Prevention and control of surgical site infection: preliminary results of a best practice implementation project

Session Type
Understanding and using evidence
Fernandes AM1, Coelho S2, Afonso A2, Martins E2, Sampaio M2, Felizardo H3, Cardoso D1
1Nursing School of Coimbra, Portugal; Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Portugal; Portugal Centre for Evidence-Based Practice: a JBI Centre of Excellence, Portugal
2Coimbra Hospital and University Center, Coimbra, Portugal;, Portugal
3Nursing School of Coimbra, Portugal; Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Portugal;, Portugal

Background: Surgical site infections (SSIs) can cause significant harm to the patient, such as increased length of stay, readmissions, suffering or even death. Depending on several factors can occur in approximately 2-5% of inpatient surgeries and for certain types, such as abdominal surgery can range from 4-25%. By preventing it, professionals can reduce the risk of adverse events and improve patient safety.
Objectives: To implement evidence-based recommendations and promote compliance with the best evidence-based recommendations on prevention and control of SSIs, in a central operating room.
Methods: This project follows the JBI Evidence Implementation framework which included three phases: i) Establishing a project team and undertaking the baseline audit, ii) Providing feedback and implementing strategies based on JBI Getting Research into Practice (GRiP) framework and iii) a follow-up audit to assess the outcomes and plan for sustainability.
Results: The project is being developed. A baseline audit was carried out (100 patients sample) and identified inconsistencies in professionals' adherence to the bundle of SSIs prevention and control interventions (9 criteria). Areas of non-compliance were highlighted (Figure 1), including inconsistent handover (9%), operating room doors unreasonably open too long (17%), and unaccomplish with trichotomy criteria (46%). Feedback was given to the staff team and results were analysed against the nine criteria through discussion groups, to identify the non-compliance causes. After, a root cause analysis identified four significant barriers: lack of knowledge regarding interventions bundle; unfamiliarity with a structured and standardized clinical handover; manual and obsolete doors; reduced number of cutting machines. An intervention plan to mitigate barriers and increase compliance, a follow-up audit and a sustainability plan are under development.
Conclusions: The improvement of compliance with those evidence-based recommendations will reduce adverse events associated with SSIs in inpatient surgeries in this central operating room. Consequently, we hope that this project will lead to better health outcomes, with a positive impact on patients’ safety, costs and healthcare quality.
Patient, public and/or healthcare consumer involvement: No