Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T02:17:50.816Z Has data issue: false hasContentIssue false

Surgical Site Infection Surveillance Analysis of Adherence to Recommendations for Routine Infection Control Practices

Published online by Cambridge University Press:  21 June 2016

Annalisa Castella
Affiliation:
Dipartimento di Sanità Pubblica e Microbiologia, Università degli Studi di Torino, Ospedale di Rivoli, ASL 5, Rivoli, Torino, Italy
Lorena Charrier
Affiliation:
Dipartimento di Sanità Pubblica e Microbiologia, Università degli Studi di Torino, Ospedale di Rivoli, ASL 5, Rivoli, Torino, Italy
Valeria Di Legami
Affiliation:
Dipartimento di Sanità Pubblica e Microbiologia, Università degli Studi di Torino, Ospedale di Rivoli, ASL 5, Rivoli, Torino, Italy
Francesca Pastorino
Affiliation:
Dipartimento di Sanità Pubblica e Microbiologia, Università degli Studi di Torino, Ospedale di Rivoli, ASL 5, Rivoli, Torino, Italy
Enzo Carlo Farina
Affiliation:
Ospedale S. Giovanni Battista, Azienda Sanitaria Ospedaliera S. Giovanni Battista, Ospedale di Rivoli, ASL 5, Rivoli, Torino, Italy
Pier Angelo Argentero
Affiliation:
Ospedale di Rivoli, ASL 5, Rivoli, Torino, Italy
Carla Maria Zotti*
Affiliation:
Dipartimento di Sanità Pubblica e Microbiologia, Università degli Studi di Torino, Ospedale di Rivoli, ASL 5, Rivoli, Torino, Italy
*
Università degli Studi di Torino, Dipartimento di Sanità Pubblica e Microbiologia, Via Santena 5 bis, 10126 Torino, Italia, ([email protected])

Abstract

Objective.

To evaluate the application of surgical site infection control procedures in general surgery departments in hospitals in the Piemonte region of Italy.

Design.

The descriptive study entailed 1 week of observation in the general surgery departments and 1 week of observation in the operating rooms of 49 hospitals in Piemonte; the survey was conducted in 2003.

Methods.

Data collection forms were designed to record information about presurgical patient preparation (form 1) and infection control practices routinely used by surgical teams (form 2).

Results.

A total of 856 patients were observed; 88% of operations were surgical wound class I or II; 70.6% of patients had hair removed, 28.8% showered the day before the operation; antimicrobial prophylaxis was administered in 63.3% of cases (68.4% on induction of anesthesia and 26% on the day of the operation) and was continued into the postoperative period in 43% of cases. A total of 799 operations were observed; the mean number of healthcare personnel in the operating room was 6; doors were opened an average of 12 times during an operation; 88% of the surgical team members wore a cap/hood and mask correctly; 25% of surgeons and 41% of instrument nurses wore an eye shield; preoperative hand and forearm scrubbing technique was correct in 78% of cases (surgeons, 74.6%; instrument nurses, 86.6%; and anesthesiologists, 73%).

Conclusions.

A comparison between the survey data and the international recommendations for SSI prevention highlighted practices that could be improved with corrective interventions. The study provided an opportunity for sharing feedback on appropriate data with healthcare personnel and was an effective instrument to audit infection control practices.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

G. Arditi, A. Biglino, V. De Micheli, G. Marchiaro, A. Moiraghi Ruggenini, R. Reale, S. Romagnoli, R. Serra, and M. L. Soranzo (Regional Study Group, Direzione 27, Assessorato alia Sanità [ASL]); G. Attanasio, S. Fantino, and G. Zanon (ASL 2); P. Caramello, P. Bianco, and L. Pani (ASL 4); N. Gentile, V. Rolando, and B. Viviani (ASL 5); N. Pasetto and A. Buono (ASL 6); T. Bassani and R. Musca (ASL 7); A. Pasqualucci, G. Chiozza, and P. Castagno (ASL 8); F. Arnoletti, M. Boux, and E. Mattea (ASL 9); B. Nucci, M. C. Allochis, and P. Costantino (ASL 10); S. Gatti, E. Pastorelli, M. Franchino, and C. Signoris (ASL 11); F. Chieppa, C. Colono, and M. Daglio (ASL 12); E. Pagani, B. Bacchetta, L. Signorotti, and L. Zanetti (ASL 13); O. Ossola, L. De Giorgis, M. Bignamini, and R. Pesce (ASL 14); M. Salvatico and L. Ghiglia (ASL 16); M. Rebora, N. Rosati, and S. Gerbaudo (ASL 17); G. Corso, S. Cabutti, and M. Noè (ASL 18); L. Bernini, G. Marchese, and M. Pozzebon (ASL 19); O. Dellalibera and A. Pernecco (ASL 20); G. Parovina, E. Ferrando, and C. Degiovanni (ASL 21); D. Balestrino, L. Bisogni, and E. Pesce (ASL 22); E. Guglielmi, N. Piccin, and A. Di Leo (Azienda Sanitaria Ospedaliera [ASO] S. Giovanni Battista); F. Gremo, G. Guidi, and S. Bagnato (ASO CTO-CRF-Maria Adelaide); G. Guareschi and R. Demartino (ASO O.I.R.M.-S. Anna); P. Silvaplana and A. Lazzarin (ASO S. Luigi); S. Borrè, E. Coppini, and E. Morici (ASO Maggiore della Carita); P. Pellegrino and P. Occelli (ASO S. Croce e Carle); G. Lomolino and F. Piccio (ASO SS Antonio e Biagio e C. Arrigo, Alessandria); R. Sacco and V. Rigobello (Casa di Cura "Ospedale Cottolengo"); and C. Macchiolo and A. Clarichetti (Presidio Sanitario “Gradenigo”).

References

1. Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR, Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 1999; 20:250278.CrossRefGoogle ScholarPubMed
2. Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985; 121:182205.CrossRefGoogle ScholarPubMed
3. Harbarth, S, Sax, H, Gastmeier, P. The preventable proportion of nosocomial infections: an overview of published reports. J Hosp Infect 2003; 54:258266.CrossRefGoogle ScholarPubMed
4. Delgado-Rodriguez, M, Gómez-Ortega, A, Sillero-Arenas, M, et al. Efficacy of surveillance in nosocomial infection control in a surgical service. Am J Infect Control 2001; 29:289294.CrossRefGoogle Scholar
5. Gastmeier, P, Brauer, H, Forster, D, Dietz, E, Dascner, F, Ruden, H. A quality management project in 8 hospitals to reduce nosocomial infections: a prospective, controlled study. Infect Control Hosp Epidemiol 2002; 23:9197.CrossRefGoogle ScholarPubMed
6. Moro, ML, Petrosillo, N, Gandin, C, Bella, A. Infection control programs in Italian hospitals. Infect Control Hosp Epidemiol 2004; 25:3640.CrossRefGoogle ScholarPubMed
7. Zotti, CM, Messori Ioli, G, Charrier, L, et al. Hospital-acquired infections in Italy: a region wide prevalence study. J Hosp Infect 2004; 56:142149.CrossRefGoogle ScholarPubMed
8. Bratzler, DW, Houck, PM. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis 2004; 38:17061715.Google ScholarPubMed
9. SIGN—Scottish Intercollegiate Guidelines Network. Antibiotic prophylaxis in surgery. July 2000. SIGN Publication 45. Available at: http://www.sign.ac.uk/guidelines/fulltext/45/index.html. Accessed July 13,2006.Google Scholar
10. PNLG— Programma Nazionale Linee Guida. Antibioticoprofilassi perioperatoria nell'adulto. Linea Guida. Milan, Italy: 2003. Available at: http://www.pnlg.it/LG/. Accessed July 13, 2006.Google Scholar
11. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004; 32:470485.CrossRefGoogle Scholar
12. Decreto Legislativo N° 626 del 19/09/1994. Attuazione delle direttive 89/391/CEE, 89/654/CEE, 89/655/CEE, 89/656/CEE, 90/269/CEE, 90/270/CEE, 90/394/CEE, 90/679/CEE, 93/88/CEE, 97/42/CEE e 1999/38/CE riguardanti il miglioramento della sicurezza e della salute dei lavoratori durante il lavoro.Google Scholar