Barriers and facilitators for surgical site infection surveillance for adult cardiac surgery in a high-income setting: an in-depth exploration.

Humans Adult Surgical Wound Infection / epidemiology Aftercare Patient Discharge Cardiac Surgical Procedures Infection Control / methods
Barriers Cardiac surgery Facilitators Surgical site infection Surveillance

Journal

The Journal of hospital infection
ISSN: 1532-2939
Titre abrégé: J Hosp Infect
Pays: England
ID NLM: 8007166

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 25 06 2023
revised: 02 08 2023
accepted: 10 08 2023
medline: 7 11 2023
pubmed: 22 9 2023
entrez: 21 9 2023
Statut: ppublish

Résumé

Surgical site infection (SSI) surveillance aims to facilitate a reduction in SSIs through identifying infection rates, benchmarking, triggering clinical review and instituting infection control measures. Participation in surveillance is, however, variable suggesting opportunities to improve wider adoption. To gain an in-depth understanding of the barriers and facilitators for SSI surveillance in a high-income European setting. Key informant interviews with 16 surveillance staff, infection prevention staff, nurses and surgeons from nine cardiac hospitals in England. Data were analysed thematically. SSI surveillance was reported to be resource intensive. Barriers to surveillance included challenges associated with data collection: data being located in numerous places, multiple SSI data reporting schemes, difficulty in finding denominator data, lack of interface between computerized systems, 'labour intensive' or 'antiquated' methods to collect data (e.g., using postal systems for patient questionnaires). Additional reported concerns included: relevance of definitions, perceived variability in data reporting, lack of surgeon engagement, unsupportive managers, low priority of SSIs among staff, and a 'blame culture' around high SSI rates. Facilitators were increased resources, better use of digital technologies (e.g., remote digital wound monitoring), integrating surveillance within routine clinical work, having champions, mandating surveillance, ensuring a closer relationship between surveillance and improved patient outcomes, increasing the focus on post-discharge surveillance, and integration with primary care data. Using novel interviews with 'front-line' staff, identified opportunities for improving participation in SSI surveillance. Translating these findings into action will increase surveillance activity and bring patient safety benefits to a larger pool of surgical patients.

Sections du résumé

BACKGROUND BACKGROUND
Surgical site infection (SSI) surveillance aims to facilitate a reduction in SSIs through identifying infection rates, benchmarking, triggering clinical review and instituting infection control measures. Participation in surveillance is, however, variable suggesting opportunities to improve wider adoption.
AIM OBJECTIVE
To gain an in-depth understanding of the barriers and facilitators for SSI surveillance in a high-income European setting.
METHODS METHODS
Key informant interviews with 16 surveillance staff, infection prevention staff, nurses and surgeons from nine cardiac hospitals in England. Data were analysed thematically.
FINDINGS RESULTS
SSI surveillance was reported to be resource intensive. Barriers to surveillance included challenges associated with data collection: data being located in numerous places, multiple SSI data reporting schemes, difficulty in finding denominator data, lack of interface between computerized systems, 'labour intensive' or 'antiquated' methods to collect data (e.g., using postal systems for patient questionnaires). Additional reported concerns included: relevance of definitions, perceived variability in data reporting, lack of surgeon engagement, unsupportive managers, low priority of SSIs among staff, and a 'blame culture' around high SSI rates. Facilitators were increased resources, better use of digital technologies (e.g., remote digital wound monitoring), integrating surveillance within routine clinical work, having champions, mandating surveillance, ensuring a closer relationship between surveillance and improved patient outcomes, increasing the focus on post-discharge surveillance, and integration with primary care data.
CONCLUSION CONCLUSIONS
Using novel interviews with 'front-line' staff, identified opportunities for improving participation in SSI surveillance. Translating these findings into action will increase surveillance activity and bring patient safety benefits to a larger pool of surgical patients.

Identifiants

DOI: 10.1016/j.jhin.2023.08.023 PMID: 37734675
pubmed: 37734675
pii: S0195-6701(23)00296-7
doi: 10.1016/j.jhin.2023.08.023
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

112-118

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Auteurs

J Tanner (J)

School of Health Sciences, University of Nottingham, Nottingham, UK. Electronic address: judith.tanner@nottingham.ac.uk.

L Brierley Jones (L)

School of Health Sciences, University of Nottingham, Nottingham, UK.

M Rochon (M)

Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK.

N Westwood (N)

Patient and Public Representative, UK.

C Wloch (C)

HCAI Fungal AMR AMU & Sepsis Division, UKHSA, London, UK.

R Vaja (R)

Department of Cardiothoracic Surgery, Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, UK.

L Rogers (L)

Department of Cardiothoracic Surgery, University Hospitals of Bristol and Weston NHS Foundation Trust.

J Dearling (J)

Patient and Public Representative, UK.

K Wilson (K)

Patient and Public Representative, UK.

R Magboo (R)

Critical Care, Barts Health NHS Trust, London, UK.

H Aujla (H)

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

S Page (S)

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

P Whiting (P)

Bristol Medical School, University of Bristol, Bristol, UK.

G Murphy (G)

Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.

C Brown (C)

HCAI Fungal AMR AMU & Sepsis Division, UKHSA, London, UK.

T Lamagni (T)

HCAI Fungal AMR AMU & Sepsis Division, UKHSA, London, UK.

P Harrington (P)

HCAI Fungal AMR AMU & Sepsis Division, UKHSA, London, UK.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Barriers and facilitators for surgical site...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Barriers and facilitators for surgical site...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Infection de plaie opératoire › Barriers and facilitators for surgical site...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Continuité des soins › Post-cure › Barriers and facilitators for surgical site...
questionsmedicales.fr › Administration des services de santé › Gestion des soins aux patients › Services de santé polyvalents › Soins de santé primaires › Continuité des soins › Sortie du patient › Barriers and facilitators for surgical site...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie thoracique › Procédures de chirurgie cardiaque › Barriers and facilitators for surgical site...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Pratiques en santé publique › Contrôle des maladies transmissibles › Prévention des infections › Barriers and facilitators for surgical site...