The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study
Background: Despite the dissemination of guidelines for surgical site infection (SSI) prevention, a gap between the theoretical measures and their compliance persists. Accurate estimates of the implementation of preventative measures is crucial before planning dissemination strategies. Methods: A we...
| Autores: | , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2020 |
| País: | España |
| Institución: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repositorio: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:20.500.12328/3057 |
| Acceso en línea: | http://hdl.handle.net/20.500.12328/3057 https://dx.doi.org/10.1016/j.ijsu.2020.08.027 |
| Access Level: | acceso abierto |
| Palabra clave: | Infecció del lloc quirúrgic Infecció de la ferida quirúrgica Mesures preventives Prevenció i control Enquestes i qüestionaris Infección del sitio quirúrgico Infección de la herida quirúrgica Medidas preventivas Prevención y control Encuestas y cuestionarios Surgical site infection Surgical wound infection Preventive measures Prevention and control Surveys and questionnaires 61 617 |
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The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative studyBadia, Josep M.Rubio-Pérez, InésLópez-Menéndez, JoséDiez, CeciliaAl-Raies Bolaños, BaderOcaña-Guaita, JuliaMeijome, Xose M.Chamorro-Pons, ManuelCalderón-Nájera, RamónOrtega-Pérez, GloriaParedes-Esteban, RosaSánchez-Viguera, CristinaVilallonga, RamonPicardo, Antonio L.Bravo-Brañas, ElenaEspin, EloyBalibrea, José M.Spanish Observatory of Surgical InfectionInfecció del lloc quirúrgicInfecció de la ferida quirúrgicaMesures preventivesPrevenció i controlEnquestes i qüestionarisInfección del sitio quirúrgicoInfección de la herida quirúrgicaMedidas preventivasPrevención y controlEncuestas y cuestionariosSurgical site infectionSurgical wound infectionPreventive measuresPrevention and controlSurveys and questionnaires61617Background: Despite the dissemination of guidelines for surgical site infection (SSI) prevention, a gap between the theoretical measures and their compliance persists. Accurate estimates of the implementation of preventative measures is crucial before planning dissemination strategies. Methods: A web-based survey was distributed to members of 11 Associations of operative nurses and surgeons. Questions aimed to determine their awareness of evidence, personal beliefs and actual use of the main preventative measures. Results: Of 1105 responders, 50.5% receive no feed-back of their SSI rate. Responders show a moderate rate of awareness of the recommendations about not removing hair, hair clipping, skin antisepsis with alcoholic solutions, and normothermia. Antibiotic prophylaxis is given for more than 24 h by 18.8% of respondents. Screening for S. aureus is performed by 27.6%. Hair removal by shaving is used by 16.6% of responders. The most common antiseptic solutions are alcoholic chlorhexidine (57.2%) and aqueous povidone (23.3%). 62.8% of surgeons allow the solution to air dry before applying surgical drapes. Adhesive drapes in the surgical field are used routinely in 33.4% of cases. Perioperative normothermia, glucose control and hyperoxia are used in 84.3%, 65.9% and 23.3% of cases. Antimicrobial sutures and negative pressure therapy are used by 20.2% and 43.5% of teams, respectively. Prior to closing the incision, 83.9% replace surgical instruments always or selectively. Wound irrigation before closing is used in 78.1% of cases, mostly with saline. Check-lists, standardized orders, surveillance, feed-back and educational programs were rated most highly by respondents as a means to improve compliance with preventative guidelines, but few of these strategies were in place at their institutions. Conclusion: Gaps in the translation of evidence into practice remain in the prevention of SSI among different surgical specialities. Several areas for improvement have been identified, as some core prevention measures are not in common use.info:eu-repo/semantics/publishedVersionElsevier2020info:eu-repo/semantics/article9http://hdl.handle.net/20.500.12328/3057https://dx.doi.org/10.1016/j.ijsu.2020.08.027reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésInternational Journal of Surgery82;© 2020 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY license.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:recercat.cat:20.500.12328/30572026-05-29T05:05:01Z |
| dc.title.none.fl_str_mv |
The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study |
| title |
The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study |
| spellingShingle |
The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study Badia, Josep M. Infecció del lloc quirúrgic Infecció de la ferida quirúrgica Mesures preventives Prevenció i control Enquestes i qüestionaris Infección del sitio quirúrgico Infección de la herida quirúrgica Medidas preventivas Prevención y control Encuestas y cuestionarios Surgical site infection Surgical wound infection Preventive measures Prevention and control Surveys and questionnaires 61 617 |
| title_short |
The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study |
| title_full |
The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study |
| title_fullStr |
The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study |
| title_full_unstemmed |
The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study |
| title_sort |
The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study |
| dc.creator.none.fl_str_mv |
Badia, Josep M. Rubio-Pérez, Inés López-Menéndez, José Diez, Cecilia Al-Raies Bolaños, Bader Ocaña-Guaita, Julia Meijome, Xose M. Chamorro-Pons, Manuel Calderón-Nájera, Ramón Ortega-Pérez, Gloria Paredes-Esteban, Rosa Sánchez-Viguera, Cristina Vilallonga, Ramon Picardo, Antonio L. Bravo-Brañas, Elena Espin, Eloy Balibrea, José M. Spanish Observatory of Surgical Infection |
| author |
Badia, Josep M. |
| author_facet |
Badia, Josep M. Rubio-Pérez, Inés López-Menéndez, José Diez, Cecilia Al-Raies Bolaños, Bader Ocaña-Guaita, Julia Meijome, Xose M. Chamorro-Pons, Manuel Calderón-Nájera, Ramón Ortega-Pérez, Gloria Paredes-Esteban, Rosa Sánchez-Viguera, Cristina Vilallonga, Ramon Picardo, Antonio L. Bravo-Brañas, Elena Espin, Eloy Balibrea, José M. Spanish Observatory of Surgical Infection |
| author_role |
author |
| author2 |
Rubio-Pérez, Inés López-Menéndez, José Diez, Cecilia Al-Raies Bolaños, Bader Ocaña-Guaita, Julia Meijome, Xose M. Chamorro-Pons, Manuel Calderón-Nájera, Ramón Ortega-Pérez, Gloria Paredes-Esteban, Rosa Sánchez-Viguera, Cristina Vilallonga, Ramon Picardo, Antonio L. Bravo-Brañas, Elena Espin, Eloy Balibrea, José M. Spanish Observatory of Surgical Infection |
| author2_role |
author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Infecció del lloc quirúrgic Infecció de la ferida quirúrgica Mesures preventives Prevenció i control Enquestes i qüestionaris Infección del sitio quirúrgico Infección de la herida quirúrgica Medidas preventivas Prevención y control Encuestas y cuestionarios Surgical site infection Surgical wound infection Preventive measures Prevention and control Surveys and questionnaires 61 617 |
| topic |
Infecció del lloc quirúrgic Infecció de la ferida quirúrgica Mesures preventives Prevenció i control Enquestes i qüestionaris Infección del sitio quirúrgico Infección de la herida quirúrgica Medidas preventivas Prevención y control Encuestas y cuestionarios Surgical site infection Surgical wound infection Preventive measures Prevention and control Surveys and questionnaires 61 617 |
| description |
Background: Despite the dissemination of guidelines for surgical site infection (SSI) prevention, a gap between the theoretical measures and their compliance persists. Accurate estimates of the implementation of preventative measures is crucial before planning dissemination strategies. Methods: A web-based survey was distributed to members of 11 Associations of operative nurses and surgeons. Questions aimed to determine their awareness of evidence, personal beliefs and actual use of the main preventative measures. Results: Of 1105 responders, 50.5% receive no feed-back of their SSI rate. Responders show a moderate rate of awareness of the recommendations about not removing hair, hair clipping, skin antisepsis with alcoholic solutions, and normothermia. Antibiotic prophylaxis is given for more than 24 h by 18.8% of respondents. Screening for S. aureus is performed by 27.6%. Hair removal by shaving is used by 16.6% of responders. The most common antiseptic solutions are alcoholic chlorhexidine (57.2%) and aqueous povidone (23.3%). 62.8% of surgeons allow the solution to air dry before applying surgical drapes. Adhesive drapes in the surgical field are used routinely in 33.4% of cases. Perioperative normothermia, glucose control and hyperoxia are used in 84.3%, 65.9% and 23.3% of cases. Antimicrobial sutures and negative pressure therapy are used by 20.2% and 43.5% of teams, respectively. Prior to closing the incision, 83.9% replace surgical instruments always or selectively. Wound irrigation before closing is used in 78.1% of cases, mostly with saline. Check-lists, standardized orders, surveillance, feed-back and educational programs were rated most highly by respondents as a means to improve compliance with preventative guidelines, but few of these strategies were in place at their institutions. Conclusion: Gaps in the translation of evidence into practice remain in the prevention of SSI among different surgical specialities. Several areas for improvement have been identified, as some core prevention measures are not in common use. |
| publishDate |
2020 |
| dc.date.none.fl_str_mv |
2020 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/20.500.12328/3057 https://dx.doi.org/10.1016/j.ijsu.2020.08.027 |
| url |
http://hdl.handle.net/20.500.12328/3057 https://dx.doi.org/10.1016/j.ijsu.2020.08.027 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
International Journal of Surgery 82; |
| dc.rights.none.fl_str_mv |
https://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess |
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https://creativecommons.org/licenses/by/4.0/ |
| eu_rights_str_mv |
openAccess |
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9 |
| dc.publisher.none.fl_str_mv |
Elsevier |
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Elsevier |
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reponame:Recercat. Dipósit de la Recerca de Catalunya instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
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