Compliance with guidelines to prevent surgical site infections: As simple as 1-2-3?

Meeks, Derek W; Lally, Kevin P.; Carrick, Matthew M.; Lew, Debbie F.; Thomas, Eric J.; Doyle, Peter D.; Kao, Lillian S.

doi:10.1016/j.amjsurg.2009.07.050

Cited by 89 publications

(69 citation statements)

References 37 publications

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“…However, various factors might have substantial impacted on the adherence rate, including lack of awareness of available principles, absence of training, individual preferences and influence from colleagues. Failure to comply with the standard of care had frequently been reported (20,23,27). In our program, all attending surgeons and nursing staff were mandatorily required to be involved in the SSI prevention campaign and abide by the supervision system.…”

Section: █ Conclusionmentioning

confidence: 99%

Neurosurgical site infection prevention: single institute experience

Xue

Ma²,

Hou³

et al. 2014

Turkish Neurosurgery

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Section: █ Conclusionmentioning

confidence: 99%

Neurosurgical site infection prevention: single institute experience

Xue

Ma²,

Hou³

et al. 2014

Turkish Neurosurgery

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“…Intermediate values have been reported for this outcome, between 61.1% and 84% 18,20,21,23,28 . However, Gul et al 19 and Tourmousoglouv et al 16 observed rates of 98% and 100%, respectively, representing appropriate values.…”

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confidence: 99%

“…The result of multivariate analysis suggests that the outcome could not be associated with any independent variable, since there was no significant variability in this outcome frequency, that is, discontinuation of the antibiotic was performed in due time in most patients (95.7% cases). However, Wright et al 27 noted that groups of patients who more often received antibiotics for a long time were those with more comorbidities or elderly females.Surgical antibiotic prophylaxis may be considered appropriate when it reaches values of the criteria established in the adopted protocols close to 100%.From 11 analyzed articles that addressed appropriate surgical antibiotic prophylaxis, this parameter was considered inadequate in 100% of them [14][15][16][17]20,21,[23][24][25]28,30 . In their systematic review of adherence to surgical antibiotic prophylaxis protocols, Gouvêa et al 35 concluded that all the studies reviewed indicated the need for greater adherence to such protocols.…”

mentioning

confidence: 99%

“…From 11 analyzed articles that addressed appropriate surgical antibiotic prophylaxis, this parameter was considered inadequate in 100% of them [14][15][16][17]20,21,[23][24][25]28,30 . In their systematic review of adherence to surgical antibiotic prophylaxis protocols, Gouvêa et al 35 concluded that all the studies reviewed indicated the need for greater adherence to such protocols.…”

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confidence: 99%

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Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital.

Gouvêa

Novaes

Iglesias

2016

Rev. Col. Bras. Cir.

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Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital. Avaliação da antibioticoprofilaxia em pacientes cirúrgicos no HospitalUniversitário Gaffrée e Guinle. This complication is one of the main forms of infections related to health care in Brazil, as demonstrated in a study conducted by the Ministry of Health, which observed SSI in 11% of all surgical procedures analyzed 4 . SSI occupies the third place in frequency among all the others, accounting for about 15% of all infectious processes observed in hospitalized patients 2,5 .Moreover, this type of complication involves financial burden to the patient, to the hospital and to the healthcare system. These facts make SSI an important public health problem and therefore a target for improving the quality of care to the patient who is candidate to surgical treatment 6 .Antibiotic prophylaxis is part of a set of measures that aim to reduce SSI incidence. The main aim of antibiotic prophylaxis is to reduce the bacterial load in the wound, to assist the natural host defenses in preventing SSI Efforts have been undertaken to establish protocols to guide the appropriate use of antibiotic prophylaxis for SSI prevention, whose goal is to provide health professionals with a standardized approach to the safe, effective and rational use of antimicrobials 9 .The aim of this study was to evaluate the use of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital, in the city of Rio de Janeiro. Gouvêa Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital METHODSThis is a prospective study of a cohort composed of patients undergoing elective surgical procedures between January and September 2014. Of the 283 patients who were initially candidates to participate in the study, we excluded 27 because they do not meet the established criteria, the final sample thus comprising 256 cases.We conducted the study at the Gaffrée e Guin- The sample calculation considered the likelihood of appropriate use of antibiotic prophylaxis to 50%, with 95% confidence interval, and type I error <5%.Thus, the estimated sample of 232 patients.Data collection included three different times:preoperative time, perioperative one and up to the seventh postoperative day; we performed the record in a standardized form. In cases of administered antibiotic, we STATISTICAL ANALYSISWe performed univariate analyzes by means of simple frequencies in order to describe the study sample, and bivariate analysis to detect differences in the distribution of independent variables for each outcome of interest, using the chi-square test. We also employed multivariate logistic regression, including the indepen- RESULTSThe characteristics of the sample represented by the 256 patients studied and the analyzed outcomes are shown in Tables 1, 2 and 3. Most patients were female (64.8%). The age ranged from 19 to 90 years, with a mean age of 52.9±16.2 and with a predominance of non-elderly (62.1%).Rega...

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“…13 A single study demonstrating reduced SSI with maintenance of intraoperative normothermia 5 rapidly changed practice. Guidelines for preventing SSI incorporated normothermia within 3 yr, 14 and pay-for-performance measures 15 did soon after. When the first study of high inspired oxygen, 4 performed by the same group and with nearly identical design, was published 4 yr later, adoption was neither universal nor rapid.…”

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confidence: 99%

High Intraoperative Inspired Oxygen Does Not Increase Postoperative Supplemental Oxygen Requirements

Mackintosh¹,

Gertsch

Hopf

et al. 2012

Anesthesiology

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Background: Although a high fraction of inspired oxygen (FIO 2 ) could reduce surgical site infection, there is concern it could increase postoperative pulmonary complications, including hypoxemia. Intraoperative positive end-expiratory pressure can improve postoperative pulmonary function. A practical measure of postoperative pulmonary function and the degree of hypoxemia is supplemental oxygen requirement. We performed a double-blind randomized 2 ϫ 2 factorial study on the effects of intraoperative FIO 2 0.3 versus more than 0.9 with and without positive end-expiratory pressure on the primary outcome of postoperative supplemental oxygen requirements in patients undergoing lower risk surgery. Methods: After Institutional Review Board approval and consent, 100 subjects were randomized using computer-generated lists into four treatment groups (intraoperative FIO 2 0.3 vs. more than 0.9, with and without 3-5 cm H 2 O positive end-expiratory pressure). Thirty minutes and 24 h after extubation, supplemental oxygen was discontinued. Arterial

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Compliance with guidelines to prevent surgical site infections: As simple as 1-2-3?

Cited by 89 publications

References 37 publications

Neurosurgical site infection prevention: single institute experience

Neurosurgical site infection prevention: single institute experience

Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital.

High Intraoperative Inspired Oxygen Does Not Increase Postoperative Supplemental Oxygen Requirements

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