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Achieving a sustained reduction in SSIs

Mr Simon R Dodds, a consultant general surgeon, at University Hospitals Birmingham, provides an insight into how a successful improvement initiative achieved a sustained 80% reduction in surgical site infection using a care bundle.

The pioneering work of Lord Lister, over 100 years ago, led to the adoption of aseptic techniques that make surgical procedures safer and more accessible to all. Despite the stringent aseptic protocols, surgical site infections (SSIs) still account for about 20% of hospital-acquired infections. In clean surgery, the primary reason is that surgical wounds are contaminated with the patient’s own skin bacteria. We continue to strive to reduce SSIs to near zero. Many approaches have been explored using multiple randomised controlled trials (RCTs) but no single intervention has been shown to be a clear game-changer. One plausible cause for this is that SSIs are multi-factorial, so addressing one factor at a time appears ineffective.

Over the last 25 years, there has been a steady rise in the adoption of continuous improvement methods, which differ from RCTs in that they are more pragmatic and use a before-and-after approach of measuring a baseline, introducing a plausible intervention, and observing the effect. This is called a ‘Context-MethodObservation’ (CMO) approach.1

In 2012, the US Institute of Healthcare Improvement (IHI) published a white paper that shared robust evidence of the benefits of an intervention called a ‘bundle of care’. The evidence came from studies in critical care where the risk of ventilator-acquired pneumonia had been dramatically reduced.2

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Upcoming Events

IP2022 IS COMING TO BOURNEMOUTH IN OCTOBER 2022

Bournemouth
17-19 October 2022

UKHCA Conference: Listen Up

Pendulum Hotel and Manchester Conference Centre, Manchester
3rd November 2022

MEDICA 2022

Dusseldorf Germany
14th November - 17th November

Future Surgery 2022

ExCel, London
15th - 16th November 2022

IDSc Annual Conference

The Eastside Rooms, Birmingham
29th - 30th November 2022

Access the latest issue of Clinical Services Journal on your mobile device together with an archive of back issues.

Download the FREE Clinical Services Journal app from your device's App store

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