Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review (2020)

Author: Tomsic I, Heinze N, Chaberny I, Krauth C, Schock B, von Lengerke T.

Surgical site infections (SSI) are amongst the most common healthcare associated infections (HCAI) in Europe with cases of SSI particularly high in abdominal surgery. Tomsic and colleagues undertook a systematic review of published articles to understand what measures to prevent SSIs have been implemented and to what effect.  Here are some of the key points from the paper:

  • SSIs can have a negative impact of patients and their families by increasing morbidity and mortality.
  • SSIs can result in extended length of stay in hospital with increased treatment costs creating a burden on healthcare systems and institutions.
  • When preventative measures are taken, often in the form of ‘bundles’, SSI can be reduced by more than 50%.
  • ‘Bundles’ are described as sets of three to five measures implemented in a combined and consistent fashion to prevent SSI.
  • Implementation interventions such as a method or technique are needed to enhance the adoption of clinical interventions.
  • Difficulties in implementing clinical interventions can include lack of knowledge or low motivation, environmental factors such as missing equipment or lack of leadership.
  • The most frequently used implementation interventions to prevent SSIs were audit and feedback, measures related to organizational culture (e.g., multidisciplinary teams), monitoring, reminders, and educational meetings.

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