1234. Mental Models of Surgical Site Infection Prevention Among Surgical Technicians and Nurses

BACKGROUND: Surgical site infections (SSI) are common and costly. Institutions have implemented complex prevention bundles to reduce SSI, but adherence remains challenging. Understanding clinicians’ mental models related to SSI prevention can help develop strategies to improve adherence. METHODS: We conducted focus groups with surgical clinicians at a tertiary care center. We used constructs from behavior change theories to analyze responses and identify relevant themes for SSI prevention. RESULTS: We had 19 participants (10 nurses, 9 surgical technicians) in 4 focus groups. We found the following SSI prevention challenges: (1) emphasis on rapid patient turnover, which impairs ability to complete all required infection control tasks; (2) OR crowding and traffic, with increased risk to sterile technique breaks; (3) poor compliance with OR attire, including wearing scrubs outside of the hospital; (4) inadequate OR cleaning between cases; (5) lack of emphasis on post-discharge wound care instructions. The following beliefs were commonly expressed: (1) belief that some SSI are inevitable, due to increased complexity and duration of surgical procedures in a referral center; (2) perceived lack of knowledge and training on OR sterile technique among medical and nursing students; (3) perceived incorrect techniques for applying skin preps among surgical residents, and, occasionally, attendings; (4) fear and hesitancy to bring up OR irregularities if individual involved is perceived as having a “difficult personality,” irrespective of social hierarchy; (5) feeling overwhelmed by too many requirements for SSI prevention, which frequently change; (6) belief that some policies originate from outside influences and are not relevant to frontline clinicians; (7) frustration to receiving SSI performance feedback that is not individualized and lacks actionable items; (8) feeling “blamed” for having SSI without knowing “how to fix it”; (9) belief that training rigor and dedication to patient care have decreased over time, and are lax among younger generations. Representative quotes categorized according to behavior change constructs are shown in Table 1. CONCLUSION: Addressing clinicians’ perceptions of SSI prevention may help improve adherence to the process and reduce SSI incidence. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.