Prevention and control of surgical site infection: preliminary results of a best practice implementation project
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, SSIs 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-patient sample) and identified inconsistencies in professionals’ adherence to the bundle of SSIs prevention and control interventions (9 criteria). Areas of noncompliance were highlighted (Figure 1), including inconsistent handover (9%), operating room doors unreasonably open too long (17%), and unaccomplished 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 noncompliance 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; and 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.