Table 2.

Timeline of the Safe Hands project (italic) and changes in standard practices

Year and quarters	Interventions and changes in routines
1 Baseline Q1-2	Systematic collection of outcome data and related variable after hip fracture surgery
Q 3–4	Introduction of the Safe Hands project (ClinicalTrials.gov ID: NCT02983136) to secure leadership commitment to infection prevention in surgery
	A new routine promoting early assessment by the consulting infectious diseases specialist in Staphylococcus aureus bacteraemia was introduced
2 Intervention Q1-2	The Safe Hands project was launched in the OR
Q3-4	A new routine was implemented that formalised the practice that junior physicians in training should receive support from a senior surgeon to avoid prolonged surgical time for hip fracture surgery. The aim was to create a culture where it would be easy and appropriate to ask for help from a senior
3 Intervention Q1-2	Antibiotic rounds twice weekly led by a consulting infectious diseases specialist were introduced on the geriatric wards with the aim of promoting sound antibiotic use, e.g. reducing the number of prophylaxis-resistant bacterial strains on the wards Accessibility to the consulting infectious diseases specialist was increased from two to four days a week for bedside assessments The preoperative shower routine consisting of a double shower with 4% chlorhexidine gluconate (CHX) was changed from two showers before surgery to one shower before surgerya If the patient had to wait for surgery for more than 48 h after the first shower, an additional CHX treatment was carried out
	Expanding the Safe Hands project; a catheter-related urinary tract infection prevention strategy (Safe Bladder) was developed
Q3-4	Safe Bladder was implemented in the full care pathway ER, OR, PACU and the geriatric wards
4. Post-intervention Q1-2
Q 3–4
5 Post-intervention Q1-2	The antibiotic rounds led by a consulting infectious diseases specialist were reduced from twice to once weekly
Q3-4