Policy Manual sample

MDT Home Health Care Agency, Inc. SSI-SURGICAL SITE INFECTION SIP/SIS-Superficial incisional surgical site infection A superficial incisional SSI (SIP or SIS) must meet the following criterion: Infection occurs within 30 days after the operative procedure and involves only skin and subcutaneous tissue of the incision DIP/DIS-Deep incisional surgical site infection A deep incisional SSI (DIP or DIS) must meet the following criterion: Infection occurs within 30 days after the operative procedure if no implant 1 is left in place or within 1 year if implant is in place and the infection appears to be related to the operative procedure and involves deep soft tissues (eg, fascial and muscle layers) of the incision Organ/space-Organ/space surgical site infection An organ/space SSI involves any part of the body, excluding the skin incision, fascia, or muscle layers, that is opened or manipulated during the operative procedure. Specific sites are assigned to organ/space SSI to identify further the location of the infection. Listed below in reporting instructions are the specific sites that must be used to differentiate organ/space SSI. An example is appendectomy with subsequent subdiaphragmatic abscess, which would be reported as an organ/space SSI at the intraabdominal specific site (SSI-IAB). An organ/space SSI must meet the following criterion: Infection occurs within 30 days after the operative procedure if no implant 1 is left in place or within 1 year if implant is in place and the infection appears to be related to the operative procedure and infection involves any part of the body, excluding the skin incision, fascia, or muscle layers, that is opened or manipulated during the operative procedure BSI-BLOODSTREAM INFECTION LCBI-Laboratory-confirmed bloodstream infection LCBI criteria 1 and 2 may be used for patients of any age, including patients <1 year of age. LCBI must meet at least 1 of the following criteria: 1. Patient has a recognized pathogen cultured from 1 or more blood cultures and organism cultured from blood is not related to an infection at another site. (See Notes 1 and 2.) 2. Patient has at least 1 of the following signs or symptoms: fever (>38 o C), chills, or hypotension and signs and symptoms and positive laboratory results are not related to an infection at another site and common skin contaminant (ie, diphtheroids [Corynebacterium spp], Bacillus [not B anthracis] spp, Propionibacterium spp, coagulase-negative staphylococci [including S epidermidis], viridans group streptococci, Aerococcus spp, Micrococcus spp) is cultured from 2 or more blood cultures drawn on separate occasions. BJ–BONE AND JOINT INFECTION BONE- Osteomyelitis Osteomyelitis must meet at least 1 of the following criteria: Patient has organisms cultured from bone. Patient has evidence of osteomyelitis on direct examination of the bone during a surgical operation or histopathologic examination. Patient has at least 2 of the following signs or symptoms with no other recognized cause: fever Home Health Agency Nursing Care & Procedures K-140