Abstract
Background
Almost half of surgical site infections (SSIs) are preventable by application of evidence-based strategies. An online survey of Nebraska hospitals was conducted by the Nebraska Healthcare-Associated Infections/Antimicrobial Resistance Advisory Council’s SSI Subcommittee between March and May 2023 to assess implementation of evidence-based practice recommendations (EBPR) from national guidelines.
Methods
Infection preventionists completed the survey in collaboration with their perioperative teams. In addition to facility demographics, data was collected on general SSI prevention practices along with those specific to colon procedures, hysterectomies, and cesarean sections. Implementation frequencies were calculated for each EBPR after excluding missing responses.
Figure 2:
Routine Audits Conducted by Facilities
Results
Response rates for acute care and critical access hospitals were 72% (21/29) and 47% (30/64), respectively. Most EBPR (19/30) assessed were reported to be implemented by majority ( >50%) of the hospitals. The least implemented EBPR was vaginal cleansing prior to all cesarean sections (16%, 5/31) (Figure 1). Audits to monitor operating room traffic and skin antisepsis were conducted by approximately a third of hospitals (31%, 15/49 and 33%, 16/48, respectively) (Figure 2). Among hospitals that performed hysterectomies (n=23), less than half reported performing vaginal cleansing prior to all hysterectomies (43%), presence of policies/protocols for pre- and intraoperative antibiotic use for hysterectomies (39%) and monitoring of antimicrobial prophylaxis practices for hysterectomies (43%). Least implemented colon procedure specific EBPR in hospitals performing these procedures (n=26) included having standardized policies/procedures for mechanical bowel preparation (35%), presence of policies/protocols for pre- and intraoperative antibiotic use for colon procedures (50%,) and monitoring of antimicrobial prophylaxis practices for colon procedures (54%).
Conclusion
Several EBPR for SSI prevention are not routinely implemented highlighting the need for educational efforts to raise awareness among hospitals. Future studies should focus on identifying practice barriers and mitigation strategies to increase implementation.
Disclosures
Trevor C. Van Schooneveld, MD, FSHEA, FIDSA, AN2 Therapeutics: Grant/Research Support|BioMerieux: Grant/Research Support|BioMerieux: Honoraria|Thermo-Fisher: Honoraria Renuga Vivekanandan, MD, MDconsult: Ownership Interest Muhammad Salman Ashraf, MBBS, Merck & Co. Inc: Grant/Research Support