,"topics":7709,"Noindex":286,"content":7710,"audience":8446,"duration":16,"regional":8447,"component":662},{"_uid":688,"title":7680,"plugin":339,"og_image":16,"og_title":16,"description":1766,"twitter_image":16,"twitter_title":16,"og_description":16,"twitter_description":16},[7689],{"_uid":693,"image":7690,"title":7692,"format":7693,"component":351,"description":7696,"key_learning":7703,"prerequisite":7706},{"id":695,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":696,"copyright":16,"fieldtype":284,"meta_data":7691,"is_external_url":286},{"alt":16,"title":16,"source":16,"copyright":16},"Hospital Harm: Pneumonia",{"type":12,"content":7694},[7695],{"type":15},{"type":12,"content":7697},[7698],{"type":15,"attrs":7699,"content":7700},{"textAlign":53},[7701],{"text":7702,"type":295},"Pneumonia is an infection of the lungs defined as the presence of \"new lung infiltrate plus clinical evidence that the infiltrate is of an infectious origin, which include the new onset of fever, purulent sputum, leukocytosis, and decline in oxygenation\" (Kalil et al., 2016). Pneumonia can be caused by viruses, bacteria, and fungi and can cause mild to severe illness in people of all ages and (Centers for Disease Control and Prevention (CDC), 2020).",{"type":12,"content":7704},[7705],{"type":15},{"type":12,"content":7707},[7708],{"type":15},[76,8],[7711,7722,7845,7883,8085,8117,8318,8339,8428],{"_uid":718,"link":7712,"image":7713,"title":722,"component":723,"media_type":724,"description":7715},[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":284,"meta_data":7714},{},{"type":12,"content":7716},[7717],{"type":15,"attrs":7718,"content":7719},{"textAlign":53},[7720],{"text":7721,"type":295},"To prevent hospital-acquired pneumonia in hospitalized adult patients by implementing proven interventions.",{"_uid":1802,"content":7723,"component":633},[7724],{"_uid":1805,"content":7725,"component":632},{"type":12,"content":7726},[7727,7731,7742,7747,7770,7775,7780,7785,7790,7795,7800,7805,7810,7840],{"type":406,"attrs":7728,"content":7729},{"level":408,"textAlign":53},[7730],{"text":743,"type":295},{"type":15,"attrs":7732,"content":7733},{"textAlign":53},[7734,7735,7741],{"text":748,"type":295},{"text":455,"type":295,"marks":7736},[7737],{"type":371,"attrs":7738},{"href":459,"uuid":460,"anchor":53,"custom":7739,"target":462,"linktype":463,"story":7740},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":756,"type":295},{"type":15,"attrs":7743,"content":7744},{"textAlign":53},[7745],{"text":7746,"type":295},"For pneumonia to occur in any setting, at least one of the following three conditions must occur:",{"type":499,"content":7748},[7749,7756,7763],{"type":440,"content":7750},[7751],{"type":15,"attrs":7752,"content":7753},{"textAlign":53},[7754],{"text":7755,"type":295},"significant impairment of host defenses,",{"type":440,"content":7757},[7758],{"type":15,"attrs":7759,"content":7760},{"textAlign":53},[7761],{"text":7762,"type":295},"introduction of an inoculum of sufficient size into the lower respiratory tract to overwhelm the host's defenses, or",{"type":440,"content":7764},[7765],{"type":15,"attrs":7766,"content":7767},{"textAlign":53},[7768],{"text":7769,"type":295},"the presence of highly virulent organisms (Centre for Communicable Diseases and Infection Control, 2010).",{"type":15,"attrs":7771,"content":7772},{"textAlign":53},[7773],{"text":7774,"type":295},"Despite advances in the understanding of contributing causes and prevention, hospital acquired pneumonia (HAP) and ventilator associated pneumonia (VAP) continue to be frequent complications of hospital care. Together, they are among the most common hospital-acquired infections (HAIs), accounting for 22 per cent of all HAIs (Kalil et al., 2016).",{"type":406,"attrs":7776,"content":7777},{"level":773,"textAlign":53},[7778],{"text":7779,"type":295},"Hospital-acquired pneumonia (HAP)",{"type":15,"attrs":7781,"content":7782},{"textAlign":53},[7783],{"text":7784,"type":295},"HAP is an acute lower respiratory tract infection that is, by definition, acquired after at least 48 hours of admission to the hospital and is not incubating at the time of admission. Among patients with hospital-acquired infections, HAP is the leading cause of death and causes 22% of all hospital-acquired infections. Though generally considered to be less severe than ventilator-associated pneumonia (VAP), even in HAP serious complications occur in approximately 50% of patients, including respiratory failure, pleural effusions, septic shock, renal failure, and empyema (Kalil et al., 2016).",{"type":406,"attrs":7786,"content":7787},{"level":773,"textAlign":53},[7788],{"text":7789,"type":295},"Ventilator-associated pneumonia (VAP)",{"type":15,"attrs":7791,"content":7792},{"textAlign":53},[7793],{"text":7794,"type":295},"Ventilator-associated pneumonia (VAP) is defined by infection of the pulmonary parenchyma in patients exposed to invasive mechanical ventilation for at least 48 hours and is part of ICU-acquired pneumonia. VAP remains one of the most common infections in patients requiring invasive mechanical ventilation.",{"type":15,"attrs":7796,"content":7797},{"textAlign":53},[7798],{"text":7799,"type":295},"VAP is reported to affect five to 40 per cent of patients receiving invasive mechanical ventilation for more than two days (Papazian et al., 2020). Compared to similar patients without VAP, these infections negatively impact important patient outcomes and prolong both the length of mechanical ventilation and hospitalization (Kalil et al., 2016). Kalil et al. indicate that while all-cause mortality associated with VAP has been reported to range from 20 to 50 per cent, the mortality directly related to VAP is debated (2016).",{"type":406,"attrs":7801,"content":7802},{"level":773,"textAlign":53},[7803],{"text":7804,"type":295},"Risk of Transmission",{"type":15,"attrs":7806,"content":7807},{"textAlign":53},[7808],{"text":7809,"type":295},"In all healthcare settings, there is significant risk of transmission of acute respiratory infection (ARI) to patients and to healthcare providers. This is due to:",{"type":499,"content":7811},[7812,7819,7826,7833],{"type":440,"content":7813},[7814],{"type":15,"attrs":7815,"content":7816},{"textAlign":53},[7817],{"text":7818,"type":295},"the large number of people (i.e., patients, family members, volunteers, visitors, workers) who come and go in these settings;",{"type":440,"content":7820},[7821],{"type":15,"attrs":7822,"content":7823},{"textAlign":53},[7824],{"text":7825,"type":295},"the ease with which droplet-spread respiratory illnesses can pass from one person to another;",{"type":440,"content":7827},[7828],{"type":15,"attrs":7829,"content":7830},{"textAlign":53},[7831],{"text":7832,"type":295},"the fact that many clients/patients/residents have other illnesses that make them more likely to experience complications from respiratory infections; and",{"type":440,"content":7834},[7835],{"type":15,"attrs":7836,"content":7837},{"textAlign":53},[7838],{"text":7839,"type":295},"the large number of people who seek care for or develop ARI in these settings",{"type":15,"attrs":7841,"content":7842},{"textAlign":53},[7843],{"text":7844,"type":295},"(Provincial Infectious Diseases Advisory Committee (PIDAC), 2013)",{"_uid":850,"content":7846,"component":633},[7847],{"_uid":853,"content":7848,"component":632},{"type":12,"content":7849},[7850,7854,7859,7864,7869,7873,7878],{"type":406,"attrs":7851,"content":7852},{"level":408,"textAlign":53},[7853],{"text":860,"type":295},{"type":15,"attrs":7855,"content":7856},{"textAlign":53},[7857],{"text":7858,"type":295},"Hospital-acquired pneumonia, and notably ventilator-associated pneumonia, developing as a consequence of lung bacterial colonization, alters clinically important outcomes, including duration of mechanical ventilation, length of stay in the intensive care unit (ICU), and mortality rates (Kalil et al., 2016; Roquilly et al., 2015).",{"type":15,"attrs":7860,"content":7861},{"textAlign":53},[7862],{"text":7863,"type":295},"VAP is one of the most serious complications for the most critically ill and vulnerable patients and can be avoided in the hospital by using proven strategies (Institute for Healthcare Improvement (IHI), 2012).",{"type":15,"attrs":7865,"content":7866},{"textAlign":53},[7867],{"text":7868,"type":295},"Vaccines can prevent some types of Pneumonia. Patients can help prevent pneumonia and other respiratory infections by following good hygiene practices. These practices include cleaning hands regularly and disinfecting frequently touched surfaces (CDC, 2020).",{"type":406,"attrs":7870,"content":7871},{"level":773,"textAlign":53},[7872],{"text":3695,"type":295},{"type":15,"attrs":7874,"content":7875},{"textAlign":53},[7876],{"text":7877,"type":295},"Claire inspires change after her passing.",{"type":15,"attrs":7879,"content":7880},{"textAlign":53},[7881],{"text":7882,"type":295},"Claire, the nine year- old daughter of an ICU nurse, died after 16 days in the same intensive care, following surgery to repair a malformation in her skull. After surgery, Claire was placed in a deep sleep and on a ventilator. She eventually succumbed to complications, including pneumonia. Her mother risked everything to fight in Claire's memory. A review of Claire's care found that ventilator management was below accepted standards. It also revealed Claire's death was precipitated by an abrupt rise in carbon dioxide caused, most commonly, by a blocked endotracheal tube. The review deemed Claire's death as preventable (Canadian Patient Safety Institute, 2011).",{"_uid":891,"items":7884,"title":1457,"component":1458,"description":8044},[7885],{"_uid":894,"title":895,"ctaLeft":7886,"ctaRight":7887,"component":898,"columnLeft":7888,"columnRight":7901},[],[],{"type":12,"content":7889},[7890],{"type":15,"attrs":7891,"content":7892},{"textAlign":53},[7893,7894,7900],{"text":2130,"type":295},{"text":2135,"type":295,"marks":7895},[7896],{"type":371,"attrs":7897},{"href":459,"uuid":460,"anchor":53,"custom":7898,"target":462,"linktype":463,"story":7899},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":540,"type":295},{"type":12,"content":7902},[7903,7914,7919,7926,7951,7958,7974,7981,7995,8002,8011,8018],{"type":15,"attrs":7904,"content":7905},{"textAlign":53},[7906,7907,7913],{"text":905,"type":295},{"text":907,"type":295,"marks":7908},[7909],{"type":371,"attrs":7910},{"href":459,"uuid":460,"anchor":53,"custom":7911,"target":462,"linktype":463,"story":7912},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":5114,"type":295},{"type":15,"attrs":7915,"content":7916},{"textAlign":53},[7917],{"text":7918,"type":295},"If your review reveals that pneumonia-related events are linked to specific processes or procedures, you may find these resources helpful:",{"type":15,"attrs":7920,"content":7921},{"textAlign":53},[7922],{"text":7923,"type":295,"marks":7924},"Association for Professionals in Infection Control and Epidemiology, Inc. (APIC)",[7925],{"type":487},{"type":499,"content":7927},[7928,7939],{"type":440,"content":7929},[7930],{"type":15,"attrs":7931,"content":7932},{"textAlign":53},[7933],{"text":7680,"type":295,"marks":7934},[7935],{"type":371,"attrs":7936},{"href":7937,"uuid":53,"anchor":53,"custom":7938,"target":374,"linktype":375},"https://apic.org/resources/topic-specific-infection-prevention/pneumonia/",{},{"type":440,"content":7940},[7941],{"type":15,"attrs":7942,"content":7943},{"textAlign":53},[7944],{"text":7945,"type":295,"marks":7946},"FAQs about Ventilator-Associated Pneumonia (VAP)",[7947],{"type":371,"attrs":7948},{"href":7949,"uuid":53,"anchor":53,"custom":7950,"target":374,"linktype":375},"https://apic.org/Resource_/TinyMceFileManager/Practice_Guidance/NNL_VAP.pdf",{},{"type":15,"attrs":7952,"content":7953},{"textAlign":53},[7954],{"text":7955,"type":295,"marks":7956},"Infectious Diseases Society of America and The American Thoracic Society",[7957],{"type":487},{"type":499,"content":7959},[7960],{"type":440,"content":7961},[7962],{"type":15,"attrs":7963,"content":7964},{"textAlign":53},[7965,7972],{"text":7966,"type":295,"marks":7967},"Management of Adults with Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines Thoracic Society; Clinical Infectious Diseases",[7968],{"type":371,"attrs":7969},{"href":7970,"uuid":53,"anchor":53,"custom":7971,"target":374,"linktype":375},"https://academic.oup.com/cid/article/63/5/e61/2237650?login=false",{},{"text":7973,"type":295},", Volume 63, Issue 5, 1 September 2016, Pages e61–111.",{"type":15,"attrs":7975,"content":7976},{"textAlign":53},[7977],{"text":7978,"type":295,"marks":7979},"Public Health Agency of Canada",[7980],{"type":487},{"type":499,"content":7982},[7983],{"type":440,"content":7984},[7985],{"type":15,"attrs":7986,"content":7987},{"textAlign":53},[7988],{"text":7989,"type":295,"marks":7990},"Infection Control Guideline for the Prevention of Healthcare-Associated Pneumonia",[7991],{"type":371,"attrs":7992},{"href":7993,"uuid":53,"anchor":53,"custom":7994,"target":374,"linktype":375},"https://publications.gc.ca/collections/collection_2012/aspc-phac/HP40-54-2010-eng.pdf",{},{"type":15,"attrs":7996,"content":7997},{"textAlign":53},[7998],{"text":7999,"type":295,"marks":8000},"Public Health Ontario",[8001],{"type":487},{"type":499,"content":8003},[8004],{"type":440,"content":8005},[8006],{"type":15,"attrs":8007,"content":8008},{"textAlign":53},[8009],{"text":8010,"type":295},"Provincial Infectious Diseases Advisory Committee (PIDAC) Annex B: Best practices for prevention of transmission of acute respiratory infection in all health care settings. 2013.",{"type":15,"attrs":8012,"content":8013},{"textAlign":53},[8014],{"text":8015,"type":295,"marks":8016},"The Society for Healthcare Epidemiology of America",[8017],{"type":487},{"type":499,"content":8019},[8020,8032],{"type":440,"content":8021},[8022],{"type":15,"attrs":8023,"content":8024},{"textAlign":53},[8025],{"text":8026,"type":295,"marks":8027},"Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and non-ventilator hospital-acquired pneumonia in acute-care hospitals: 2022 Update",[8028],{"type":371,"attrs":8029},{"href":8030,"uuid":53,"anchor":53,"custom":8031,"target":374,"linktype":375},"https://www.cambridge.org/core/journals/infection-control-and-hospital-epidemiology/article/strategies-to-prevent-ventilatorassociated-pneumonia-ventilatorassociated-events-and-nonventilator-hospitalacquired-pneumonia-in-acutecare-hospitals-2022-update/A2124BA9B088027AE30BE46C28887084",{},{"type":440,"content":8033},[8034],{"type":15,"attrs":8035,"content":8036},{"textAlign":53},[8037],{"text":8038,"type":295,"marks":8039},"SHEA/IDSA Strategies to Prevent Ventilator-Associated Pneumonia in Acute Care Hospitals: 2014 Update",[8040],{"type":371,"attrs":8041},{"href":8042,"uuid":53,"anchor":53,"custom":8043,"target":374,"linktype":375},"https://www.jstor.org/stable/10.1086/677144#metadata_info_tab_contents",{},{"type":12,"content":8045},[8046,8054,8058],{"type":15,"attrs":8047,"content":8048},{"textAlign":53},[8049,8050,8053],{"text":2529,"type":295},{"text":7680,"type":295,"marks":8051},[8052],{"type":402},{"text":2535,"type":295},{"type":15,"attrs":8055,"content":8056},{"textAlign":868},[8057],{"text":1470,"type":295},{"type":435,"attrs":8059,"content":8060},{"order":437},[8061,8067,8073,8079],{"type":440,"content":8062},[8063],{"type":15,"attrs":8064,"content":8065},{"textAlign":53},[8066],{"text":1480,"type":295},{"type":440,"content":8068},[8069],{"type":15,"attrs":8070,"content":8071},{"textAlign":53},[8072],{"text":1487,"type":295},{"type":440,"content":8074},[8075],{"type":15,"attrs":8076,"content":8077},{"textAlign":53},[8078],{"text":1494,"type":295},{"type":440,"content":8080},[8081],{"type":15,"attrs":8082,"content":8083},{"textAlign":53},[8084],{"text":1501,"type":295},{"_uid":1503,"items":8086,"title":1548,"component":1549,"description":8111},[8087,8093,8099,8105],{"_uid":1506,"image":8088,"title":2572,"component":1512,"description":8090},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":8089,"is_external_url":286},{},{"type":12,"content":8091},[8092],{"type":15},{"_uid":1517,"image":8094,"title":2579,"component":1512,"description":8096},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":8095,"is_external_url":286},{},{"type":12,"content":8097},[8098],{"type":15},{"_uid":1525,"image":8100,"title":1511,"component":1512,"description":8102},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":8101,"is_external_url":286},{},{"type":12,"content":8103},[8104],{"type":15},{"_uid":1533,"image":8106,"title":1528,"component":1512,"description":8108},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":8107,"is_external_url":286},{},{"type":12,"content":8109},[8110],{"type":15},{"type":12,"content":8112},[8113],{"type":15,"attrs":8114,"content":8115},{"textAlign":53},[8116],{"text":2601,"type":295},{"_uid":1563,"items":8118,"title":1680,"component":1458,"description":8300},[8119,8167,8266],{"_uid":1566,"title":1567,"ctaLeft":8120,"ctaRight":8121,"component":898,"columnLeft":8122,"columnRight":8134},[],[],{"type":12,"content":8123},[8124,8130],{"type":15,"attrs":8125,"content":8126},{"textAlign":53},[8127],{"text":1630,"type":295,"marks":8128},[8129],{"type":487},{"type":15,"attrs":8131,"content":8132},{"textAlign":53},[8133],{"text":1639,"type":295},{"type":12,"content":8135},[8136,8146,8154,8158,8162],{"type":15,"attrs":8137,"content":8138},{"textAlign":53},[8139,8143],{"text":2613,"type":295,"marks":8140},[8141,8142],{"type":487},{"type":402},{"text":2685,"type":295,"marks":8144},[8145],{"type":402},{"type":15,"attrs":8147,"content":8148},{"textAlign":53},[8149,8153],{"text":8150,"type":295,"marks":8151},"J10.0, J11.0, J12.–, J13, J14, J15.–, J16.8, J18.–, J85.1",[8152],{"type":487},{"text":2828,"type":295},{"type":15,"attrs":8155,"content":8156},{"textAlign":53},[8157],{"text":1591,"type":295},{"type":15,"attrs":8159,"content":8160},{"textAlign":53},[8161],{"text":1596,"type":295},{"type":15,"attrs":8163,"content":8164},{"textAlign":53},[8165],{"text":8166,"type":295},"Identified as diagnosis type (3) AND J95.88 as diagnosis type (2) AND Y60–Y84 in the same diagnosis cluster",{"_uid":2668,"title":2669,"ctaLeft":8168,"ctaRight":8169,"component":898,"columnLeft":8170,"columnRight":8176},[],[],{"type":12,"content":8171},[8172,8174],{"type":15,"attrs":8173},{"textAlign":53},{"type":15,"attrs":8175},{"textAlign":53},{"type":12,"content":8177},[8178,8185,8194,8203,8212,8221,8230,8239,8248,8257],{"type":15,"attrs":8179,"content":8180},{"textAlign":53},[8181,8184],{"text":2613,"type":295,"marks":8182},[8183],{"type":487},{"text":2685,"type":295},{"type":15,"attrs":8186,"content":8187},{"textAlign":53},[8188,8192],{"text":8189,"type":295,"marks":8190},"J10.0",[8191],{"type":487},{"text":8193,"type":295},": Influenza with pneumonia, other influenza virus identified",{"type":15,"attrs":8195,"content":8196},{"textAlign":53},[8197,8201],{"text":8198,"type":295,"marks":8199},"J11.0",[8200],{"type":487},{"text":8202,"type":295},": Influenza with pneumonia, virus not identified",{"type":15,"attrs":8204,"content":8205},{"textAlign":53},[8206,8210],{"text":8207,"type":295,"marks":8208},"J12.–",[8209],{"type":487},{"text":8211,"type":295},": Viral pneumonia, not elsewhere classified",{"type":15,"attrs":8213,"content":8214},{"textAlign":53},[8215,8219],{"text":8216,"type":295,"marks":8217},"J13",[8218],{"type":487},{"text":8220,"type":295},": Pneumonia due to Streptococcus pneumoniae",{"type":15,"attrs":8222,"content":8223},{"textAlign":53},[8224,8228],{"text":8225,"type":295,"marks":8226},"J14",[8227],{"type":487},{"text":8229,"type":295},": Pneumonia due to Haemophilus influenzae",{"type":15,"attrs":8231,"content":8232},{"textAlign":53},[8233,8237],{"text":8234,"type":295,"marks":8235},"J15.–",[8236],{"type":487},{"text":8238,"type":295},": Bacterial pneumonia, not elsewhere classified",{"type":15,"attrs":8240,"content":8241},{"textAlign":53},[8242,8246],{"text":8243,"type":295,"marks":8244},"J16.8",[8245],{"type":487},{"text":8247,"type":295},": Pneumonia due to other specified infectious organisms",{"type":15,"attrs":8249,"content":8250},{"textAlign":53},[8251,8255],{"text":8252,"type":295,"marks":8253},"J18.–",[8254],{"type":487},{"text":8256,"type":295},": Pneumonia, organism unspecified",{"type":15,"attrs":8258,"content":8259},{"textAlign":53},[8260,8264],{"text":8261,"type":295,"marks":8262},"J85.1",[8263],{"type":487},{"text":8265,"type":295},": Abscess of lung with pneumonia",{"_uid":5767,"title":1654,"ctaLeft":8267,"ctaRight":8268,"component":898,"columnLeft":8269,"columnRight":8275},[],[],{"type":12,"content":8270},[8271,8273],{"type":15,"attrs":8272},{"textAlign":53},{"type":15,"attrs":8274},{"textAlign":53},{"type":12,"content":8276},[8277,8286],{"type":15,"attrs":8278,"content":8279},{"textAlign":53},[8280,8284],{"text":8281,"type":295,"marks":8282},"J95.88",[8283],{"type":487},{"text":8285,"type":295},": Other post-procedural respiratory disorders Includes: Ventilator associated pneumonia (VAP)",{"type":15,"attrs":8287,"content":8288},{"textAlign":53},[8289,8292,8294,8299],{"text":1614,"type":295,"marks":8290},[8291],{"type":487},{"text":8293,"type":295},": Complications of medical and surgical care(refer to Appendix A of the ",{"text":1674,"type":295,"marks":8295},[8296],{"type":371,"attrs":8297},{"href":6157,"uuid":53,"anchor":53,"custom":8298,"target":374,"linktype":375},{},{"text":999,"type":295},{"type":12,"content":8301},[8302,8310],{"type":15,"attrs":8303,"content":8304},{"textAlign":53},[8305,8306],{"text":2985,"type":295},{"text":8307,"type":295,"marks":8308},"B16: Pneumonia",[8309],{"type":487},{"type":15,"attrs":8311,"content":8312},{"textAlign":53},[8313,8316],{"text":7335,"type":295,"marks":8314},[8315],{"type":487},{"text":8317,"type":295},": Pneumonia identified during a hospital stay.",{"_uid":8319,"content":8320,"component":633},"d361792c-d181-435c-b454-b0bb5048b39e",[8321],{"_uid":8322,"content":8323,"component":632},"d765c34f-1301-447d-a1f9-69fb1261891f",{"type":12,"content":8324},[8325,8329,8334],{"type":406,"attrs":8326,"content":8327},{"level":408,"textAlign":53},[8328],{"text":1709,"type":295},{"type":406,"attrs":8330,"content":8331},{"level":773,"textAlign":53},[8332],{"text":8333,"type":295},"Oral Hygiene for Pneumonia Prevention",{"type":15,"attrs":8335,"content":8336},{"textAlign":53},[8337],{"text":8338,"type":295},"Many care-dependent clients in acute surgical settings are at risk for hospital-acquired pneumonia. A concern about high HAP rates on the neurosurgical ward at Royal Columbian Hospital (RCH) was identified by the Clinical Nurse Specialist (CNS). A multidisciplinary team was formed, led by the CNS and a Speech Language Pathologist (SLP) (Health Standards Organization, 2015)",{"_uid":3408,"items":8340,"title":3523,"component":1458,"description":8425},[8341],{"_uid":3411,"title":3412,"ctaLeft":8342,"ctaRight":8343,"component":898,"columnLeft":8344,"columnRight":8350},[],[],{"type":12,"content":8345},[8346,8348],{"type":15,"attrs":8347},{"textAlign":53},{"type":15,"attrs":8349},{"textAlign":53},{"type":12,"content":8351},[8352,8357,8369,8381,8393,8398,8403,8408,8413],{"type":15,"attrs":8353,"content":8354},{"textAlign":53},[8355],{"text":8356,"type":295},"Canadian Patient Safety Institute. Claire inspires change after her passing. Published 2011. ",{"type":15,"attrs":8358,"content":8359},{"textAlign":53},[8360,8362],{"text":8361,"type":295},"Centre for Communicable Diseases and Infection Control. Infection Control Guideline for the Prevention of Healthcare-Associated Pneumonia. Ottawa, ON: Public Health Agency of Canada; 2010. ",{"text":8363,"type":295,"marks":8364},"http://publications.gc.ca/collections/collection_2012/aspc-phac/HP40-54-2010-eng.pdf ",[8365],{"type":371,"attrs":8366},{"href":8367,"uuid":53,"anchor":53,"custom":8368,"target":374,"linktype":375},"https://publications.gc.ca/site/archivee-archived.html?url=https%3A%2F%2Fpublications.gc.ca%2Fcollections%2Fcollection_2012%2Faspc-phac%2FHP40-54-2010-eng.pdf",{},{"type":15,"attrs":8370,"content":8371},{"textAlign":53},[8372,8374],{"text":8373,"type":295},"Centers for Disease Control and Prevention (CDC). Pneumonia. CDC. Published March 9, 2020. ",{"text":8375,"type":295,"marks":8376},"http://www.cdc.gov/pneumonia/index.html ",[8377],{"type":371,"attrs":8378},{"href":8379,"uuid":53,"anchor":53,"custom":8380,"target":374,"linktype":375},"https://www.cdc.gov/pneumonia/index.html",{},{"type":15,"attrs":8382,"content":8383},{"textAlign":53},[8384,8386],{"text":8385,"type":295},"Health Standards Organization. Leading Practices Library. Accreditation Canada. Published 2015. ",{"text":8387,"type":295,"marks":8388},"https://accreditation.ca/leading-practices ",[8389],{"type":371,"attrs":8390},{"href":8391,"uuid":53,"anchor":53,"custom":8392,"target":374,"linktype":375},"https://accreditation.ca/leading-practices/",{},{"type":15,"attrs":8394,"content":8395},{"textAlign":53},[8396],{"text":8397,"type":295},"Institute for Healthcare Improvement (IHI). How-to Guide: Prevent Ventilator-Associated Pneumonia. Cambridge, MA: IHI; 2012. http://www.ihi.org/resources/Pages/Tools/HowtoGuidePreventVAP.aspx ",{"type":15,"attrs":8399,"content":8400},{"textAlign":53},[8401],{"text":8402,"type":295},"Kalil AC, Metersky ML, Klompas M, et al. Management of Adults with hospital-acquired and ventilator-associated pneumonia: 2016 Clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016;63(5):e61-e111. doi:10.1093/cid/ciw353 ",{"type":15,"attrs":8404,"content":8405},{"textAlign":53},[8406],{"text":8407,"type":295},"Papazian L, Klompas M, Luyt C-E. Ventilator-associated pneumonia in adults: A narrative review. Intensive Care Medicine. March 2020. doi:10.1007/s00134-020-05980-0",{"type":15,"attrs":8409,"content":8410},{"textAlign":53},[8411],{"text":8412,"type":295},"Provincial Infectious Diseases Advisory Committee (PIDAC). Annex B: Best Practices for Prevention of Transmission of Acute Respiratory Infection In All Health Care Settings. Toronto, ON: Public Health Ontario; 2013. https://www.publichealthontario.ca/-/media/documents/bp-prevention-transmission-ari.pdf?la=en ",{"type":15,"attrs":8414,"content":8415},{"textAlign":53},[8416,8418],{"text":8417,"type":295},"Roquilly A, Marret E, Abraham E, Asehnoune K. Pneumonia prevention to decrease mortality in intensive care unit: a systematic review and meta-analysis. Clin Infect Dis. 2015;60(1):64-75. doi:10.1093/cid/ciu740. [Erratum: Roquilly et al. Clin Infect Dis 2015; 60: 64-75]. ",{"text":8419,"type":295,"marks":8420},"http://cid.oxfordjournals.org/content/60/1/64.full.pdf",[8421],{"type":371,"attrs":8422},{"href":8423,"uuid":53,"anchor":53,"custom":8424,"target":374,"linktype":375},"https://academic.oup.com/cid/article-abstract/60/1/64/2895643?redirectedFrom=fulltext",{},{"type":12,"content":8426},[8427],{"type":15},{"id":16,"_uid":8429,"items":8430,"component":659},"40924503-5ad6-48eb-b352-b225f0df68da",[8431],{"_uid":8432,"link":8433,"image":8438,"title":651,"component":652,"description":8440},"1ced0c12-2798-4968-bb15-6cd41d8a454a",[8434],{"_uid":8435,"link":8436,"label":645,"component":646},"b0d98062-7e82-42f8-a0f7-3f26e855db4b",{"id":275,"url":16,"linktype":463,"fieldtype":643,"cached_url":303,"story":8437},{"name":270,"id":274,"uuid":275,"slug":9,"url":303,"full_slug":303,"_stopResolving":301},{"id":648,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":649,"copyright":16,"fieldtype":284,"meta_data":8439,"is_external_url":286},{},{"type":12,"content":8441},[8442],{"type":15,"attrs":8443,"content":8444},{"textAlign":53},[8445],{"text":294,"type":295},[129,150,136,122,143,115,157],[185,192,200],"pneumonia","resources/pneumonia",-18660,[],"088138fa-0e16-4ede-b351-209a08f78584","2025-12-09T22:46:17.781Z",[],[8456],{"path":8457,"name":8458,"lang":315,"published":301},"ressources/pneumonie","Pneumonie",{"name":8460,"created_at":8461,"published_at":8462,"updated_at":8463,"id":8464,"uuid":8465,"content":8466,"slug":9978,"full_slug":9979,"sort_by_date":53,"position":9980,"tag_list":9981,"is_startpage":286,"parent_id":667,"meta_data":53,"group_id":9982,"first_published_at":9983,"release_id":53,"lang":309,"path":53,"alternates":9984,"default_full_slug":9979,"translated_slugs":9985},"Post Procedural Infections","2025-12-10T13:59:27.705Z","2026-03-10T16:36:53.170Z","2026-03-10T16:36:53.240Z",121592085574467,"767a19b8-88f1-4959-aeca-98152956d6c3",{"new":286,"seo":8467,"_uid":690,"hero":8468,"type":174,"topics":8492,"Noindex":286,"content":8493,"audience":9976,"duration":16,"regional":9977,"component":662},{"_uid":688,"title":8460,"plugin":339,"og_image":16,"og_title":16,"description":1766,"twitter_image":16,"twitter_title":16,"og_description":16,"twitter_description":16},[8469],{"_uid":693,"image":8470,"title":8472,"format":8473,"component":351,"description":8476,"key_learning":8486,"prerequisite":8489},{"id":695,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":696,"copyright":16,"fieldtype":284,"meta_data":8471,"is_external_url":286},{"alt":16,"title":16,"source":16,"copyright":16},"Hospital Harm: Post Procedural Infections",{"type":12,"content":8474},[8475],{"type":15},{"type":12,"content":8477},[8478],{"type":15,"attrs":8479,"content":8480},{"textAlign":53},[8481],{"text":8482,"type":295,"marks":8483},"A Post Procedure infection is associated with a medical or surgical procedure and results from colonization with a bacterial load greater than the capability of the immune system to manage. These infections can significantly increase cost, morbidity and even mortality.",[8484],{"type":298,"attrs":8485},{"color":2834},{"type":12,"content":8487},[8488],{"type":15},{"type":12,"content":8490},[8491],{"type":15},[76,8],[8494,8505,8542,8600,9275,9307,9755,9789,9958],{"_uid":718,"link":8495,"image":8496,"title":722,"component":723,"media_type":724,"description":8498},[],{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":284,"meta_data":8497},{},{"type":12,"content":8499},[8500],{"type":15,"attrs":8501,"content":8502},{"textAlign":53},[8503],{"text":8504,"type":295},"To prevent post procedural infections and deaths in hospitalized patients by reliably implementing evidence-based procedural care for all patients undergoing invasive procedures.",{"_uid":1802,"content":8506,"component":633},[8507],{"_uid":1805,"content":8508,"component":632},{"type":12,"content":8509},[8510,8514,8525,8530,8535,8540],{"type":406,"attrs":8511,"content":8512},{"level":408,"textAlign":53},[8513],{"text":743,"type":295},{"type":15,"attrs":8515,"content":8516},{"textAlign":53},[8517,8518,8524],{"text":748,"type":295},{"text":455,"type":295,"marks":8519},[8520],{"type":371,"attrs":8521},{"href":459,"uuid":460,"anchor":53,"custom":8522,"target":462,"linktype":463,"story":8523},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":756,"type":295},{"type":15,"attrs":8526,"content":8527},{"textAlign":53},[8528],{"text":8529,"type":295},"Surgical site infections (SSIs) are infections of the incision, or organ, or space that occur after surgery. Surgical patients initially seen with more complex comorbidities and the emergence of antimicrobial-resistant pathogens increase the cost and challenge of treating SSIs. The prevention of SSI is increasingly important as the number of surgical procedures performed … continues to rise. It has been estimated that approximately half of SSIs are preventable by application of evidence-based strategies (Berríos-Torres et al., 2017). SSIs affect up to one-third of patients who have undergone a surgical procedure (World Health Organization, 2018). Surgical site infections are a frequent cause of morbidity following surgical procedures and  have also been shown to increase mortality, readmission rates, length of stay, and costs for patients who incur them. (Cataife et al., 2014).",{"type":15,"attrs":8531,"content":8532},{"textAlign":53},[8533],{"text":8534,"type":295},"The pooled incidence of SSIs in low- and middle-income countries is 11.8 per 100 surgical procedures. Although it is much lower in high-income countries, it remains the second most frequent type of healthcare-associated infections (HAI) in Europe and the United States of America (USA). The highest cumulative incidence was for colon surgery with 9.5 per cent episodes per 100 operations, followed by 3.5 per cent for coronary artery bypass graft, 2.9 per cent for caesarean section, 1.4 per cent for cholecystectomy, 1.0 per cent for hip prosthesis, 0.8 per cent for laminectomy and 0.75 per cent for knee prosthesis (WHO, 2018).",{"type":15,"attrs":8536,"content":8537},{"textAlign":53},[8538],{"text":8539,"type":295},"Many factors in a patient's journey through surgery have been identified as contributing to the risk of SSI. The prevention of these infections is complex and requires the integration of a range of measures before, during and after surgery (WHO, 2018).",{"type":15,"attrs":8541},{"textAlign":53},{"_uid":4401,"items":8543,"title":860,"component":1458,"description":8583},[8544,8563],{"_uid":4404,"title":8545,"ctaLeft":8546,"ctaRight":8547,"component":898,"columnLeft":8552,"columnRight":8556},"Ginny's Story",[],[8548],{"_uid":8549,"link":8550,"label":6596,"component":4028},"bb7ac13b-79e5-4293-a6c9-13d340ec53fa",{"id":16,"url":8551,"target":374,"linktype":375,"fieldtype":643,"cached_url":8551},"https://www.youtube.com/watch?v=s5x1f3_NJX8",{"type":12,"content":8553},[8554],{"type":15,"attrs":8555},{"textAlign":53},{"type":12,"content":8557},[8558],{"type":15,"attrs":8559,"content":8560},{"textAlign":53},[8561],{"text":8562,"type":295},"Ginny's life was changed forever by a preventable hospital-acquired infection.",{"_uid":8564,"title":8565,"ctaLeft":8566,"ctaRight":8567,"component":898,"columnLeft":8572,"columnRight":8576},"5ef0d9a6-9e1e-4c94-b978-490b98e13f92","One Is Too Many: Viewing Infection Data from the Patient's Perspective",[],[8568],{"_uid":8569,"link":8570,"label":8565,"component":4028},"0666c8d3-6124-4c78-bded-a0f61c0e90ed",{"id":16,"url":8571,"target":374,"linktype":375,"fieldtype":643,"cached_url":8571},"http://www.ihi.org/resources/Pages/AudioandVideo/OneIsTooManyViewingInfectionDatafromPatientsPerspective.aspx",{"type":12,"content":8573},[8574],{"type":15,"attrs":8575},{"textAlign":53},{"type":12,"content":8577},[8578],{"type":15,"attrs":8579,"content":8580},{"textAlign":53},[8581],{"text":8582,"type":295},"A surgical patient who contracted MRSA following knee replacement surgery describes the effects of the surgical site infection (SSI) on her life, and how her experience led her health care providers to make changes to prevent SSIs. ",{"type":12,"content":8584},[8585,8590,8595],{"type":15,"attrs":8586,"content":8587},{"textAlign":53},[8588],{"text":8589,"type":295},"Skin is a natural barrier against infection. Even with many precautions and protocols to prevent infection in place, any surgery that causes a break in the skin can lead to an infection (Johns Hopkins Medicine, n.d.). When patients get an infection following surgery or procedure, it delays healing, extends the patient's length of stay and increases their risk for harm and readmission. By implementing the appropriate interventions, patients are safer and go home sooner (Institute for Healthcare Improvement, n.d.).",{"type":15,"attrs":8591,"content":8592},{"textAlign":53},[8593],{"text":8594,"type":295},"Most patients who have surgery do well, but about three out of every 100 surgery patients get an infection. This can lead to other problems such as a longer hospital stay and rarely, an infection-related death (IHI, 2012).",{"type":15,"attrs":8596,"content":8597},{"textAlign":53},[8598],{"text":8599,"type":295},"Patients and carers should be given information and advice on how to care for their wound after discharge, how to recognize a surgical site infection, and who to contact if they are concerned (NICE, 2019).",{"_uid":891,"items":8601,"title":1457,"component":1458,"description":9235},[8602],{"_uid":894,"title":895,"ctaLeft":8603,"ctaRight":8604,"component":898,"columnLeft":8605,"columnRight":8624},[],[],{"type":12,"content":8606},[8607],{"type":15,"attrs":8608,"content":8609},{"textAlign":53},[8610,8614,8620],{"text":2130,"type":295,"marks":8611},[8612],{"type":298,"attrs":8613},{"color":300},{"text":2135,"type":295,"marks":8615},[8616],{"type":371,"attrs":8617},{"href":459,"uuid":460,"anchor":53,"custom":8618,"target":462,"linktype":463,"story":8619},{},{"name":455,"id":465,"uuid":460,"slug":466,"url":467,"full_slug":467,"_stopResolving":301},{"text":540,"type":295,"marks":8621},[8622],{"type":298,"attrs":8623},{"color":300},{"type":12,"content":8625},[8626,8631],{"type":15,"attrs":8627,"content":8628},{"textAlign":53},[8629],{"text":8630,"type":295},"If your review reveals that your cases of Post Procedural Infections are linked to specific processes or procedures, you may find these resources helpful:",{"type":499,"content":8632},[8633,8664,8693,8783,8814,8842,8887,8939,8967,8995,9045,9079,9123,9166,9200],{"type":440,"content":8634},[8635,8646],{"type":15,"attrs":8636,"content":8637},{"textAlign":53},[8638,8640],{"text":8639,"type":295},"American Journal of Health-System Pharmacy",{"text":8641,"type":295,"marks":8642}," https://academic.oup.com/ajhp",[8643,8645],{"type":371,"attrs":8644},{"href":6758,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":499,"content":8647},[8648],{"type":440,"content":8649},[8650],{"type":15,"attrs":8651,"content":8652},{"textAlign":53},[8653,8655,8659],{"text":8654,"type":295},"Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70(3):195-283. doi:10.2146/ajhp120568",{"text":1003,"type":295,"marks":8656},[8657],{"type":298,"attrs":8658},{"color":16},{"text":6773,"type":295,"marks":8660},[8661,8663],{"type":371,"attrs":8662},{"href":6773,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8665},[8666,8678],{"type":15,"attrs":8667,"content":8668},{"textAlign":53},[8669,8671],{"text":8670,"type":295},"AORN - Association of Perioperative Registered Nurses ",{"text":8672,"type":295,"marks":8673},"www.aorn.org",[8674,8677],{"type":371,"attrs":8675},{"href":8676,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},"http://www.aorn.org/",{"type":5096},{"type":499,"content":8679},[8680],{"type":440,"content":8681},[8682],{"type":15,"attrs":8683,"content":8684},{"textAlign":53},[8685,8687],{"text":8686,"type":295},"Association of perioperative Registered Nurses. Guidelines for Perioperative Practice. Published n.d. ",{"text":8688,"type":295,"marks":8689},"https://www.aorn.org/guidelines/about-aorn-guidelines",[8690,8692],{"type":371,"attrs":8691},{"href":8688,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":5096},{"type":440,"content":8694},[8695,8708],{"type":15,"attrs":8696,"content":8697},{"textAlign":53},[8698,8699,8702,8703],{"text":997,"type":295},{"text":999,"type":295,"marks":8700},[8701],{"type":402},{"text":1003,"type":295},{"text":1005,"type":295,"marks":8704},[8705,8707],{"type":371,"attrs":8706},{"href":1009,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":499,"content":8709},[8710,8728,8746,8764],{"type":440,"content":8711},[8712],{"type":15,"attrs":8713,"content":8714},{"textAlign":53},[8715,8716,8720,8722],{"text":1018,"type":295},{"text":8717,"type":295,"marks":8718},"APIC Implementation Guide: Guide to Preventing Central Line-Associated Bloodstream Infections",[8719],{"type":402},{"text":8721,"type":295},". APIC; 2015. ",{"text":8723,"type":295,"marks":8724},"https://apic.org/Resource_/TinyMceFileManager/2015/APIC_CLABSI_WEB.pdf",[8725,8727],{"type":371,"attrs":8726},{"href":8723,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8729},[8730],{"type":15,"attrs":8731,"content":8732},{"textAlign":53},[8733,8734,8738,8740],{"text":1018,"type":295},{"text":8735,"type":295,"marks":8736},"Guide to the Elimination of Infections in Hemodialysis.",[8737],{"type":402},{"text":8739,"type":295}," APIC; 2010. ",{"text":8741,"type":295,"marks":8742},"https://apic.org/wp-content/uploads/2019/02/APIC-Hemodialysis.pdf",[8743,8745],{"type":371,"attrs":8744},{"href":8741,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8747},[8748],{"type":15,"attrs":8749,"content":8750},{"textAlign":53},[8751,8752,8756,8758],{"text":1018,"type":295},{"text":8753,"type":295,"marks":8754},"Guide to the Elimination of Orthopedic Surgical Site Infections",[8755],{"type":402},{"text":8757,"type":295},". APIC; 2010. ",{"text":8759,"type":295,"marks":8760},"https://apic.org/wp-content/uploads/2019/10/APIC-Ortho-Guide.pdf",[8761,8763],{"type":371,"attrs":8762},{"href":8759,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8765},[8766],{"type":15,"attrs":8767,"content":8768},{"textAlign":53},[8769,8771,8775,8777],{"text":8770,"type":295},"Association for Professionals in Infection Control and Epidemiology",{"text":8772,"type":295,"marks":8773},". Guide for the Prevention of Mediastinitis Surgical Site Infections Following Cardiac Surgery",[8774],{"type":402},{"text":8776,"type":295},". APIC; 2008. ",{"text":8778,"type":295,"marks":8779},"https://apic.org/wp-content/uploads/2019/02/APIC-Mediastinitis-Elimination-Guide.pdf",[8780,8782],{"type":371,"attrs":8781},{"href":8778,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8784},[8785,8794],{"type":15,"attrs":8786,"content":8787},{"textAlign":53},[8788,8789],{"text":6812,"type":295},{"text":6814,"type":295,"marks":8790},[8791,8793],{"type":371,"attrs":8792},{"href":6814,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":499,"content":8795},[8796],{"type":440,"content":8797},[8798],{"type":15,"attrs":8799,"content":8800},{"textAlign":53},[8801,8803,8807,8809],{"text":8802,"type":295},"Chow AW, Evans GA, Nathens AB, et al. Canadian practice guidelines for surgical intra-abdominal infections. ",{"text":8804,"type":295,"marks":8805},"Can J Infect Dis Med Microbiol J Can Mal Infect Microbiol Medicale",[8806],{"type":402},{"text":8808,"type":295},". 2010;21(1):11-37. doi:10.1155/2010/580340 ",{"text":6829,"type":295,"marks":8810},[8811,8813],{"type":371,"attrs":8812},{"href":6833,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":5096},{"type":440,"content":8815},[8816,8827],{"type":15,"attrs":8817,"content":8818},{"textAlign":53},[8819,8821],{"text":8820,"type":295},"Canadian Nosocomial Infection Surveillance Program (CNISP) ",{"text":8822,"type":295,"marks":8823},"https://www.canada.ca/en/public-health/services/surveillance.html#a6",[8824,8826],{"type":371,"attrs":8825},{"href":8822,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":499,"content":8828},[8829],{"type":440,"content":8830},[8831],{"type":15,"attrs":8832,"content":8833},{"textAlign":53},[8834,8836],{"text":8835,"type":295},"Canadian Patient Safety Institute. CNISP Protocols. The Canadian Nosocomial Infection Surveillance Program (CNISP) Publications. ",{"text":8837,"type":295,"marks":8838},"https://www.healthcareexcellence.ca/en/resources/healthcare-associated-infection-surveillance/the-canadian-nosocomial-infection-surveillance-program-cnisp-publications/",[8839,8841],{"type":371,"attrs":8840},{"href":8837,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":5096},{"type":440,"content":8843},[8844,8853],{"type":15,"attrs":8845,"content":8846},{"textAlign":53},[8847,8848],{"text":5201,"type":295},{"text":1076,"type":295,"marks":8849},[8850,8852],{"type":371,"attrs":8851},{"href":1076,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":499,"content":8854},[8855,8874],{"type":440,"content":8856},[8857],{"type":15,"attrs":8858,"content":8859},{"textAlign":53},[8860,8862,8866,8868],{"text":8861,"type":295},"Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection. ",{"text":8863,"type":295,"marks":8864},"JAMA Surg",[8865],{"type":402},{"text":8867,"type":295},". 2017;152(8):784-791. doi:10.1001/jamasurg.2017.0904 ",{"text":8869,"type":295,"marks":8870},"https://jamanetwork.com/journals/jamasurgery/fullarticle/2623725",[8871,8873],{"type":371,"attrs":8872},{"href":8869,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8875},[8876],{"type":15,"attrs":8877,"content":8878},{"textAlign":53},[8879,8881],{"text":8880,"type":295},"Centers for Disease Control and Prevention (CDC). Central Line-associated Bloodstream Infection (CLABSI). Healthcare-associated Infections. Published April 19, 2019. ",{"text":8882,"type":295,"marks":8883},"https://www.cdc.gov/hai/bsi/bsi.html",[8884,8886],{"type":371,"attrs":8885},{"href":8882,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8888},[8889,8900],{"type":15,"attrs":8890,"content":8891},{"textAlign":53},[8892,8894],{"text":8893,"type":295},"CIRCULATION ",{"text":8895,"type":295,"marks":8896},"https://www.ahajournals.org/journal/circ",[8897,8899],{"type":371,"attrs":8898},{"href":8895,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":499,"content":8901},[8902,8921],{"type":440,"content":8903},[8904],{"type":15,"attrs":8905,"content":8906},{"textAlign":53},[8907,8909,8913,8915],{"text":8908,"type":295},"Nishimura Rick A., Carabello Blase A., Faxon David P., et al. ACC/AHA 2008 Guideline Update on Valvular Heart Disease: Focused Update on Infective Endocarditis. ",{"text":8910,"type":295,"marks":8911},"Circulation",[8912],{"type":402},{"text":8914,"type":295},". 2008;118(8):887-896. doi:10.1161/CIRCULATIONAHA.108.190377 ",{"text":8916,"type":295,"marks":8917},"http://circ.ahajournals.org/content/118/8/887.full.pdf",[8918,8920],{"type":371,"attrs":8919},{"href":8916,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8922},[8923],{"type":15,"attrs":8924,"content":8925},{"textAlign":53},[8926,8928,8931,8933],{"text":8927,"type":295},"Warnes Carole A., Williams Roberta G., Bashore Thomas M., et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease. ",{"text":8910,"type":295,"marks":8929},[8930],{"type":402},{"text":8932,"type":295},". 2008;118(23):e714-e833. doi:10.1161/CIRCULATIONAHA.108.190690 ",{"text":8934,"type":295,"marks":8935},"http://circ.ahajournals.org/content/118/23/e714.full.pdf",[8936,8938],{"type":371,"attrs":8937},{"href":8934,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8940},[8941,8952],{"type":15,"attrs":8942,"content":8943},{"textAlign":53},[8944,8946],{"text":8945,"type":295},"European Heart Journal ",{"text":8947,"type":295,"marks":8948},"https://www.escardio.org/Journals/ESC-Journal-Family/European-Heart-Journal",[8949,8951],{"type":371,"attrs":8950},{"href":8947,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":499,"content":8953},[8954],{"type":440,"content":8955},[8956],{"type":15,"attrs":8957,"content":8958},{"textAlign":53},[8959,8961],{"text":8960,"type":295},"Habib G, Hoen B, Tornos P, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): The Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Eur Heart J. 2009;30(19):2369-2413. doi:10.1093/eurheartj/ehp285 ",{"text":8962,"type":295,"marks":8963},"http://eurheartj.oxfordjournals.org/content/30/19/2369.long",[8964,8966],{"type":371,"attrs":8965},{"href":8962,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8968},[8969,8980],{"type":15,"attrs":8970,"content":8971},{"textAlign":53},[8972,8974],{"text":8973,"type":295},"Health and Human Services ",{"text":8975,"type":295,"marks":8976},"https://www.hhs.gov/",[8977,8979],{"type":371,"attrs":8978},{"href":8975,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":499,"content":8981},[8982],{"type":440,"content":8983},[8984],{"type":15,"attrs":8985,"content":8986},{"textAlign":53},[8987,8989],{"text":8988,"type":295},"Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S. Department of Health and Human Services. National HAI Action Plan. health.gov. Published July 24, 2020. ",{"text":8990,"type":295,"marks":8991},"https://health.gov/our-work/health-care-quality/health-care-associated-infections/national-hai-action-plan",[8992,8994],{"type":371,"attrs":8993},{"href":8990,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":8996},[8997,9007],{"type":15,"attrs":8998,"content":8999},{"textAlign":53},[9000,9001],{"text":1248,"type":295},{"text":1250,"type":295,"marks":9002},[9003,9006],{"type":371,"attrs":9004},{"href":9005,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.ihi.org/",{"type":5096},{"type":499,"content":9008},[9009,9027],{"type":440,"content":9010},[9011],{"type":15,"attrs":9012,"content":9013},{"textAlign":53},[9014,9016,9020,9022],{"text":9015,"type":295},"Institute for Healthcare Improvement. ",{"text":9017,"type":295,"marks":9018},"How-to Guide: Prevent Surgical Site Infections",[9019],{"type":402},{"text":9021,"type":295},". IHI; 2012. ",{"text":6906,"type":295,"marks":9023},[9024,9026],{"type":371,"attrs":9025},{"href":6906,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":9028},[9029],{"type":15,"attrs":9030,"content":9031},{"textAlign":53},[9032,9034,9038,9039],{"text":9033,"type":295},"IHI. ",{"text":9035,"type":295,"marks":9036},"How-to Guide: Prevent Surgical Site Infection for Hip and Knee Arthroplasty",[9037],{"type":402},{"text":9021,"type":295},{"text":9040,"type":295,"marks":9041},"http://www.ihi.org/resources/pages/tools/howtoguidepreventssiforhipkneearthroplasty.aspx",[9042,9044],{"type":371,"attrs":9043},{"href":9040,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":9046},[9047,9058],{"type":15,"attrs":9048,"content":9049},{"textAlign":53},[9050,9052],{"text":9051,"type":295},"Journal of the American College of Surgeons ",{"text":9053,"type":295,"marks":9054},"https://www.journalacs.org/",[9055,9057],{"type":371,"attrs":9056},{"href":9053,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":5096},{"type":499,"content":9059},[9060],{"type":440,"content":9061},[9062],{"type":15,"attrs":9063,"content":9064},{"textAlign":53},[9065,9067,9071,9073],{"text":9066,"type":295},"Ban KA, Minei JP, Laronga C, et al. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. ",{"text":9068,"type":295,"marks":9069},"J Am Coll Surg",[9070],{"type":402},{"text":9072,"type":295},". 2017;224(1):59-74. doi:10.1016/j.jamcollsurg.2016.10.029 ",{"text":9074,"type":295,"marks":9075},"https://www.journalacs.org/article/S1072-7515(16)31563-0/fulltext",[9076],{"type":371,"attrs":9077},{"href":9074,"uuid":53,"anchor":53,"custom":9078,"target":374,"linktype":375},{},{"type":440,"content":9080},[9081,9091],{"type":15,"attrs":9082,"content":9083},{"textAlign":53},[9084,9085],{"text":6917,"type":295},{"text":6919,"type":295,"marks":9086},[9087,9090],{"type":371,"attrs":9088},{"href":9089,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.nice.org.uk/",{"type":5096},{"type":499,"content":9092},[9093,9104],{"type":440,"content":9094},[9095],{"type":15,"attrs":9096,"content":9097},{"textAlign":53},[9098,9099],{"text":6933,"type":295},{"text":6935,"type":295,"marks":9100},[9101,9103],{"type":371,"attrs":9102},{"href":6935,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":9105},[9106],{"type":15,"attrs":9107,"content":9108},{"textAlign":53},[9109,9111,9115,9117],{"text":9110,"type":295},"National Institute for Health and Care Excellence (NICE). ",{"text":9112,"type":295,"marks":9113},"Prophylaxis against Infective Endocarditis: Antimicrobial Prophylaxis against Infective Endocarditis in Adults and Children Undergoing Interventional Procedures",[9114],{"type":402},{"text":9116,"type":295},". NICE; 2008. ",{"text":9118,"type":295,"marks":9119},"https://www.nice.org.uk/guidance/cg64",[9120,9122],{"type":371,"attrs":9121},{"href":9118,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":9124},[9125,9134],{"type":15,"attrs":9126,"content":9127},{"textAlign":53},[9128,9129],{"text":6973,"type":295},{"text":6975,"type":295,"marks":9130},[9131,9133],{"type":371,"attrs":9132},{"href":6975,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":5096},{"type":499,"content":9135},[9136,9154],{"type":440,"content":9137},[9138],{"type":15,"attrs":9139,"content":9140},{"textAlign":53},[9141,9143,9147,9149],{"text":9142,"type":295},"Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. ",{"text":9144,"type":295,"marks":9145},"Infect Control Hosp Epidemiol",[9146],{"type":402},{"text":9148,"type":295},". 2014;35(6):605-627. doi:10.1086/676022 ",{"text":6990,"type":295,"marks":9150},[9151,9153],{"type":371,"attrs":9152},{"href":6990,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":9155},[9156],{"type":15,"attrs":9157,"content":9158},{"textAlign":53},[9159,9161,9164],{"text":9160,"type":295},"Marschall J, Mermel LA, Fakih M, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. ",{"text":9144,"type":295,"marks":9162},[9163],{"type":402},{"text":9165,"type":295},". 2014;35(7):753-771. doi:10.1086/676533",{"type":440,"content":9167},[9168,9179],{"type":15,"attrs":9169,"content":9170},{"textAlign":53},[9171,9173],{"text":9172,"type":295},"University of Toronto – Best Practice in Surgery ",{"text":9174,"type":295,"marks":9175},"http://bestpracticeinsurgery.ca/",[9176,9178],{"type":371,"attrs":9177},{"href":9174,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":499,"content":9180},[9181],{"type":440,"content":9182},[9183],{"type":15,"attrs":9184,"content":9185},{"textAlign":53},[9186,9188,9192,9194],{"text":9187,"type":295},"Bonnar P, Dhar P, Rotstein O, et al. ",{"text":9189,"type":295,"marks":9190},"Surgical Site Infection Prevention",[9191],{"type":402},{"text":9193,"type":295},". University of Toronto; 2017. ",{"text":9195,"type":295,"marks":9196},"http://bestpracticeinsurgery.ca/wp-content/uploads/2017/11/SSI-BPS-CPG-Nov20.pdf",[9197,9199],{"type":371,"attrs":9198},{"href":9195,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":440,"content":9201},[9202,9214],{"type":15,"attrs":9203,"content":9204},{"textAlign":53},[9205,9207],{"text":9206,"type":295},"World Health Organization ",{"text":9208,"type":295,"marks":9209},"www.who.int",[9210,9213],{"type":371,"attrs":9211},{"href":9212,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"http://www.who.int/",{"type":5096},{"type":499,"content":9215},[9216],{"type":440,"content":9217},[9218],{"type":15,"attrs":9219,"content":9220},{"textAlign":53},[9221,9223,9227,9229],{"text":9222,"type":295},"World Health Organization. ",{"text":9224,"type":295,"marks":9225},"Global Guidelines for the Prevention of Surgical Site Infection",[9226],{"type":402},{"text":9228,"type":295},". World Health Organization; 2018. ",{"text":9230,"type":295,"marks":9231},"https://www.ncbi.nlm.nih.gov/books/NBK536404/pdf/Bookshelf_NBK536404.pdf",[9232,9234],{"type":371,"attrs":9233},{"href":9230,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":12,"content":9236},[9237,9242,9246,9273],{"type":15,"attrs":9238,"content":9239},{"textAlign":53},[9240],{"text":9241,"type":295},"Given the broad range of potential causes of Post Procedural Infections, in addition to recommendations listed above, we recommend conducting clinical and system reviews to identify latent causes and determine appropriate recommendations.",{"type":15,"attrs":9243,"content":9244},{"textAlign":868},[9245],{"text":1470,"type":295},{"type":435,"attrs":9247,"content":9248},{"order":437},[9249,9255,9261,9267],{"type":440,"content":9250},[9251],{"type":15,"attrs":9252,"content":9253},{"textAlign":53},[9254],{"text":1480,"type":295},{"type":440,"content":9256},[9257],{"type":15,"attrs":9258,"content":9259},{"textAlign":53},[9260],{"text":1487,"type":295},{"type":440,"content":9262},[9263],{"type":15,"attrs":9264,"content":9265},{"textAlign":53},[9266],{"text":1494,"type":295},{"type":440,"content":9268},[9269],{"type":15,"attrs":9270,"content":9271},{"textAlign":53},[9272],{"text":1501,"type":295},{"type":15,"attrs":9274},{"textAlign":868},{"_uid":1503,"items":9276,"title":1548,"component":1549,"description":9301},[9277,9283,9289,9295],{"_uid":1506,"image":9278,"title":2572,"component":1512,"description":9280},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":9279,"is_external_url":286},{},{"type":12,"content":9281},[9282],{"type":15},{"_uid":1517,"image":9284,"title":2579,"component":1512,"description":9286},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":9285,"is_external_url":286},{},{"type":12,"content":9287},[9288],{"type":15},{"_uid":1525,"image":9290,"title":1511,"component":1512,"description":9292},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":9291,"is_external_url":286},{},{"type":12,"content":9293},[9294],{"type":15},{"_uid":1533,"image":9296,"title":1528,"component":1512,"description":9298},{"id":1508,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1509,"copyright":16,"fieldtype":284,"meta_data":9297,"is_external_url":286},{},{"type":12,"content":9299},[9300],{"type":15},{"type":12,"content":9302},[9303],{"type":15,"attrs":9304,"content":9305},{"textAlign":53},[9306],{"text":2601,"type":295},{"_uid":1563,"items":9308,"title":1680,"component":1458,"description":9719},[9309,9536,9685],{"_uid":1566,"title":1567,"ctaLeft":9310,"ctaRight":9311,"component":898,"columnLeft":9312,"columnRight":9316},[],[],{"type":12,"content":9313},[9314],{"type":15,"attrs":9315},{"textAlign":53},{"type":12,"content":9317},[9318,9325],{"type":15,"attrs":9319,"content":9320},{"textAlign":53},[9321,9324],{"text":2613,"type":295,"marks":9322},[9323],{"type":487},{"text":5530,"type":295},{"type":499,"content":9326},[9327,9337,9354,9370,9386,9403,9419,9436,9452,9468,9485,9502,9519],{"type":440,"content":9328},[9329],{"type":15,"attrs":9330,"content":9331},{"textAlign":53},[9332,9336],{"text":9333,"type":295,"marks":9334},"O86.002",[9335],{"type":487},{"text":5598,"type":295},{"type":440,"content":9338},[9339],{"type":15,"attrs":9340,"content":9341},{"textAlign":53},[9342,9345,9347,9350,9351],{"text":5787,"type":295,"marks":9343},[9344],{"type":487},{"text":9346,"type":295},": Identified as diagnosis type (2) ",{"text":1605,"type":295,"marks":9348},[9349],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9352},[9353],{"type":487},{"type":440,"content":9355},[9356],{"type":15,"attrs":9357,"content":9358},{"textAlign":53},[9359,9362,9363,9366,9367],{"text":5801,"type":295,"marks":9360},[9361],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9364},[9365],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9368},[9369],{"type":487},{"type":440,"content":9371},[9372],{"type":15,"attrs":9373,"content":9374},{"textAlign":53},[9375,9378,9379,9382,9383],{"text":5819,"type":295,"marks":9376},[9377],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9380},[9381],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9384},[9385],{"type":487},{"type":440,"content":9387},[9388],{"type":15,"attrs":9389,"content":9390},{"textAlign":53},[9391,9395,9396,9399,9400],{"text":9392,"type":295,"marks":9393},"T82.7–",[9394],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9397},[9398],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9401},[9402],{"type":487},{"type":440,"content":9404},[9405],{"type":15,"attrs":9406,"content":9407},{"textAlign":53},[9408,9411,9412,9415,9416],{"text":5846,"type":295,"marks":9409},[9410],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9413},[9414],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9417},[9418],{"type":487},{"type":440,"content":9420},[9421],{"type":15,"attrs":9422,"content":9423},{"textAlign":53},[9424,9428,9429,9432,9433],{"text":9425,"type":295,"marks":9426},"T84.5–T84.6–",[9427],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9430},[9431],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9434},[9435],{"type":487},{"type":440,"content":9437},[9438],{"type":15,"attrs":9439,"content":9440},{"textAlign":53},[9441,9444,9445,9448,9449],{"text":5873,"type":295,"marks":9442},[9443],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9446},[9447],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9450},[9451],{"type":487},{"type":440,"content":9453},[9454],{"type":15,"attrs":9455,"content":9456},{"textAlign":53},[9457,9460,9461,9464,9465],{"text":5882,"type":295,"marks":9458},[9459],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9462},[9463],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9466},[9467],{"type":487},{"type":440,"content":9469},[9470],{"type":15,"attrs":9471,"content":9472},{"textAlign":53},[9473,9477,9478,9481,9482],{"text":9474,"type":295,"marks":9475},"T87.0*1",[9476],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9479},[9480],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9483},[9484],{"type":487},{"type":440,"content":9486},[9487],{"type":15,"attrs":9488,"content":9489},{"textAlign":53},[9490,9494,9495,9498,9499],{"text":9491,"type":295,"marks":9492},"T87.1*1",[9493],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9496},[9497],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9500},[9501],{"type":487},{"type":440,"content":9503},[9504],{"type":15,"attrs":9505,"content":9506},{"textAlign":53},[9507,9511,9512,9515,9516],{"text":9508,"type":295,"marks":9509},"T87.201",[9510],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9513},[9514],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9517},[9518],{"type":487},{"type":440,"content":9520},[9521],{"type":15,"attrs":9522,"content":9523},{"textAlign":53},[9524,9528,9529,9532,9533],{"text":9525,"type":295,"marks":9526},"T87.4–",[9527],{"type":487},{"text":9346,"type":295},{"text":1605,"type":295,"marks":9530},[9531],{"type":487},{"text":7196,"type":295},{"text":7198,"type":295,"marks":9534},[9535],{"type":487},{"_uid":2668,"title":2669,"ctaLeft":9537,"ctaRight":9538,"component":898,"columnLeft":9539,"columnRight":9543},[],[],{"type":12,"content":9540},[9541],{"type":15,"attrs":9542},{"textAlign":53},{"type":12,"content":9544},[9545,9552],{"type":15,"attrs":9546,"content":9547},{"textAlign":53},[9548,9551],{"text":2613,"type":295,"marks":9549},[9550],{"type":487},{"text":2685,"type":295},{"type":499,"content":9553},[9554,9564,9573,9582,9591,9600,9609,9618,9627,9636,9645,9655,9665,9675],{"type":440,"content":9555},[9556],{"type":15,"attrs":9557,"content":9558},{"textAlign":53},[9559,9562],{"text":9333,"type":295,"marks":9560},[9561],{"type":487},{"text":9563,"type":295},": Infection of obstetric surgical wound; delivered with mention of postpartum complication",{"type":440,"content":9565},[9566],{"type":15,"attrs":9567,"content":9568},{"textAlign":53},[9569,9572],{"text":5787,"type":295,"marks":9570},[9571],{"type":487},{"text":5793,"type":295},{"type":440,"content":9574},[9575],{"type":15,"attrs":9576,"content":9577},{"textAlign":53},[9578,9581],{"text":5801,"type":295,"marks":9579},[9580],{"type":487},{"text":5805,"type":295},{"type":440,"content":9583},[9584],{"type":15,"attrs":9585,"content":9586},{"textAlign":53},[9587,9590],{"text":5819,"type":295,"marks":9588},[9589],{"type":487},{"text":5823,"type":295},{"type":440,"content":9592},[9593],{"type":15,"attrs":9594,"content":9595},{"textAlign":53},[9596,9599],{"text":5828,"type":295,"marks":9597},[9598],{"type":487},{"text":5832,"type":295},{"type":440,"content":9601},[9602],{"type":15,"attrs":9603,"content":9604},{"textAlign":53},[9605,9608],{"text":5846,"type":295,"marks":9606},[9607],{"type":487},{"text":5850,"type":295},{"type":440,"content":9610},[9611],{"type":15,"attrs":9612,"content":9613},{"textAlign":53},[9614,9617],{"text":5855,"type":295,"marks":9615},[9616],{"type":487},{"text":5859,"type":295},{"type":440,"content":9619},[9620],{"type":15,"attrs":9621,"content":9622},{"textAlign":53},[9623,9626],{"text":5864,"type":295,"marks":9624},[9625],{"type":487},{"text":5868,"type":295},{"type":440,"content":9628},[9629],{"type":15,"attrs":9630,"content":9631},{"textAlign":53},[9632,9635],{"text":5873,"type":295,"marks":9633},[9634],{"type":487},{"text":5877,"type":295},{"type":440,"content":9637},[9638],{"type":15,"attrs":9639,"content":9640},{"textAlign":53},[9641,9644],{"text":5882,"type":295,"marks":9642},[9643],{"type":487},{"text":5886,"type":295},{"type":440,"content":9646},[9647],{"type":15,"attrs":9648,"content":9649},{"textAlign":53},[9650,9653],{"text":9474,"type":295,"marks":9651},[9652],{"type":487},{"text":9654,"type":295},": Complication of reattached (part of) upper extremity; infection",{"type":440,"content":9656},[9657],{"type":15,"attrs":9658,"content":9659},{"textAlign":53},[9660,9663],{"text":9491,"type":295,"marks":9661},[9662],{"type":487},{"text":9664,"type":295},": Complications of reattached (part of) lower extremity; infection",{"type":440,"content":9666},[9667],{"type":15,"attrs":9668,"content":9669},{"textAlign":53},[9670,9673],{"text":9508,"type":295,"marks":9671},[9672],{"type":487},{"text":9674,"type":295},": Infection of other reattached body part",{"type":440,"content":9676},[9677],{"type":15,"attrs":9678,"content":9679},{"textAlign":53},[9680,9683],{"text":9525,"type":295,"marks":9681},[9682],{"type":487},{"text":9684,"type":295},": Infection of amputation stump",{"_uid":5767,"title":1654,"ctaLeft":9686,"ctaRight":9687,"component":898,"columnLeft":9688,"columnRight":9692},[],[],{"type":12,"content":9689},[9690],{"type":15,"attrs":9691},{"textAlign":53},{"type":12,"content":9693},[9694,9701],{"type":15,"attrs":9695,"content":9696},{"textAlign":53},[9697,9700],{"text":7290,"type":295,"marks":9698},[9699],{"type":487},{"text":7294,"type":295},{"type":499,"content":9702},[9703],{"type":440,"content":9704},[9705],{"type":15,"attrs":9706,"content":9707},{"textAlign":53},[9708,9712,9714],{"text":9709,"type":295,"marks":9710},"Y60-Y84",[9711],{"type":487},{"text":9713,"type":295},": Complications of medical and surgical care (refer to Appendix A) of the ",{"text":1674,"type":295,"marks":9715},[9716],{"type":371,"attrs":9717},{"href":1678,"uuid":53,"anchor":53,"custom":9718,"target":462,"linktype":375},{},{"type":12,"content":9720},[9721,9725,9738,9746],{"type":15,"attrs":9722,"content":9723},{"textAlign":53},[9724],{"text":2985,"type":295},{"type":499,"content":9726},[9727],{"type":440,"content":9728},[9729],{"type":15,"attrs":9730,"content":9731},{"textAlign":53},[9732,9736],{"text":9733,"type":295,"marks":9734},"B14",[9735],{"type":487},{"text":9737,"type":295},": Post Procedural Infections",{"type":15,"attrs":9739,"content":9740},{"textAlign":53},[9741,9744],{"text":7335,"type":295,"marks":9742},[9743],{"type":487},{"text":9745,"type":295},": Infections associated with a medical or surgical procedure.",{"type":15,"attrs":9747,"content":9748},{"textAlign":53},[9749,9753],{"text":9750,"type":295,"marks":9751},"Notes",[9752],{"type":487},{"text":9754,"type":295},": This clinical group may include inflammatory reactions in the absence of infection.",{"_uid":9756,"content":9757,"component":633},"5d74840d-8140-4d06-a1bb-46e735184517",[9758,9780],{"_uid":9759,"content":9760,"component":632},"8b89c40b-1e60-4131-ace9-d4840e8aabe7",{"type":12,"content":9761},[9762,9766,9771,9776],{"type":406,"attrs":9763,"content":9764},{"level":408,"textAlign":53},[9765],{"text":1709,"type":295},{"type":406,"attrs":9767,"content":9768},{"level":773,"textAlign":53},[9769],{"text":9770,"type":295},"HSO Leading Practices Library",{"type":15,"attrs":9772,"content":9773},{"textAlign":53},[9774],{"text":9775,"type":295},"Healthcare associated infections are considered a serious threat to the hospitalized patient's safety. Among surgical site infections, those related to orthopaedic procedures are considered severe and can increase morbidity-mortality rates. Factors in the preoperative, intraoperative, and postoperative periods that can help prevent orthopaedic infections include good preoperative skin care, optimal care during the operative phase, high rates of hand hygiene compliance throughout the continuum of care, stringent aseptic technique with postoperative dressing changes and the reduction of any incision site complications such as blisters. In the pre-operative period, the goal is effective skin preparation to reduce the resident microbial count and is achieved by having patients shower using Chlorhexidine 2 per cent, eliminating shaving, and screening for antibiotic resistant organisms such as MRSA. In the operative phase, the administration and timing of prophylactic antibiotics are crucial to the reduction of infection rates. Timing was improved by having Nurses start the infusion when the previous patient leaves the OR. The dose of the antibiotic Ancef was increased from 1 to 2 gms, and antibiotic impregnated cement (methyl methacrylate) was introduced. Perioperative normothermia has been shown to help decrease infections in orthopaedic patients so all patients are provided with warming blankets. Hand Hygiene is considered the single most important way to reduce nosocomial infections. Holland Centre compliances rates went from 28 per cent in 2008 to 85 per cent in 2012 with education, increased access to hand wash stations and products at Point-of-Care. We also now have full compliance with staff not wearing hand or arm jewelry and not eating and drinking in the nursing stations. These two factors are known to decrease infection rates. The introduction of a new wound care product and protocol, reduced the need for dressing changes, allowed greater flexibility for patients mobilizing and showering after surgery, and reduced blistering around the wound. The Holland Centre performs over 2,100 Total Joint procedures annually. A comprehensive process is in place to monitor and report infection rates for 12 months following surgery. In 2011/12 surgical infection rate in total hip and knee replacement patients was 0.00 per cent (compared to the National Healthcare Safety Network (NHSN) target rates of 0.75 per cent for hips and 0.68 per cent for knees). Preliminary data for 2012/13 shows that the program has sustained a 0.00 per cent infection rate for both hip and knee patients. We continually strive to improve practice throughout the entire process in order to eliminate surgical site infections in our patient population.",{"type":15,"attrs":9777,"content":9778},{"textAlign":53},[9779],{"text":1003,"type":295},{"_uid":9781,"file":9782,"link":9784,"label":9786,"linkType":371,"component":9787,"linkLabel":9788},"7a0dc658-8ff9-4ca0-8861-5f09f23ab22a",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":284,"meta_data":9783},{},{"id":16,"url":9785,"target":374,"linktype":375,"fieldtype":643,"cached_url":9785},"https://healthstandards.org/leading-practice/best-practice-in-infection-prevention-and-control-in-a-surgical-patient-population/","Best Practice in Infection Prevention and Control in a Surgical Patient Population (Health Standards Organization, 2013)","banner-link","Download the report",{"_uid":3408,"items":9790,"title":3523,"component":1458,"description":9954},[9791],{"_uid":3411,"title":3412,"ctaLeft":9792,"ctaRight":9793,"component":898,"columnLeft":9794,"columnRight":9798},[],[],{"type":12,"content":9795},[9796],{"type":15,"attrs":9797},{"textAlign":53},{"type":12,"content":9799},[9800,9809,9826,9837,9852,9862,9876,9887,9897,9909,9924,9941],{"type":15,"attrs":9801,"content":9802},{"textAlign":53},[9803,9804,9807],{"text":8861,"type":295},{"text":8863,"type":295,"marks":9805},[9806],{"type":402},{"text":9808,"type":295},". 2017;152(8):784-791. doi:10.1001/jamasurg.2017.0904",{"type":15,"attrs":9810,"content":9811},{"textAlign":868},[9812,9814,9818,9820],{"text":9813,"type":295},"Canadian Institute for Health Information. Appendix A. In: ",{"text":9815,"type":295,"marks":9816},"Hospital Harm Indicator: General Methodology Notes",[9817],{"type":402},{"text":9819,"type":295},". Canadian Institute for Health Information; 2019. ",{"text":9821,"type":295,"marks":9822},"https://indicatorlibrary.cihi.ca/display/HSPIL/Hospital+Harm?preview=/10453027/15564910/Hospital%20Harm%20Indicator%20General%20Methodology%20Notes.pdf",[9823,9825],{"type":371,"attrs":9824},{"href":9821,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":9827,"content":9828},{"textAlign":868},[9829,9831,9835],{"text":9830,"type":295},"Cataife G, Weinberg DA, Wong H-H, Kahn KL. The Effect of Surgical Care Improvement Project (SCIP) Compliance on Surgical Site Infections (SSI). ",{"text":9832,"type":295,"marks":9833},"Med Care",[9834],{"type":402},{"text":9836,"type":295},". 2014;52 (2 Suppl 1): S66-S73. doi: 10.1097/MLR.0000000000000028.",{"type":15,"attrs":9838,"content":9839},{"textAlign":868},[9840,9842,9845,9847],{"text":9841,"type":295},"Health Care for All. ",{"text":8545,"type":295,"marks":9843},[9844],{"type":402},{"text":9846,"type":295},". 2008. Accessed February 2021. ",{"text":8551,"type":295,"marks":9848},[9849,9851],{"type":371,"attrs":9850},{"href":8551,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":9853,"content":9854},{"textAlign":868},[9855,9857],{"text":9856,"type":295},"Health Standards Organization. Best Practice in Infection Prevention and Control in a Surgical Patient Population. HSO Leading Practices Library. Published 2013. ",{"text":9785,"type":295,"marks":9858},[9859,9861],{"type":371,"attrs":9860},{"href":9785,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":9863,"content":9864},{"textAlign":868},[9865,9867,9870,9871],{"text":9866,"type":295},"Institute for Healthcare Improvement (IHI). ",{"text":9017,"type":295,"marks":9868},[9869],{"type":402},{"text":9021,"type":295},{"text":6906,"type":295,"marks":9872},[9873,9875],{"type":371,"attrs":9874},{"href":6906,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":9877,"content":9878},{"textAlign":868},[9879,9881],{"text":9880,"type":295},"Institute for Healthcare Improvement. One Is Too Many: Viewing Infection Data from the Patient's Perspective. Published 2016. ",{"text":9882,"type":295,"marks":9883},"http://www.ihi.org:80/resources/Pages/AudioandVideo/OneIsTooManyViewingInfectionDatafromPatientsPerspective.aspx",[9884,9886],{"type":371,"attrs":9885},{"href":8571,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":9888,"content":9889},{"textAlign":868},[9890,9891,9895],{"text":9866,"type":295},{"text":9892,"type":295,"marks":9893},"IHI Improvement Map",[9894],{"type":402},{"text":9896,"type":295},". IHI; n.d. (Out of print)",{"type":15,"attrs":9898,"content":9899},{"textAlign":868},[9900,9902],{"text":9901,"type":295},"Johns Hopkins Medicine. Surgical Site Infections. Health: Conditions and Diseases. Accessed February 2021.",{"text":9903,"type":295,"marks":9904}," https://www.hopkinsmedicine.org/health/conditions-and-diseases/surgical-site-infections",[9905,9908],{"type":371,"attrs":9906},{"href":9907,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},"https://www.hopkinsmedicine.org/health/conditions-and-diseases/surgical-site-infections",{"type":5096},{"type":15,"attrs":9910,"content":9911},{"textAlign":868},[9912,9913,9917,9919],{"text":9110,"type":295},{"text":9914,"type":295,"marks":9915},"NICE Surgical Site Infections: Prevention and Treatment.",[9916],{"type":402},{"text":9918,"type":295}," NICE; 2019. ",{"text":6935,"type":295,"marks":9920},[9921,9923],{"type":371,"attrs":9922},{"href":6935,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":375},{"type":5096},{"type":15,"attrs":9925,"content":9926},{"textAlign":868},[9927,9929,9933,9935],{"text":9928,"type":295},"Public Health Agency of Canada. ",{"text":9930,"type":295,"marks":9931},"Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings",[9932],{"type":402},{"text":9934,"type":295},". Public Health Agency of Canada; 2012. ",{"text":9936,"type":295,"marks":9937},"http://publications.gc.ca/collections/collection_2013/aspc-phac/HP40-83-2013-eng.pdf",[9938,9940],{"type":371,"attrs":9939},{"href":9936,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":15,"attrs":9942,"content":9943},{"textAlign":868},[9944,9945,9948,9949],{"text":9222,"type":295},{"text":9224,"type":295,"marks":9946},[9947],{"type":402},{"text":9228,"type":295},{"text":9230,"type":295,"marks":9950},[9951,9953],{"type":371,"attrs":9952},{"href":9230,"uuid":53,"anchor":53,"custom":53,"target":374,"linktype":375},{"type":5096},{"type":12,"content":9955},[9956],{"type":15,"attrs":9957},{"textAlign":53},{"id":16,"_uid":9959,"items":9960,"component":659},"70a219c1-6fc3-485b-8930-b922bea7deba",[9961],{"_uid":9962,"link":9963,"image":9968,"title":651,"component":652,"description":9970},"38f7ece4-620a-463b-99b4-2316228eaa55",[9964],{"_uid":9965,"link":9966,"label":645,"component":646},"cbf091ce-d9da-43af-8a8c-3289d9318c7a",{"id":275,"url":16,"linktype":463,"fieldtype":643,"cached_url":303,"story":9967},{"name":270,"id":274,"uuid":275,"slug":9,"url":303,"full_slug":303,"_stopResolving":301},{"id":648,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":649,"copyright":16,"fieldtype":284,"meta_data":9969,"is_external_url":286},{},{"type":12,"content":9971},[9972],{"type":15,"attrs":9973,"content":9974},{"textAlign":53},[9975],{"text":294,"type":295},[129,150,136,122,143,115,157],[185,192,200],"post-procedural-infections","resources/post-procedural-infections",-18670,[],"74cc9d5f-1e09-4895-9cec-d826250595d7","2025-12-10T16:54:18.167Z",[],[9986],{"path":9987,"name":9988,"lang":315,"published":301},"ressources/infections-post-intervention","Infections post-intervention",28,1776087521791]