CHICAGO (May 6, 2014) – Surgical site infections (SSIs) are the most common and costly healthcare-associated infection (HAI) in the United States. New evidence-based recommendations provide a framework for healthcare institutions to prioritize and implement strategies to reduce the number of infections.
The guidelines are published in the June issue of Infection Control and Hospital Epidemiology and were produced in a collaborative effort led by the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, the American Hospital Association, the Association for Professionals in Infection Control and Epidemiology, and The Joint Commission. The new practice recommendations are a part of Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates.
SSIs occur in as many as five percent of patients undergoing inpatient surgery, amounting to approximately 160,000-300,000 SSI cases each year in the U.S. However, as many as 60 percent of SSIs are preventable by using evidence-based guidelines. Each case is associated with at least seven days of prolonged hospitalization, accounting for at least $3.5 billion in healthcare expenditures annually.
"The evidence-based recommendations released today are broader and more inclusive than other clinical guidelines and include 15 strategies for prevention that go beyond standard practices required by the government or other national organizations," said Deverick Anderson, MD, MPH, co-lead author of the guidelines.
"Formal recommendations can be limited if they rely exclusively on randomized control trial supporting data," said Keith Kaye, MD, MPH, co-lead author of the guidelines. "The current Compendium details strategies that incorporate information from a wider variety of study designs to emulate "real world" scenarios in order to provide practical recommendations for SSI prevention and surveillance."
Below are key strategies included in the guidance:
- Antimicrobial pre-and-post operative therapy: Healthcare professionals should adhere to appropriate antimicrobial prescribing
- Preparation and monitoring protocols: Following protocols for proper hair removal, preoperative skin disinfection, and control of blood glucose levels in cardiac patients provides additional methods to help reduce SSIs.
- Postoperative surveillance: Because the indirect method of SSI surveillance is both reliable and specific, healthcare professionals are urged to use this approach and review microbiology reports, patient medical records, surgeon and patient surveys, and screen for readmission or return to the operating room in an effort to prevent SSIs.
The updated guidelines include a special section on implementation, emphasizing a team-based approach to prevention. These activities include engaging a multidisciplinary team that includes senior leadership and a champion physician in a culture of safety; educating surgical teams, senior leadership, and patients and families on prevention techniques; executing with a focus on reducing barriers and improving adherence with evidence-based practices to lower the risk of SSIs; and evaluating tools, practices and long-term SSI rates.
The 2014 Compendium released today updates the initial 2008 Compendium publication.
Deverick Anderson, Kelly Podgornny, Sandra Berrios-Torres, Dale Bratzler, Patchen Dellinger, Linda Greene, Ann-Christine Nyquist, Lisa Saiman, Deborah Yokoe, Lisa Maragakis, Keith Kaye. "Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update." Infection Control and Hospital Epidemiology 35:6 (June 2014)
Published through a partnership between the Society for Healthcare Epidemiology of America and The University of Chicago Press, Infection Control and Hospital Epidemiology provides original, peer-reviewed scientific articles for anyone involved with an infection control or epidemiology program in a hospital or healthcare facility. ICHE is ranked 13 out of 158 journals in its discipline in the latest Web of Knowledge Journal Citation Reports from Thomson Reuters.
About the Society for Healthcare Epidemiology of America
SHEA is a professional society representing more than 2,000 physicians and other healthcare professionals globally with expertise in and passion for healthcare epidemiology and infection prevention. SHEA's mission is to prevent and control healthcare-associated infections and advance the field of healthcare epidemiology. The society promotes science and research, develops expert guidelines and guidance for healthcare workers, provides high-quality education, promotes antimicrobial stewardship, encourages transparency in public reporting related to HAIs, works to ensure a safe healthcare environment, and facilitates the exchange of knowledge. SHEA upholds the value and critical contributions of healthcare epidemiology to improving patient care and healthcare worker safety in all healthcare settings. Visit SHEA online at http://www.shea-online.org, http://www.facebook.com/SHEApreventingHAIs and @SHEA_Epi.
About the Infectious Diseases Society of America
The Infectious Diseases Society of America (IDSA) is an organization of physicians, scientists, and other health care professionals dedicated to promoting health through excellence in infectious diseases research, education, prevention, and patient care. The Society, which has more than 10,000 members, was founded in 1963 and is based in Arlington, VA. For more information, see http://www.idsociety.org.
About the American Hospital Association
The AHA is a not-for-profit association of health care provider organizations and individuals that are committed to the improvement of health in their communities. The AHA is the national advocate for its members, which include nearly 5,000 hospitals, health care systems, networks and other providers of care. Founded in 1898, the AHA provides education for health care leaders and is a source of information on health care issues and trends. For more information visit the website at http://www.aha.org.
About the Association for Professionals in Infection Control and Epidemiology
APIC's mission is to create a safer world through prevention of infection. The association's more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at http://www.apic.org. Follow APIC on Twitter: http://twitter.com/apic and Facebook: http://www.facebook.com/APICInfectionPreventionandYou. For information on what patients and families can do, visit APIC's Infection Prevention and You website at http://www.apic.org/infectionpreventionandyou.
About The Joint Commission
Founded in 1951, The Joint Commission seeks to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value. The Joint Commission evaluates and accredits more than 20,000 health care organizations and programs in the United States, including more than 10,300 hospitals and home care organizations, and more than 6,500 other health care organizations that provide nursing and rehabilitation center care, behavioral health care, laboratory and ambulatory care services. The Joint Commission currently certifies more than 2,000 disease-specific care programs, focused on the care of patients with chronic illnesses such as stroke, joint replacement, stroke rehabilitation, heart failure and many others. The Joint Commission also provides health care staffing services certification for more than 750 staffing offices. An independent, not-for-profit organization, The Joint Commission is the nation's oldest and largest standards-setting and accrediting body in health care. Learn more about The Joint Commission at http://www.jointcommission.org.
Journal
Infection Control and Hospital Epidemiology