Validation of surgical wound classification in the operating room.

D. M. Cardo, P. S. Falk, C. G. Mayhall

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE: To determine the accuracy with which circulating nurses (CNs) classify surgical procedures by risk of contamination in the operating room. DESIGN: Classification of surgical procedures by CNs was compared with the classification of surgical procedures by a physician observer. SETTING: University-affiliated, tertiary care hospital. METHODS: Circulating nurses used the traditional wound classification system of clean, clean-contaminated, contaminated, and dirty-infected to classify surgical wounds in the operating room. A physician remained in the operating room throughout each of 100 surgical procedures and simultaneously classified surgical wounds without the knowledge of the CNs. RESULTS: Classification of surgical wounds by CNs was compared with classification by the physician observer for 50 cases in general surgery and 50 cases in trauma surgery. Compared with the physician observer, the overall accuracy of classification by CNs was 88% (95% confidence interval [CI] of 81.6% to 94.4%; Kappa statistic, 0.83). Classification of surgical wounds was more difficult in trauma surgery (accuracy of 82%) than in general surgery (accuracy of 94%). Accuracy increased for both services when surgical wounds were classified into just two categories (clean or clean-contaminated versus contaminated or dirty-infected). CONCLUSIONS: Surgical wounds can be classified in the operating room with a high degree of accuracy by CNs. Classification was more difficult in trauma than in general surgery, but classification in trauma surgery improved with feedback to and additional education of CNs. The accuracy of classification by CNs was even higher when classifications were divided into just two categories.

Original languageEnglish (US)
Pages (from-to)255-259
Number of pages5
JournalInfection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
Volume14
Issue number5
StatePublished - May 1993
Externally publishedYes

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Operating Rooms
Nurses
Wounds and Injuries
Physicians
Surgical Wound
Tertiary Healthcare
Tertiary Care Centers
Confidence Intervals
Education

ASJC Scopus subject areas

  • Immunology
  • Microbiology (medical)

Cite this

Validation of surgical wound classification in the operating room. / Cardo, D. M.; Falk, P. S.; Mayhall, C. G.

In: Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America, Vol. 14, No. 5, 05.1993, p. 255-259.

Research output: Contribution to journalArticle

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