Surgical site infection: poor compliance with guidelines and care bundles

Surgical site infections (SSIs) are probably the most preventable of the health care- associated infections. Despite the widespread international introduction of level I evidence-based guidelines for the prevention of SSIs, such as that of the National Institute for Clinical Excellence (NICE) in the...

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Main Authors: Leaper, David J., Tanner, Judith, Kiernan, Martin, Assadian, Ojan, Edmiston, Charles E.
Format: Article
Published: Wiley 2015
Subjects:
Online Access:https://eprints.nottingham.ac.uk/50777/
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author Leaper, David J.
Tanner, Judith
Kiernan, Martin
Assadian, Ojan
Edmiston, Charles E.
author_facet Leaper, David J.
Tanner, Judith
Kiernan, Martin
Assadian, Ojan
Edmiston, Charles E.
author_sort Leaper, David J.
building Nottingham Research Data Repository
collection Online Access
description Surgical site infections (SSIs) are probably the most preventable of the health care- associated infections. Despite the widespread international introduction of level I evidence-based guidelines for the prevention of SSIs, such as that of the National Institute for Clinical Excellence (NICE) in the UK and the surgical care improvement project (SCIP) of the USA, SSI rates have not measurably fallen. The care bundle approach is an accepted method of packaging best, evidence-based measures into routine care for all patients and, common to many guidelines for the prevention of SSI, includes methods for preoperative removal of hair (where appropriate), rational antibiotic prophylaxis, avoidance of perioperative hypothermia, management of perioperative blood glucose and effective skin preparation. Reasons for poor compliance with care bundles are not clear and have not matched the wide uptake and perceived benefit of the WHO ‘Safe Surgery Saves Lives’ checklist. Recommendations include the need for further research and continuous updating of guidelines; comprehensive surveillance, using validated definitions that facilitate benchmarking of anonymised surgeon-specific SSI rates; assurance that incorporation of checklists and care bundles has taken place; the development of effective communication strategies for all health care providers and those who commission services and comprehensive information for patients.
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spelling nottingham-507772020-05-04T17:08:36Z https://eprints.nottingham.ac.uk/50777/ Surgical site infection: poor compliance with guidelines and care bundles Leaper, David J. Tanner, Judith Kiernan, Martin Assadian, Ojan Edmiston, Charles E. Surgical site infections (SSIs) are probably the most preventable of the health care- associated infections. Despite the widespread international introduction of level I evidence-based guidelines for the prevention of SSIs, such as that of the National Institute for Clinical Excellence (NICE) in the UK and the surgical care improvement project (SCIP) of the USA, SSI rates have not measurably fallen. The care bundle approach is an accepted method of packaging best, evidence-based measures into routine care for all patients and, common to many guidelines for the prevention of SSI, includes methods for preoperative removal of hair (where appropriate), rational antibiotic prophylaxis, avoidance of perioperative hypothermia, management of perioperative blood glucose and effective skin preparation. Reasons for poor compliance with care bundles are not clear and have not matched the wide uptake and perceived benefit of the WHO ‘Safe Surgery Saves Lives’ checklist. Recommendations include the need for further research and continuous updating of guidelines; comprehensive surveillance, using validated definitions that facilitate benchmarking of anonymised surgeon-specific SSI rates; assurance that incorporation of checklists and care bundles has taken place; the development of effective communication strategies for all health care providers and those who commission services and comprehensive information for patients. Wiley 2015-05-12 Article PeerReviewed Leaper, David J., Tanner, Judith, Kiernan, Martin, Assadian, Ojan and Edmiston, Charles E. (2015) Surgical site infection: poor compliance with guidelines and care bundles. International Wound Journal, 12 (3). pp. 357-362. ISSN 1742-481X Care bundles compliance guidelines surgical site infection https://onlinelibrary.wiley.com/doi/abs/10.1111/iwj.12243 doi:10.1111/iwj.12243 doi:10.1111/iwj.12243
spellingShingle Care bundles
compliance
guidelines
surgical site infection
Leaper, David J.
Tanner, Judith
Kiernan, Martin
Assadian, Ojan
Edmiston, Charles E.
Surgical site infection: poor compliance with guidelines and care bundles
title Surgical site infection: poor compliance with guidelines and care bundles
title_full Surgical site infection: poor compliance with guidelines and care bundles
title_fullStr Surgical site infection: poor compliance with guidelines and care bundles
title_full_unstemmed Surgical site infection: poor compliance with guidelines and care bundles
title_short Surgical site infection: poor compliance with guidelines and care bundles
title_sort surgical site infection: poor compliance with guidelines and care bundles
topic Care bundles
compliance
guidelines
surgical site infection
url https://eprints.nottingham.ac.uk/50777/
https://eprints.nottingham.ac.uk/50777/
https://eprints.nottingham.ac.uk/50777/