| Cut Set | Contributed Probability | Events Included in Cut Set (Probability of Each Individual Event) |
|||||
|---|---|---|---|---|---|---|---|
| 1 | 0.000103 | Event 173 (0.9)
Staff fails to provide patient with instructions for weight reduction |
Event 142 (0.3)
Staff not well-trained in infection control |
Event 450 (0.293)
Obese, but not diabetic, patient |
Event 642 (0.2)
Fail to protect patient effectively (failure related to skin prep, antibiotics admin, shaving surgical site, etc.) |
Event 182 (0.2)
Fail to administer indicated antibiotics |
Event 543 (0.0325)
SSI risk for obese patient, weight not reduced and nutrition not improved |
| 2 | 0.00006856 | Event 173 (0.9)
Staff fails to provide patient with instructions for weight reduction |
Event 450 (0.293)
Obese, but not diabetic, patient |
Event 660 (0.16)
Patient fails to notice infection during home care |
Event 433 (0.05)
Patient has organism at postoperative visit |
Event 543 (0.0325)
SSI risk for obese patient, weight not reduced and nutrition not improved |
- |
| 3 | 0.0000643 | Event 173 (0.9)
Staff fails to provide patient with instructions for weight reduction |
Event 142 (0.3)
Staff not well-trained in infection control |
Event 450 (0.293)
Obese, but not diabetic, patient |
Event 642 (0.2)
Fail to protect patient effectively (failure related to skin prep, antibiotics admin, shaving surgical site, etc.) |
Event 30 (0.125)
Fail to prepare skin appropriately |
Event 543 (0.0325)
SSI risk for obese patient, weight not reduced and nutrition not improved |
| 4 | 0.0000617 | Event 173 (0.9)
Staff fails to provide patient with instructions for weight reduction |
Event 450 (0.293)
Obese, but not diabetic, patient |
Event 642 (0.2)
Fail to protect patient effectively (failure related to skin prep, antibiotics admin, shaving surgical site, etc.) |
Event 182 (0.2)
Fail to administer indicated antibiotics |
Event 659 (0.18)
Glove puncture |
Event 543 (0.0325)
SSI risk for obese patient, weight not reduced and nutrition not improved |
| 5 | 0.0000514 | Event 173 (0.9)
Staff fails to provide patient with instructions for weight reduction |
Event 450 (0.293)
Obese, but not diabetic, patient (30<BMI<40) |
Event 642 (0.2)
Fail to protect patient effectively (failure related to skin prep, antibiotics admin, shaving surgical site, etc.) |
Event 182 (0.2)
Fail to administer indicated antibiotics |
Event 138 (0.15)
Fail to remove watch/jewelry/fake nails |
Event 543 (0.0325)
SSI risk for obese patient, weight not reduced and nutrition not improved |
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Proactive Risk Assessment of Surgical Site Infection in Ambulatory Surgery Centers
Exhibit 9. Top five minimal cut sets for the basic case
Table of Contents
- Proactive Risk Assessment of Surgical Site Infection in Ambulatory Surgery Centers
- Executive Summary
- Chapter 1. Introduction
- Chapter 2. ST-PRA Development
- Chapter 3. Risk-Informed Interventions
- Chapter 4. Conclusions and Next Steps
- Appendix A. Literature Review
- Appendix B. Database Analysis
- Appendix C. Site Visit Protocol
- Appendix D. Site Visit Process Comparison
- Appendix E. Study Parameters
- Appendix F. ST-PRA Fault Tree Model With Probability Estimates
- Appendix G. References for Fault Tree Model Probability Estimates
- References
Publication: 12-0045-EF
Page last reviewed April 2018
Page originally created April 2013
Internet Citation: Exhibit 9. Top five minimal cut sets for the basic case. Content last reviewed April 2018. Agency for Healthcare Research and Quality, Rockville, MD.
https://www.ahrq.gov/research/findings/final-reports/stpra/stpraexh9.html
