Over one third of post-operative deaths are related, in part at least, to surgical site infections. KATE WOODHEAD RGN DMS looks at the latest clinical guidelines and recommendations aimed at reducing harm to patients.
A recent report by the National Audit Office1, which follows previous reviews of progress in the fight to reduce healthcareassociated infections (HCAIs), has made a variety of further recommendations for all practitioners to concentrate their efforts. Despite enormous progress made on reducing harm to patients over the last few years, there is still more that can be done. One of the recommendations made within the report is that further action should be made to implement a mandatory surveillance reporting system relating to surgical site infections (among others), which constitute 14% of all HCAIs. The report identifies that the surveillance should be based on a transparent assessment of local risk factors with support and guidance by local Health Protection Units, analysed and fed back to Trusts. Trusts should ensure that clinical teams respond to the feedback and records should be made of changes to practice.
NICE clinical guideline
Clinical guidelines have been developed by the National Institute for Health and Clinical Excellence (NICE) as “systematically developed statements which assist clinicians and patients in making decisions about appropriate treatment for specific conditions.” Clinical guideline 74 has been developed to provide guidance on all the perioperative phases of the patients’ journey through surgery. The guideline was published in October 2008 and is entitled: Surgical site infection: prevention and treatment of surgical site infection.2 Recommendations are, as expected, based on extensive review of available evidence particularly randomised control trials and other well designed, high level research. A short review of the recommendations is undertaken, here, to highlight to surgical and infection control teams the necessary actions and basis for future audit of changing practice. It should be read by all surgeons in training, surgeons and theatre team members and its recommendations implemented. Helpfully, NICE has also produced an audit tool that sits beside the clinical guideline.3
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