Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project
Abstract Background Surgical site infection (SSI) after acute hip fracture surgery is a devastating complication associated with increased suffering and mortality. The aim of the study was to investigate early SSI, sepsis, pneumonia and urinary tract infections over five years, before and after the...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | Antimicrobial Resistance and Infection Control |
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| Online Access: | https://doi.org/10.1186/s13756-022-01153-4 |
| _version_ | 1811211525433589760 |
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| author | Annette Erichsen Andersson Brigid M. Gillespie Magnus Karlsson Henrik Malchau Bengt Nellgård Ewa Wikström Cecilia Rogmark Jonatan Tillander |
| author_facet | Annette Erichsen Andersson Brigid M. Gillespie Magnus Karlsson Henrik Malchau Bengt Nellgård Ewa Wikström Cecilia Rogmark Jonatan Tillander |
| author_sort | Annette Erichsen Andersson |
| collection | DOAJ |
| description | Abstract Background Surgical site infection (SSI) after acute hip fracture surgery is a devastating complication associated with increased suffering and mortality. The aim of the study was to investigate early SSI, sepsis, pneumonia and urinary tract infections over five years, before and after the implementation of the Safe Hands project. Methods This was a single-centre observational study with a 5-year longitudinal design, investigating the effects of an infection-prevention intervention targeting the clinical care pathway of individuals with acute hip fracture. Statistical analyses were based on routinely collected patient outcome data comprising 3553 patients. The study conforms to the criteria of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Results The incidence of early SSIs decreased from 2.5% in years 1–2 to 1.1% in years 4–5. Similar results were observed for sepsis (2.7% to 1.3%) and urinary tract infections (14.2% to 4.2%). The multivariable regression results suggest that, for every observed year, the odds of early SSIs decreased. Male gender, procedure time, sepsis and preoperative skin damage increased the odds significantly. Conclusions Our preventive bundle, based on partnership between researchers, managers and clinicians and a strong commitment to change from the involved professions, appear to be effective in reducing the frequency of potentially devastating SSIs and other hospital acquired infections after hip fracture surgery. The use of external and internal facilitators was crucial to enable individual and organisational learning and overcoming barriers to improvements. Trial registration: Clinical Trials.gov ID: NCT02983136 Registered 6 December 2016—Retrospectively registered. |
| first_indexed | 2024-04-12T05:15:33Z |
| format | Article |
| id | doaj.art-0d6f7b24ab944af18d7ec621ce49c2ab |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-04-12T05:15:33Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-0d6f7b24ab944af18d7ec621ce49c2ab2022-12-22T03:46:38ZengBMCAntimicrobial Resistance and Infection Control2047-29942022-09-0111111010.1186/s13756-022-01153-4Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands projectAnnette Erichsen Andersson0Brigid M. Gillespie1Magnus Karlsson2Henrik Malchau3Bengt Nellgård4Ewa Wikström5Cecilia Rogmark6Jonatan Tillander7Institute of Health Care Sciences, Sahlgrenska Academy, University of GothenburgNHMRC Centre of Research Excellence in Wiser Wounds, Menzies Health Institute, Queensland, Griffith University & Gold Coast University Hospital and Health ServiceDepartment of Orthopedics, Sahlgrenska University HospitalDepartment of Orthopedics, Sahlgrenska University HospitalDepartment of Anesthesiology and Intensive Care Medicine, Sahlgrenska University HospitalDepartment of Business Administration, School of Business, Economics and Law, University of GothenburgDepartment of Orthopedics, Skane University Hospital, Lund UniversityDepartment of Infectious Diseases, Sahlgrenska University HospitalAbstract Background Surgical site infection (SSI) after acute hip fracture surgery is a devastating complication associated with increased suffering and mortality. The aim of the study was to investigate early SSI, sepsis, pneumonia and urinary tract infections over five years, before and after the implementation of the Safe Hands project. Methods This was a single-centre observational study with a 5-year longitudinal design, investigating the effects of an infection-prevention intervention targeting the clinical care pathway of individuals with acute hip fracture. Statistical analyses were based on routinely collected patient outcome data comprising 3553 patients. The study conforms to the criteria of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Results The incidence of early SSIs decreased from 2.5% in years 1–2 to 1.1% in years 4–5. Similar results were observed for sepsis (2.7% to 1.3%) and urinary tract infections (14.2% to 4.2%). The multivariable regression results suggest that, for every observed year, the odds of early SSIs decreased. Male gender, procedure time, sepsis and preoperative skin damage increased the odds significantly. Conclusions Our preventive bundle, based on partnership between researchers, managers and clinicians and a strong commitment to change from the involved professions, appear to be effective in reducing the frequency of potentially devastating SSIs and other hospital acquired infections after hip fracture surgery. The use of external and internal facilitators was crucial to enable individual and organisational learning and overcoming barriers to improvements. Trial registration: Clinical Trials.gov ID: NCT02983136 Registered 6 December 2016—Retrospectively registered.https://doi.org/10.1186/s13756-022-01153-4Surgical site infectionsHip fractureHip surgeryInfection preventionImplementation researchKnowledge translation |
| spellingShingle | Annette Erichsen Andersson Brigid M. Gillespie Magnus Karlsson Henrik Malchau Bengt Nellgård Ewa Wikström Cecilia Rogmark Jonatan Tillander Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project Antimicrobial Resistance and Infection Control Surgical site infections Hip fracture Hip surgery Infection prevention Implementation research Knowledge translation |
| title | Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project |
| title_full | Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project |
| title_fullStr | Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project |
| title_full_unstemmed | Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project |
| title_short | Reduction of early surgical site and other care related infections in 3553 hip fracture patients: lessons learned from the 5-year Safe Hands project |
| title_sort | reduction of early surgical site and other care related infections in 3553 hip fracture patients lessons learned from the 5 year safe hands project |
| topic | Surgical site infections Hip fracture Hip surgery Infection prevention Implementation research Knowledge translation |
| url | https://doi.org/10.1186/s13756-022-01153-4 |
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