Surgical site infection

Poor compliance with guidelines and care bundles

David J. Leaper, Judith Tanner, Martin Kiernan, Ojan Assadian, Charles E. Edmiston

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)357-362
Number of pages6
JournalInternational Wound Journal
Volume12
Issue number3
DOIs
Publication statusPublished - 1 Jun 2015

Fingerprint

Patient Care Bundles
Surgical Wound Infection
Guidelines
Checklist
Hair Removal
Benchmarking
Information Services
Antibiotic Prophylaxis
Product Packaging
Cross Infection
Hypothermia
Health Personnel
Blood Glucose
Patient Care
Communication
Skin
Research

Cite this

Leaper, D. J., Tanner, J., Kiernan, M., Assadian, O., & Edmiston, C. E. (2015). Surgical site infection: Poor compliance with guidelines and care bundles. International Wound Journal, 12(3), 357-362. https://doi.org/10.1111/iwj.12243
Leaper, David J. ; Tanner, Judith ; Kiernan, Martin ; Assadian, Ojan ; Edmiston, Charles E. / Surgical site infection : Poor compliance with guidelines and care bundles. In: International Wound Journal. 2015 ; Vol. 12, No. 3. pp. 357-362.
@article{13c3f7f3e552406ca2317b96f64e585c,
title = "Surgical site infection: Poor compliance with guidelines and care bundles",
abstract = "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.",
keywords = "Care bundles, Compliance, Guidelines, Surgical site infection",
author = "Leaper, {David J.} and Judith Tanner and Martin Kiernan and Ojan Assadian and Edmiston, {Charles E.}",
year = "2015",
month = "6",
day = "1",
doi = "10.1111/iwj.12243",
language = "English",
volume = "12",
pages = "357--362",
journal = "International Wound Journal",
issn = "1742-4801",
publisher = "Wiley",
number = "3",

}

Leaper, DJ, Tanner, J, Kiernan, M, Assadian, O & Edmiston, CE 2015, 'Surgical site infection: Poor compliance with guidelines and care bundles', International Wound Journal, vol. 12, no. 3, pp. 357-362. https://doi.org/10.1111/iwj.12243

Surgical site infection : Poor compliance with guidelines and care bundles. / Leaper, David J.; Tanner, Judith; Kiernan, Martin; Assadian, Ojan; Edmiston, Charles E.

In: International Wound Journal, Vol. 12, No. 3, 01.06.2015, p. 357-362.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Surgical site infection

T2 - Poor compliance with guidelines and care bundles

AU - Leaper, David J.

AU - Tanner, Judith

AU - Kiernan, Martin

AU - Assadian, Ojan

AU - Edmiston, Charles E.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - 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.

AB - 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.

KW - Care bundles

KW - Compliance

KW - Guidelines

KW - Surgical site infection

UR - http://www.scopus.com/inward/record.url?scp=84929278424&partnerID=8YFLogxK

U2 - 10.1111/iwj.12243

DO - 10.1111/iwj.12243

M3 - Article

VL - 12

SP - 357

EP - 362

JO - International Wound Journal

JF - International Wound Journal

SN - 1742-4801

IS - 3

ER -