Prioritizing patient skin and wound hygiene, and tracking and reporting patient outcomes are the most effective operating room practices to reduce surgical site infections, according to a study published in the Journal of the American College of Surgeons.
For the study, researchers polled surgeon leaders at 20 Texas hospitals affiliated with the Texas Alliance for Surgical Quality, a collaborative of the American College of Surgeons National Surgical Quality Improvement Program. In the survey, physicians ranked surgery, anesthesia and nursing adherence rates for 38 infection control practices in six categories: attire, preoperative preparation, during-surgery protocols, antibiotics, postoperative care and outcomes reporting.
Researchers also analyzed outcomes data on risk-adjusted odds ratios for surgical site infections using ACS NSQIP hospital-level risk-adjusted reports for July 2016.
Most hospitals reported maximum adherence for surgical care improvement project metrics, such as removing hair at the surgical site with clippers and properly using preventative antibiotic. Hospitals with the lowest SSI rates had the best compliance for eight other infection control practices, including preoperative showers, the use of clean instruments for wound closure and dressing changes, and transparent internal reporting of SSI data. Infection control practices relating to operating room attire did not correlate with SSI rates.
"The best performing hospitals were vigilant about skin prep, using a clean closure and giving antibiotics appropriately — all those things that happened right at the level of the wound," said lead author Thomas A. Aloia, MD, a surgeon at the University of Texas MD Anderson Cancer Center in Houston. "In addition, the hospitals that reported out their data on a formal basis — monthly or quarterly — to their surgeons, departments, and institutions also had the highest performance."
More articles on infection control and clinical quality:
Montana hospital confirms Legionnaires' case — Legionella bacteria detected in water supply
Top 10 infection control stories, Sept. 11-15
800+ households at risk of rare infection linked to contaminated milk, says CDC