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Adhering to a national surgical care bundle reduces the risk of surgical site infections

BACKGROUND: In 2008, a bundle of care to prevent Surgical Site Infections (SSIs) was introduced in the Netherlands. The bundle consisted of four elements: antibiotic prophylaxis according to local guidelines, no hair removal, normothermia and ‘hygiene discipline’ in the operating room (i.e. number o...

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Autores principales: Koek, Mayke B. G., Hopmans, Titia E. M., Soetens, Loes C., Wille, Jan C., Geerlings, Suzanne E., Vos, Margreet C., van Benthem, Birgit H. B., de Greeff, Sabine C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587118/
https://www.ncbi.nlm.nih.gov/pubmed/28877223
http://dx.doi.org/10.1371/journal.pone.0184200
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author Koek, Mayke B. G.
Hopmans, Titia E. M.
Soetens, Loes C.
Wille, Jan C.
Geerlings, Suzanne E.
Vos, Margreet C.
van Benthem, Birgit H. B.
de Greeff, Sabine C.
author_facet Koek, Mayke B. G.
Hopmans, Titia E. M.
Soetens, Loes C.
Wille, Jan C.
Geerlings, Suzanne E.
Vos, Margreet C.
van Benthem, Birgit H. B.
de Greeff, Sabine C.
author_sort Koek, Mayke B. G.
collection PubMed
description BACKGROUND: In 2008, a bundle of care to prevent Surgical Site Infections (SSIs) was introduced in the Netherlands. The bundle consisted of four elements: antibiotic prophylaxis according to local guidelines, no hair removal, normothermia and ‘hygiene discipline’ in the operating room (i.e. number of door movements). Dutch hospitals were advised to implement the bundle and to measure the outcome. This study’s goal was to assess how effective the bundle was in reducing SSI risk. METHODS: Hospitals assessed whether their staff complied with each of the bundle elements and voluntary reported compliance data to the national SSI surveillance network (PREZIES). From PREZIES data, we selected data from 2009 to 2014 relating to 13 types of surgical procedures. We excluded surgeries with missing (non)compliance data, and calculated for each remaining surgery with reported (non)compliance data the level of compliance with the bundle (that is, being compliant with 0, 1, 2, 3, or 4 of the elements). Subsequently, we used this level of compliance to assess the effect of bundle compliance on the SSI risk, using multilevel logistic regression techniques. RESULTS: 217 489 surgeries were included, of which 62 486 surgeries (29%) had complete bundle reporting. Within this group, the SSI risk was significantly lower for surgeries with complete bundle compliance compared to surgeries with lower compliance levels. Odds ratios ranged from 0.63 to 0.86 (risk reduction of 14% to 37%), while a 13% risk reduction was demonstrated for each point increase in compliance-level. Sensitivity analysis indicated that due to analysing reported bundles only, we probably underestimated the total effect of implementing the bundle. CONCLUSIONS: This study demonstrated that adhering to a surgical care bundle significantly reduced the risk of SSIs. Reporting of and compliance with the bundle compliance can, however, still be improved. Therefore an even greater effect might be achieved.
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spelling pubmed-55871182017-09-15 Adhering to a national surgical care bundle reduces the risk of surgical site infections Koek, Mayke B. G. Hopmans, Titia E. M. Soetens, Loes C. Wille, Jan C. Geerlings, Suzanne E. Vos, Margreet C. van Benthem, Birgit H. B. de Greeff, Sabine C. PLoS One Research Article BACKGROUND: In 2008, a bundle of care to prevent Surgical Site Infections (SSIs) was introduced in the Netherlands. The bundle consisted of four elements: antibiotic prophylaxis according to local guidelines, no hair removal, normothermia and ‘hygiene discipline’ in the operating room (i.e. number of door movements). Dutch hospitals were advised to implement the bundle and to measure the outcome. This study’s goal was to assess how effective the bundle was in reducing SSI risk. METHODS: Hospitals assessed whether their staff complied with each of the bundle elements and voluntary reported compliance data to the national SSI surveillance network (PREZIES). From PREZIES data, we selected data from 2009 to 2014 relating to 13 types of surgical procedures. We excluded surgeries with missing (non)compliance data, and calculated for each remaining surgery with reported (non)compliance data the level of compliance with the bundle (that is, being compliant with 0, 1, 2, 3, or 4 of the elements). Subsequently, we used this level of compliance to assess the effect of bundle compliance on the SSI risk, using multilevel logistic regression techniques. RESULTS: 217 489 surgeries were included, of which 62 486 surgeries (29%) had complete bundle reporting. Within this group, the SSI risk was significantly lower for surgeries with complete bundle compliance compared to surgeries with lower compliance levels. Odds ratios ranged from 0.63 to 0.86 (risk reduction of 14% to 37%), while a 13% risk reduction was demonstrated for each point increase in compliance-level. Sensitivity analysis indicated that due to analysing reported bundles only, we probably underestimated the total effect of implementing the bundle. CONCLUSIONS: This study demonstrated that adhering to a surgical care bundle significantly reduced the risk of SSIs. Reporting of and compliance with the bundle compliance can, however, still be improved. Therefore an even greater effect might be achieved. Public Library of Science 2017-09-06 /pmc/articles/PMC5587118/ /pubmed/28877223 http://dx.doi.org/10.1371/journal.pone.0184200 Text en © 2017 Koek et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Koek, Mayke B. G.
Hopmans, Titia E. M.
Soetens, Loes C.
Wille, Jan C.
Geerlings, Suzanne E.
Vos, Margreet C.
van Benthem, Birgit H. B.
de Greeff, Sabine C.
Adhering to a national surgical care bundle reduces the risk of surgical site infections
title Adhering to a national surgical care bundle reduces the risk of surgical site infections
title_full Adhering to a national surgical care bundle reduces the risk of surgical site infections
title_fullStr Adhering to a national surgical care bundle reduces the risk of surgical site infections
title_full_unstemmed Adhering to a national surgical care bundle reduces the risk of surgical site infections
title_short Adhering to a national surgical care bundle reduces the risk of surgical site infections
title_sort adhering to a national surgical care bundle reduces the risk of surgical site infections
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587118/
https://www.ncbi.nlm.nih.gov/pubmed/28877223
http://dx.doi.org/10.1371/journal.pone.0184200
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