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Implementation strategies to reduce surgical site infections: A systematic review

Published online by Cambridge University Press:  21 February 2019

Promise Ariyo Open the ORCID record for Promise Ariyo [Opens in a new window] ,
Bassem Zayed ,
Victoria Riese ,
Blair Anton ,
Asad Latif ,
Claire Kilpatrick ,
Benedetta Allegranzi  and
Sean Berenholtz
Promise Ariyo*
Affiliation:
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
Bassem Zayed
Affiliation:
Antimicrobial Resistance and Infection Control Team, WHO Regional Office for Eastern Mediterranean, Cairo, Egypt
Victoria Riese
Affiliation:
Welch Medical Library, Johns Hopkins University, School of Medicine, Baltimore, Maryland, United States
Blair Anton
Affiliation:
Welch Medical Library, Johns Hopkins University, School of Medicine, Baltimore, Maryland, United States
Asad Latif
Affiliation:
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
Claire Kilpatrick
Affiliation:
Infection Prevention and Control Global Unit, Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
Benedetta Allegranzi
Affiliation:
Infection Prevention and Control Global Unit, Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland
Sean Berenholtz
Affiliation:
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
*
Author for correspondence: Promise Ariyo, Email: pariyo1@jhmi.edu
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Abstract

Background:

Surgical site infections (SSIs) portend high patient morbidity and mortality. Although evidence-based clinical interventions can reduce SSIs, they are not reliably delivered in practice, and data are limited on the best approach to improve adherence.

Objective:

To summarize implementation strategies aimed at improving adherence to evidence-based interventions that reduce SSIs.

Design:

Systematic review

Methods:

We searched PubMed, Embase, CINAHL, the Cochrane Library, the WHO Regional databases, AFROLIB, and Africa-Wide for studies published between January 1990 and December 2015. The Effective Practice and Organization Care (EPOC) criteria were used to identify an acceptable-quality study design. We used structured forms to extract data on implementation strategies and grouped them into an implementation model called the “Four Es” framework (ie, engage, educate, execute, and evaluate).

Results:

In total, 125 studies met our inclusion criteria, but only 8 studies met the EPOC criteria, which limited our ability to identify best practices. Most studies used multifaceted strategies to improve adherence with evidence-based interventions. Engagement strategies included multidisciplinary work and strong leadership involvement. Education strategies included various approaches to introduce evidence-based practices to clinicians and patients. Execution strategies standardized the interventions into simple tasks to facilitate uptake. Evaluation strategies assessed adherence with evidence-based interventions and patient outcomes, providing feedback of performance to providers.

Conclusions:

Multifaceted implementation strategies represent the most common approach to facilitating the adoption of evidence-based practices. We believe that this summary of implementation strategies complements existing clinical guidelines and may accelerate efforts to reduce SSIs.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 3 , March 2019 , pp. 287 - 300
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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References

Kirkland, KB, Briggs, JP, Trivette, SL, Wilkinson, WE, Sexton, DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999;20:725–730.CrossRefGoogle ScholarPubMed
Gaynes, RP, Culver, DH, Horan, TC, Edwards, JR, Richards, C, Tolson, JS. Surgical site infection (SSI) rates in the United States, 1992–1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis 2001;33 Suppl 2:S69–S77.CrossRefGoogle ScholarPubMed
Report on the Burden of Endemic Health Care-Associated Infection Worldwide. World Health Organization website. http://apps.who.int.ezp.welch.jhmi.edu/iris/bitstream/10665/80135/1/9789241501507_eng.pdf. Published 2011. Accessed July 2017.Google Scholar
Allegranzi, B, Bagheri Nejad, S, Combescure, C, et al. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 2011;377:228–241.CrossRefGoogle ScholarPubMed
Graf, K, Ott, E, Vonberg, RP, et al. Surgical site infections--economic consequences for the health care system. Langenbecks Arch Surg 2011;396:453–459.CrossRefGoogle ScholarPubMed
de Lissovoy, G, Fraeman, K, Hutchins, V, Murphy, D, Song, D, Vaughn, BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009;37:387–397.CrossRefGoogle ScholarPubMed
European Centre for Disease Prevention and Control. Healthcare-associated infections: surgical site infections. In: ECDC. Annual epidemiological report for 2015. Stockholm: ECDC; 2017.Google Scholar
Berrios-Torres, SI, Umscheid, CA, Bratzler, DW, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg 2017;152:784–791.CrossRefGoogle ScholarPubMed
Global Guidelines on the prevention of surgical site infection, 2016. World Health Organization website. http://www.who.int/infection-prevention/publications/ssi-prevention-guidelines/en/. Published 2016. Accessed August 23, 2017.Google Scholar
Allegranzi, B, Zayed, B, Bischoff, P, et al. New WHO recommendations on intraoperative and postoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis 2016;16:e288–e303.CrossRefGoogle ScholarPubMed
Allegranzi, B, Bischoff, P, de Jonge, S, et al. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis 2016;16:e276–e287.CrossRefGoogle ScholarPubMed
Guidelines for safe surgery, 2009. World Health Organization website. http://apps.who.int/iris/bitstream/handle/10665/44185/9789241598552_eng.pdf?sequence=1&isAllowed=y. Published 2009. Accessed December 15, 2018.Google Scholar
Davis, D, Evans, M, Jadad, A, et al. The case for knowledge translation: shortening the journey from evidence to effect. BMJ 2003;327:33–35.CrossRefGoogle Scholar
Pronovost, PJ, Murphy, DJ, Needham, DM. The science of translating research into practice in intensive care. Am J Respir Crit Care Med 2010;182:1463–1464.CrossRefGoogle ScholarPubMed
Leaper, DJ, Tanner, J, Kiernan, M, Assadian, O, Edmiston, CE Jr. Surgical site infection: poor compliance with guidelines and care bundles. Int Wound J 2015;12:357–362.CrossRefGoogle ScholarPubMed
Grol, R. Improving the quality of medical care: building bridges among professional pride, payer profit, and patient satisfaction. JAMA 2001;286:2578–2585.CrossRefGoogle ScholarPubMed
Gagliardi, AR, Brouwers, MC, Palda, VA, Lemieux-Charles, L, Grimshaw, JM. How can we improve guideline use? A conceptual framework of implementability. Implement Sci 2011;6:26.CrossRefGoogle ScholarPubMed
Pronovost, PJ, Berenholtz, SM, Needham, DM. Translating evidence into practice: a model for large scale knowledge translation. BMJ 2008;337:a1714.CrossRefGoogle ScholarPubMed
Pronovost, P, Needham, D, Berenholtz, S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006;355:2725–2732.CrossRefGoogle ScholarPubMed
DePalo, VA, McNicoll, L, Cornell, M, Rocha, JM, Adams, L, Pronovost, PJ. The Rhode Island ICU collaborative: a model for reducing central line-associated bloodstream infection and ventilator-associated pneumonia statewide. Qual Saf Health Care 2010;19:555–561.Google ScholarPubMed
Hong, AL, Sawyer, MD, Shore, A, et al. Decreasing central-line-associated bloodstream infections in Connecticut intensive care units. J Healthc Qual 2013;35:78–87.CrossRefGoogle ScholarPubMed
Berenholtz, SM, Pham, JC, Thompson, DA, et al. Collaborative cohort study of an intervention to reduce ventilator-associated pneumonia in the intensive care unit. Infect Control Hosp Epidemiol 2011;32:305–314.CrossRefGoogle ScholarPubMed
Berenholtz, SM, Lubomski, LH, Weeks, K, et al. Eliminating central line-associated bloodstream infections: a national patient safety imperative. Infect Control Hosp Epidemiol 2014;35:56–62.CrossRefGoogle ScholarPubMed
Streiff, MB, Carolan, HT, Hobson, DB, et al. Lessons from the Johns Hopkins Multi-Disciplinary Venous Thromboembolism (VTE) Prevention Collaborative. BMJ 2012;344:e3935.CrossRefGoogle Scholar
Needham, DM, Korupolu, R, Zanni, JM, et al. Early physical medicine and rehabilitation for patients with acute respiratory failure: a quality improvement project. Arch Phys Med Rehabil 2010;91:536–542.CrossRefGoogle ScholarPubMed
Septimus, E, Yokoe, DS, Weinstein, RA, Perl, TM, Maragakis, LL, Berenholtz, SM. Maintaining the momentum of change: the role of the 2014 updates to the compendium in preventing healthcare-associated infections. Infect Control Hosp Epidemiol 2014;35 Suppl 2:S6–S9.CrossRefGoogle ScholarPubMed
Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250–280.CrossRefGoogle ScholarPubMed
World Bank countries and lending groups. World Bank website. http://data.worldbank.org/income-level/low-income. Published 2015. Accessed August 21, 2018.Google Scholar
What study designs should be included in an EPOC review? EPOC resources for review authors, 2017. Cochrane Effective Practice and Organization of Care (EPOC) website. http://epoc.cochrane.org/resources/epoc-resources-review-authors. Published July 2017. Accessed December 2018.Google Scholar
Toor, AA, Farooka, MW, Ayyaz, M, Sarwar, H, Malik, AA, Shabbir, F. Pre-operative antibiotic use reduces surgical site infection. J Pak Med Assoc 2015;65:733–736.Google ScholarPubMed
van Kasteren, ME, Mannien, J, Kullberg, BJ, et al. Quality improvement of surgical prophylaxis in Dutch hospitals: evaluation of a multi-site intervention by time series analysis. J Antimicrob Chemother 2005;56:1094–1102.CrossRefGoogle ScholarPubMed
Wilson, AP, Hodgson, B, Liu, M, et al. Reduction in wound infection rates by wound surveillance with postdischarge follow-up and feedback. Br J Surg 2006;93:630–638.CrossRefGoogle Scholar
Adler, AL, Martin, ET, Cohen, G, et al. A comprehensive intervention associated with reduced surgical site infections among pediatric cardiovascular surgery patients, including those with delayed closure. J Pediatric Infect Dis Soc 2012;1:35–43.CrossRefGoogle ScholarPubMed
Ballard, MR, Miller, NH, Nyquist, AC, Elise, B, Baulesh, DM, Erickson, MA. A multidisciplinary approach improves infection rates in pediatric spine surgery. J Pediatr Orthop 2012;32:266–270.CrossRefGoogle ScholarPubMed
Dimopoulou, A, Kourlaba, G, Psarris, A, Coffin, S, Spoulou, V, Zaoutis, T. Perioperative antimicrobial prophylaxis in pediatric patients in Greece: compliance with guidelines and impact of an educational intervention. J Pediatr Surg 2015;51:1307–1311.CrossRefGoogle ScholarPubMed
Izquierdo-Blasco, J, Campins-Marti, M, Soler-Palacin, P, et al. Impact of the implementation of an interdisciplinary infection control program to prevent surgical wound infection in pediatric heart surgery. Eur J Pediatr 2015;174:957–963.CrossRefGoogle ScholarPubMed
Jenkins, KJ, Castaneda, AR, Cherian, KM, et al. Reducing mortality and infections after congenital heart surgery in the developing world. Pediatrics 2014;134:e1422–e1430.CrossRefGoogle ScholarPubMed
Kelly, RE Jr, Wenger, A, Horton, C Jr, Nuss, D, Croitoru, DP, Pestian, JP. The effects of a pediatric unilateral inguinal hernia clinical pathway on quality and cost. J Pediatr Surg 2000;35:1045–1048.CrossRefGoogle ScholarPubMed
Murray, MT, Corda, R, Turcotte, R, Bacha, E, Saiman, L, Krishnamurthy, G. Implementing a standardized perioperative antibiotic prophylaxis protocol for neonates undergoing cardiac surgery. Ann Thorac Surg 2014;98:927–933.CrossRefGoogle ScholarPubMed
Nayar, V, Kennedy, A, Pappas, J, et al. Improving cardiac surgical site infection reporting and prevention by using registry data for case ascertainment. Ann Thorac Surg 2016;101:190–199.CrossRefGoogle ScholarPubMed
Ryan, SL, Sen, A, Staggers, K, Luerssen, TG, Jea, A. A standardized protocol to reduce pediatric spine surgery infection: a quality improvement initiative. J Neurosurg Pediatr 2014;14:259–265.CrossRefGoogle ScholarPubMed
Ryckman, FC, Schoettker, PJ, Hays, KR, et al. Reducing surgical site infections at a pediatric academic medical center. Jt Comm J Qual Patient Saf 2009;35:192–198.CrossRefGoogle Scholar
Schaffzin, JK, Harte, L, Marquette, S, et al. Surgical site infection reduction by the solutions for patient safety hospital engagement network. Pediatrics 2015;136:e1353–e1360.CrossRefGoogle ScholarPubMed
Schonmeyr, B, Restrepo, C, Wendby, L, Gillenwater, J, Campbell, A. Lessons learned from two consecutive cleft lip and palate missions and the impact of patient education. J Craniofac Surg 2014;25:1610–1613.CrossRefGoogle ScholarPubMed
Toltzis, P, O’Riordan, M, Cunningham, DJ, et al. A statewide collaborative to reduce pediatric surgical site infections. Pediatrics 2014;134:e1174–e1180.CrossRefGoogle ScholarPubMed
Woodward, CS, Son, M, Taylor, R, Husain, SA. Prevention of sternal wound infection in pediatric cardiac surgery: a protocolized approach. World J Pediatr Congenit Heart Surg 2012;3:463–469.CrossRefGoogle ScholarPubMed
Chien, CY, Lin, CH, Hsu, RB. Care bundle to prevent methicillin-resistant Staphylococcus aureus sternal wound infection after off-pump coronary artery bypass. Am J Infect Control 2014;42:562–564.CrossRefGoogle ScholarPubMed
Haycock, C, Laser, C, Keuth, J, et al. Implementing evidence-based practice findings to decrease postoperative sternal wound infections following open heart surgery. J Cardiovasc Nurs 2005;20:299–305.CrossRefGoogle ScholarPubMed
Hannan, MM, O’ullivan, KE, Higgins, AM, et al. The combined impact of surgical team education and chlorhexidine 2% alcohol on the reduction of surgical site infection following cardiac surgery. Surg Infect 2015;16:799–805.CrossRefGoogle ScholarPubMed
Hogle, NJ, Cohen, B, Hyman, S, Larson, E, Fowler, DL. Incidence and risk factors for and the effect of a program to reduce the incidence of surgical site infection after cardiac surgery. Surg Infect 2014;15:299–304.CrossRefGoogle ScholarPubMed
Kles, CL, Murrah, CP, Smith, K, Baugus-Wellmeier, E, Hurry, T, Morris, CD. Achieving and sustaining zero: preventing surgical site infections after isolated coronary artery bypass with saphenous vein harvest site through implementation of a staff-driven quality improvement process. Dimens Crit Care Nurs 2015;34:265–272.CrossRefGoogle ScholarPubMed
Lindblom, RP, Lytsy, B, Sandstrom, C, et al. Outcomes following the implementation of a quality control campaign to decrease sternal wound infections after coronary artery by-pass grafting. BMC Cardiovasc Disord 2015;15:154.CrossRefGoogle ScholarPubMed
Lutarewych, M, Morgan, SP, Hall, MM. Improving outcomes of coronary artery bypass graft infections with multiple interventions: putting science and data to the test. Infect Control Hosp Epidemiol 2004;25:517–519.CrossRefGoogle ScholarPubMed
Miyahara, K, Matsuura, A, Takemura, H, Mizutani, S, Saito, S, Toyama, M. Implementation of bundled interventions greatly decreases deep sternal wound infection following cardiovascular surgery. J Thorac Cardiovasc Surg 2014;148:2381–2388.CrossRefGoogle ScholarPubMed
Rao, N, Schilling, D, Rice, J, Ridenour, M, Mook, W, Santa, E. Prevention of postoperative mediastinitis: a clinical process improvement model. J Healthc Qual 2004;26:22–28.CrossRefGoogle ScholarPubMed
Singh, S, Kumar, RK, Sundaram, KR, Kanjilal, B, Nair, P. Improving outcomes and reducing costs by modular training in infection control in a resource-limited setting. Int J Qual Health Care 2012;24:641–648.CrossRefGoogle Scholar
Trussell, J, Gerkin, R, Coates, B, et al. Impact of a patient care pathway protocol on surgical site infection rates in cardiothoracic surgery patients. Am J Surg 2008;196:883–889.CrossRefGoogle ScholarPubMed
Usry, GH, Johnson, L, Weems, JJ Jr. Blackhurst, D. Process improvement plan for the reduction of sternal surgical site infections among patients undergoing coronary artery bypass graft surgery. Am J Infect Control 2002;30:434–436.CrossRefGoogle ScholarPubMed
Schweizer, ML, Chiang, HY, Septimus, E, et al. Association of a bundled intervention with surgical site infections among patients undergoing cardiac, hip, or knee surgery. JAMA 2015;313:2162–2171.CrossRefGoogle ScholarPubMed
Walsh, EE, Greene, L, Kirshner, R. Sustained reduction in methicillin-resistant Staphylococcus aureus wound infections after cardiothoracic surgery. Arch Intern Med 2011;171:68–73.Google ScholarPubMed
Jog, S, Cunningham, R, Cooper, S, et al. Impact of preoperative screening for meticillin-resistant Staphylococcus aureus by real-time polymerase chain reaction in patients undergoing cardiac surgery. J Hosp Infect 2008;69:124–130.CrossRefGoogle ScholarPubMed
Acklin, YP, Widmer, AF, Renner, RM, Frei, R, Gross, T. Unexpectedly increased rate of surgical site infections following implant surgery for hip fractures: problem solution with the bundle approach. Injury 2011;42:209–216.CrossRefGoogle ScholarPubMed
Douglas, P, Asimus, M, Swan, J, Spigelman, A. Prevention of orthopaedic wound infections: a quality improvement project. J Qual Clin Pract 2001;21:149–153.CrossRefGoogle ScholarPubMed
Garcia-Paris, J, Cohena-Jimenez, M, Montano-Jimenez, P, Cordoba-Fernandez, A. Implementation of the WHO “Safe Surgery Saves Lives” checklist in a podiatric surgery unit in Spain: a single-center retrospective observational study. Patient Saf Surg 2015;9:29.CrossRefGoogle Scholar
Hutzler, L, Kraemer, K, Iaboni, L, Berger, N, Bosco, JA 3rd. A hospital-wide initiative to eliminate preventable causes of immediate use steam sterilization. AORN J 2013;98:597–607.CrossRefGoogle ScholarPubMed
Johnson, B, Starks, I, Bancroft, G, Roberts, PJ. The effect of care bundle development on surgical site infection after hemiarthroplasty: an 8-year review. J Trauma Acute Care Surg 2012;72:1375–1379.CrossRefGoogle ScholarPubMed
Jordan, CJ, Goldstein, RY, Michels, RF, Hutzler, L, Slover, JD, Bosco, JA 3rd. Comprehensive program reduces hospital readmission rates after total joint arthroplasty. Am J Orthop (Belle Mead NJ) 2012;41:E147–E151.Google ScholarPubMed
Kawamura, H, Matsumoto, K, Shigemi, A, et al. A bundle that includes active surveillance, contact precaution for carriers, and cefazolin-based antimicrobial prophylaxis prevents methicillin-resistant Staphylococcus aureus infections in clean orthopedic surgery. Am J Infect Control 2016;44:210–214.CrossRefGoogle ScholarPubMed
McDonald, LT, Clark, AM, Landauer, AK, Kuxhaus, L. Winning the war on surgical site infection: evidence-based preoperative interventions for total joint arthroplasty. AORN J 2015;102:182.e181–182.e111.CrossRefGoogle ScholarPubMed
Mejia, E, Williams, A, Long, M. Decreasing prosthetic joint surgical site infections: an interdisciplinary approach. AORN J 2015;101:213–222.CrossRefGoogle Scholar
Mori, C. Implementing evidence-based practice to reduce infections following arthroplasty. Orthop Nurs 2015;34:188–196.CrossRefGoogle ScholarPubMed
Morris, AJ, Panting, AL, Roberts, SA, Shuker, C, Merry, AF. A new surgical site infection improvement programme for New Zealand: early progress. N Z Med J 2015;128:51–59.Google ScholarPubMed
Rovaldi, CJ, King, PJ. The effect of an interdisciplinary QI project to reduce OR foot traffic. AORN J 2015;101:666–681.CrossRefGoogle ScholarPubMed
Sanchez-Hernandez, N, Saez-Lopez, P, Paniagua-Tejo, S, Valverde-Garcia, JA. Results following the implementation of a clinical pathway in the process of care to elderly patients with osteoporotic hip fracture in a second level hospital. Rev Esp Cir Ortop Traumatol 2016;60:1–11.Google Scholar
Sechriest, IVF, Carney, JR, Kuskowski, MA, Haffner, JL, Mullen, MJ, Covey, DC. Incidence of knee sepsis after ACL reconstruction at one institution: the impact of a clinical pathway. J Bone Joint Surg A 2013;95:843–849.CrossRefGoogle ScholarPubMed
Starčević, S, Munitlak, S, Mijović, B, Mikić, D, Suljagić, V. Surgical site infection surveillance in orthopedic patients in the military medical academy, Belgrade. Vojnosanit Pregl 2015;72:499–504.CrossRefGoogle ScholarPubMed
Boaz, M, Bermant, A, Ezri, T, et al. Effect of surgical safety checklist implementation on the occurrence of postoperative complications in orthopedic patients. Isr Med Assoc J 2014;16:20–25.Google ScholarPubMed
Rao, N, Cannella, BA, Crossett, LS, Yates, AJ Jr, McGough, RL 3rd, Hamilton, CW. Preoperative screening/decolonization for Staphylococcus aureus to prevent orthopedic surgical site infection: prospective cohort study with 2-year follow-up. J Arthroplasty 2011;26:1501–1507.CrossRefGoogle ScholarPubMed
Hadley, S, Immerman, I, Hutzler, L, Slover, J, Bosco, J. Staphylococcus aureus decolonization protocol decreases surgical site infections for total joint replacement. Arthritis 2010;2010:924518.CrossRefGoogle ScholarPubMed
Kim, DH, Spencer, M, Davidson, SM, et al. Institutional prescreening for detection and eradication of methicillin-resistant Staphylococcus aureus in patients undergoing elective orthopaedic surgery. J Bone Joint Surg Am 2010;92:1820–1826.CrossRefGoogle ScholarPubMed
Brisibe, SF, Ordinioha, B, Gbeneolol, PK. The effect of hospital infection control policy on the prevalence of surgical site infection in a tertiary hospital in South-South Nigeria. Niger Med J 2015;56:194–198.CrossRefGoogle Scholar
Bullough, L, Wilkinson, D, Burns, S, Wan, L. Changing wound care protocols to reduce postoperative caesarean section infection and readmission. Wounds UK 2014;10:84–89.Google Scholar
Corcoran, S, Jackson, V, Coulter-Smith, S, Loughrey, J, McKenna, P, Cafferkey, M. Surgical site infection after cesarean section: implementing 3 changes to improve the quality of patient care. Am J Infect Control 2013;41:1258–1263.CrossRefGoogle ScholarPubMed
Dyrkorn, OA, Kristoffersen, M, Walberg, M. Reducing post-caesarean surgical wound infection rate: an improvement project in a Norwegian maternity clinic. BMJ Qual Saf 2012;21:206–210.CrossRefGoogle Scholar
Hickson, E, Harris, J, Brett, D. A journey to zero: reduction of post-operative cesarean surgical site infections over a five-year period. Surg Infect 2015;16:174–177.CrossRefGoogle Scholar
Ng, W, Brown, A, Alexander, D, et al. A multifaceted prevention program to reduce infection after cesarean section: Interventions assessed using an intensive postdischarge surveillance system. Am J Infect Control 2015;43:805–809.CrossRefGoogle ScholarPubMed
Rauk, PN. Educational intervention, revised instrument sterilization methods, and comprehensive preoperative skin preparation protocol reduce cesarean section surgical site infections. Am J Infect Control 2010;38:319–323.CrossRefGoogle ScholarPubMed
Riley, MM, Suda, D, Tabsh, K, Flood, A, Pegues, DA. Reduction of surgical site infections in low transverse cesarean section at a university hospital. Am J Infect Control 2012;40:820–825.CrossRefGoogle Scholar
Salim, R, Braverman, M, Berkovic, I, Suliman, A, Teitler, N, Shalev, E. Effect of interventions in reducing the rate of infection after cesarean delivery. Am J Infect Control 2011;39:e73–e78.CrossRefGoogle ScholarPubMed
Vincent, A, Ayzac, L, Girard, R, et al. Downward trends in surgical site and urinary tract infections after cesarean delivery in a French surveillance network, 1997–2003. Infect Control Hosp Epidemiol 2008;29:227–233.CrossRefGoogle Scholar
Weinberg, M, Fuentes, JM, Ruiz, AI, et al. Reducing infections among women undergoing cesarean section in Colombia by means of continuous quality improvement methods. Arch Intern Med 2001;161:2357–2365.CrossRefGoogle ScholarPubMed
Witter, FR, Lawson, P, Ferrell, J. Decreasing cesarean section surgical site infection: an ongoing comprehensive quality improvement program. Am J Infect Control 2014;42:429–431.CrossRefGoogle ScholarPubMed
Wu, M-S, Sun, T-B, Shyr, M-H, et al. Quality improvement of antimicrobial prophylaxis for abdominal hysterectomy in a medical center in eastern Taiwan. Tzu Chi Med J 2008;20:112–118.CrossRefGoogle Scholar
Aguilar-Nascimento, JE, Caporossi, C, Bicudo, AS, Silva, RM, Santos, TP, Cardoso, EA. Enhancing surgical recovery in central West Brazil: the Acerto protocol results. J Parenter Enter Nutr 2008;32:322.Google Scholar
de Aguilar-Nascimento, JE, Bicudo-Salomao, A, Caporossi, C, Silva, RM, Cardoso, EA, Santos, TP. Enhancing surgical recovery in central West Brazil: the ACERTO protocol results. e-SPEN 2008;3:e78–e83.CrossRefGoogle Scholar
Anthony, T, Murray, BW, Sum-Ping, JT, et al. Evaluating an evidence-based bundle for preventing surgical site infection: a randomized trial. Arch Surg (Chicago) 2011;146:263–269.CrossRefGoogle ScholarPubMed
Connolly, TM, Foppa, C, Kazi, E, Denoya, PI, Bergamaschi, R. Impact of a surgical site infection reduction strategy after colorectal resection. Colorectal Dis 2016;18:910–918.CrossRefGoogle ScholarPubMed
Crolla, RM, van der Laan, L, Veen, EJ, Hendriks, Y, van Schendel, C, Kluytmans, J. Reduction of surgical site infections after implementation of a bundle of care. PLoS One 2012;7:e44599.CrossRefGoogle ScholarPubMed
Hill, MV, Holubar, SD, Garfield Legare, CI, Luurtsema, CM, Barth, RJ Jr. Perioperative bundle decreases postoperative hepatic surgery infections. Ann Surg Oncol 2015;22 Suppl 3:S1140–S1146.CrossRefGoogle ScholarPubMed
Forbes, SS, Stephen, WJ, Harper, WL, et al. Implementation of evidence-based practices for surgical site infection prophylaxis: results of a pre- and postintervention study. J Am Coll Surg 2008;207:336–341.CrossRefGoogle ScholarPubMed
Hechenbleikner, EM, Hobson, DB, Bennett, JL, Wick, EC. Implementation of surgical quality improvement: auditing tool for surgical site infection prevention practices. Dis Colon Rectum 2015;58:83–90.CrossRefGoogle ScholarPubMed
Hedrick, TL, Heckman, JA, Smith, RL, Sawyer, RG, Friel, CM, Foley, EF. Efficacy of protocol implementation on incidence of wound infection in colorectal operations. J Am Coll Surg 2007;205:432–438.CrossRefGoogle ScholarPubMed
Hedrick, TL, Turrentine, FE, Smith, RL, et al. Single-institutional experience with the surgical infection prevention project in intra-abdominal surgery. Surg Infect 2007;8:425–435.CrossRefGoogle ScholarPubMed
Hernández-Navarrete, J, Arribas-Llorente, JL, Solano Bernad, VM, et al. Quality improvement program of nosocomial infection in colorectal surgery. Medicina Clínica 2005;125:521–524.Google Scholar
Keenan, JE, Speicher, PJ, Nussbaum, DP, et al. Improving outcomes in colorectal surgery by sequential implementation of multiple standardized care programs. J Am Coll Surg 2015;221:404–414.CrossRefGoogle ScholarPubMed
Khan, MA, Rao, PGM, Rao, A, Rodrigues, G. Survey and evaluation of antibiotic prophylaxis usage in surgery wards of tertiary level institution before and after the implementation of clinical guidelines. Indian J Surg 2006;68:150–156.Google Scholar
Larochelle, M, Hyman, N, Gruppi, L, Osler, T. Diminishing surgical site infections after colorectal surgery with surgical care improvement project: is it time to move on? Dis Colon Rectum 2011;54:394–400.CrossRefGoogle Scholar
Lavu, H, Klinge, MJ, Nowcid, LJ, et al. Perioperative surgical care bundle reduces pancreaticoduodenectomy wound infections. J Surg Res 2012;174:215–221.CrossRefGoogle ScholarPubMed
Miller, TE, Thacker, JK, White, WD, et al. Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol. Anesth Analg 2014;118:1052–1061.CrossRefGoogle ScholarPubMed
Perez-Blanco, V, Garcia-Olmo, D, Maseda-Garrido, E, Najera-Santos, MC, Garcia-Caballero, J. Evaluation of a preventive surgical site infection bundle in colorectal surgery. Cir Esp 2015;93:222–228.Google ScholarPubMed
Reames, BN, Krell, RW, Campbell, DA Jr, Dimick, JB. A checklist-based intervention to improve surgical outcomes in Michigan: evaluation of the Keystone Surgery program. JAMA Surg 2015;150:208–215.CrossRefGoogle ScholarPubMed
Waits, SA, Fritze, D, Banerjee, M, et al. Developing an argument for bundled interventions to reduce surgical site infection in colorectal surgery. Surgery 2014;155:602–606.CrossRefGoogle ScholarPubMed
Wick, EC, Galante, DJ, Hobson, DB, et al. organizational culture changes result in improvement in patient-centered outcomes: implementation of an integrated recovery pathway for surgical patients. J Am Coll Surg 2015;221:669–677.CrossRefGoogle ScholarPubMed
Wick, EC, Gibbs, L, Indorf, LA, Varma, MG, Garcia-Aguilar, J. Implementation of quality measures to reduce surgical site infection in colorectal patients. Dis Colon Rectum 2008;51:1004–1009.CrossRefGoogle ScholarPubMed
Cima, R, Dankbar, E, Lovely, J, et al. Colorectal surgery surgical site infection reduction program: a national surgical quality improvement program—driven multidisciplinary single-institution experience. J Am Coll Surg 2013;216:23–33.CrossRefGoogle ScholarPubMed
Bull, A, Wilson, J, Worth, LJ, et al. A bundle of care to reduce colorectal surgical infections: an Australian experience. J Hosp Infect 2011;78:297–301.CrossRefGoogle Scholar
Hover, AR, Sistrunk, WW, Cavagnol, RM, et al. Effectiveness and cost of failure mode and effects analysis methodology to reduce neurosurgical site infections. Am J Med Qual 2014;29:517–521.CrossRefGoogle ScholarPubMed
Le, C, Guppy, KH, Axelrod, YV, et al. Lower complication rates for cranioplasty with peri-operative bundle. Clin Neurol Neurosurg 2014;120:41–44.CrossRefGoogle ScholarPubMed
Lepanluoma, M, Rahi, M, Takala, R, Loyttyniemi, E, Ikonen, TS. Analysis of neurosurgical reoperations: use of a surgical checklist and reduction of infection-related and preventable complication-related reoperations. J Neurosurg 2015;123:145–152.CrossRefGoogle ScholarPubMed
Biskup, N, Workman, AD, Kutzner, E, Adetayo, OA, Gupta, SC. Perioperative safety in plastic surgery: is the world health organization checklist useful in a broad practice? Ann Plast Surg 2016;76:550–555.CrossRefGoogle Scholar
Aiken, AM, Wanyoro, AK, Mwangi, J, Juma, F, Mugoya, IK, Scott, JA. Changing use of surgical antibiotic prophylaxis in Thika Hospital, Kenya: a quality improvement intervention with an interrupted time series design. PLoS One 2013;8:e78942.CrossRefGoogle ScholarPubMed
Anchalia, MM, D’Ambruoso, L. Seeking solutions: scaling-up audit as a quality improvement tool for infection control in Gujarat, India. Int J Qual Health Care 2011;23:464–470.CrossRefGoogle ScholarPubMed
Askarian, M, Kouchak, F, Palenik, CJ. Effect of surgical safety checklists on postoperative morbidity and mortality rates, Shiraz, Faghihy Hospital, a 1-year study. Qual Manag Health Care 2011;20:293–297.CrossRefGoogle ScholarPubMed
Brandt, C, Sohr, D, Behnke, M, Daschner, F, Ruden, H, Gastmeier, P. Reduction of surgical site infection rates associated with active surveillance. Infect Control Hosp Epidemiol 2006;27:1347–1351.CrossRefGoogle ScholarPubMed
Dimopoulou, A, Kourlaba, G, Psarris, A, Coffin, S, Spoulou, V, Zaoutis, T. Perioperative antimicrobial prophylaxis in pediatric patients in Greece: compliance with guidelines and impact of an educational intervention. J Pediatr Surg 2016;51:1307–1311.CrossRefGoogle ScholarPubMed
El Mhamdi, S, Letaief, M, Cherif, Y, Bouanene, I, Kallel, W, Hamdi, A. Implementation of the safe surgery checklist of the World Health Organization at the University Hospital of Monastir (Tunisia). Tunis Med 2014;92:385–390.Google Scholar
Geubbels, EL, Bakker, HG, Houtman, P, et al. Promoting quality through surveillance of surgical site infections: five prevention success stories. Am J Infect Control 2004;32:424–430.CrossRefGoogle ScholarPubMed
Geubbels, EL, Nagelkerke, NJ, Mintjes-De, G, Vandenbroucke-Grauls, CM, Grobbee, DE, De Boer, AS. Reduced risk of surgical site infections through surveillance in a network. Int J Qual Health Care 2006;18:127–133.CrossRefGoogle ScholarPubMed
Gomez, MI, Acosta-Gnass, SI, Mosqueda-Barboza, L, Basualdo, JA. Reduction in surgical antibiotic prophylaxis expenditure and the rate of surgical site infection by means of a protocol that controls the use of prophylaxis. Infect Control Hosp Epidemiol 2006;27:1358–1365.CrossRefGoogle ScholarPubMed
Horst, HM, Rubinfeld, I, Mlynarek, M, et al. A tight glycemic control initiative in a surgical intensive care unit and hospitalwide. Jt Comm J Qual Patient Saf 2010;36:291–300.CrossRefGoogle Scholar
Kanter, G, Connelly, NR, Fitzgerald, J. A system and process redesign to improve perioperative antibiotic administration. Anesth Analg 2006;103:1517–1521.CrossRefGoogle ScholarPubMed
Kim, RY, Kwakye, G, Kwok, AC, et al. Sustainability and long-term effectiveness of the WHO surgical safety checklist combined with pulse oximetry in a resource-limited setting: two-year update from Moldova. JAMA Surg 2015;150:473–479.CrossRefGoogle Scholar
Koch, AM, Nilsen, RM, Dalheim, A, Cox, RJ, Harthug, S. Need for more targeted measures - only less severe hospital-associated infections declined after introduction of an infection control program. J Infect Public Health 2015;8:282–290.CrossRefGoogle ScholarPubMed
Kwok, AC, Funk, LM, Baltaga, R, et al. Implementation of the World Health Organization surgical safety checklist, including introduction of pulse oximetry, in a resource-limited setting. Ann Surg 2013;257:633–639.CrossRefGoogle Scholar
Liau, KH, Aung, KT, Chua, N, et al. Outcome of a strategy to reduce surgical site infection in a tertiary-care hospital. Surg Infect 2010;11:151–159.CrossRefGoogle Scholar
Neumayer, L, Mastin, M, Vanderhoof, L, Hinson, D. Using the Veterans Administration National Surgical Quality Improvement Program to improve patient outcomes. J Surg Res 2000;88:58–61.CrossRefGoogle ScholarPubMed
Ng, WK, Awad, N. Performance improvement initiative: prevention of surgical site infection (SSI). BMJ Qual Improv Rep 2015;4.CrossRefGoogle Scholar
Suchitra, JB, Lakshmidevi, N. Hospital-acquired infections: are prevention strategies matching incidence rates? Healthcare Infect 2009;14:21–25.CrossRefGoogle Scholar
Thompson, KM, Oldenburg, WA, Deschamps, C, Rupp, WC, Smith, CD. Chasing zero: the drive to eliminate surgical site infections. Ann Surg 2011;254:430–437.CrossRefGoogle ScholarPubMed
Tillman, M, Wehbe-Janek, H, Hodges, B, Smythe, WR, Papaconstantinou, HT. Surgical care improvement project and surgical site infections: can integration in the surgical safety checklist improve quality performance and clinical outcomes? J Surg Res 2013;184:150–156.CrossRefGoogle ScholarPubMed
Woster, PS, Ryan, ML, Ginsberg-Evans, L, Olson, J. Use of total quality management techniques to improve compliance with a medication use indicator. Top Hosp Pharm Manage 1995;14:68–77.Google ScholarPubMed
Yang, Z, Zhao, P, Wang, J, et al. DRUGS system enhancing adherence of Chinese surgeons to antibiotic use guidelines during perioperative period. PLoS One 2014;9:e102226.CrossRefGoogle ScholarPubMed
Yegge, JA, Gase, KA, Hopkins-Broyles, D, Leone, CL, Trovillion, EW, Babcock, HM. Development of a standardized process improvement protocol to address elevated health care-associated infection rates on an incented quality scorecard. Am J Infect Control 2014;42:185–189.CrossRefGoogle ScholarPubMed
Barchitta, M, Matranga, D, Quattrocchi, A, et al. Prevalence of surgical site infections before and after the implementation of a multimodal infection control programme. J Antimicrob Chemother 2012;67:749–755.CrossRefGoogle ScholarPubMed
Everett, BR, Sitton, JT, Wilson, M. Efficacy and cost-benefit analysis of a global environmental cleaning algorithm on hospital-acquired infection rates. J Patient Saf 2017;13:207–210.CrossRefGoogle ScholarPubMed
John, H, Nimeri, A, Ellahham, S. Improved surgical site infection (SSI) rate through accurately assessed surgical wounds. BMJ Qual Improv Rep 2015;4(1):u205509–w2980.CrossRefGoogle ScholarPubMed
Joyce, JS, Cioffi, GA, Petriwsky, JG, Robinson, JS. Legacy Health’s ‘Big Aims’ initiative to improve patient safety reduced rates of infection and mortality among patients. Health Aff (Millwood) 2011;30:619–627.CrossRefGoogle ScholarPubMed
Marchi, M, Pan, A, Gagliotti, C, et al. The Italian national surgical site infection surveillance programme and its positive impact, 2009 to 2011. Euro Surveill 2014;19.CrossRefGoogle ScholarPubMed
Pegues, DA. Translating and scaling the HHS action plan to prevent healthcare-associated infections to the local level: experience of a Los Angeles Health System. Med Care 2014;52:S60–S65.CrossRefGoogle ScholarPubMed
Prospero, E, Barbadoro, P, Marigliano, A, Martini, E, D’Errico, MM. Perioperative antibiotic prophylaxis: improved compliance and impact on infection rates. Epidemiol Infect 2011;139:1326–1331.CrossRefGoogle ScholarPubMed
Shea, KG, Styhl, AC, King, HA, Hammons, J, Clapp, M. Surgical site infection reduction program: challenges and opportunities. J Pediatr Orthop 2015;35:S51–S54.CrossRefGoogle ScholarPubMed
Starling, CE, Couto, BR, Pinheiro, SM. Applying the centers for disease control and prevention and national nosocomial surveillance system methods in Brazilian hospitals. Am J Infect Control 1997;25:303–311.CrossRefGoogle ScholarPubMed
Staszewicz, W, Eisenring, MC, Bettschart, V, Harbarth, S, Troillet, N. Thirteen years of surgical site infection surveillance in Swiss hospitals. J Hosp Infect 2014;88:40–47.CrossRefGoogle ScholarPubMed
Takahashi, Y, Takesue, Y, Nakajima, K, et al. Implementation of a hospital-wide project for appropriate antimicrobial prophylaxis. J Infect Chemother 2010;16:418–423.CrossRefGoogle ScholarPubMed
van der Slegt, J, van der Laan, L, Veen, EJ, Hendriks, Y, Romme, J, Kluytmans, J. Implementation of a bundle of care to reduce surgical site infections in patients undergoing vascular surgery. PLoS One 2013;8:e71566.CrossRefGoogle ScholarPubMed
Wick, EC, Hobson, DB, Bennett, JL, et al. Implementation of a surgical comprehensive unit-based safety program to reduce surgical site infections. J Am Coll Surg 2012;215:193–200.CrossRefGoogle ScholarPubMed
Lepanluoma, M, Takala, R, Kotkansalo, A, Rahi, M, Ikonen, TS. Surgical safety checklist is associated with improved operating room safety culture, reduced wound complications, and unplanned readmissions in a pilot study in neurosurgery. Scand J Surg 2014;103:66–72.CrossRefGoogle Scholar
Taylor, G, Buchanan-Chell, M, Kirkland, T, McKenzie, M, Sutherland, B, Wiens, R. Reduction in surgical wound infection rates associated with reporting data to surgeons. Can J Infect Dis 1994;5:263–267.CrossRefGoogle ScholarPubMed
Pronovost, PJ, Watson, SR, Goeschel, CA, Hyzy, RC, Berenholtz, SM. Sustaining reductions in central line-associated bloodstream infections in Michigan intensive care units: a 10-year analysis. Am J Med Qual 2016;31:197–202.CrossRefGoogle ScholarPubMed
Pronovost, PJ, Weaver, SJ, Berenholtz, SM, et al. Reducing preventable harm: observations on minimizing bloodstream infections. J Health Organ Manag 2017;31:2–9.CrossRefGoogle ScholarPubMed
Serra-Aracil, X, Garcia-Domingo, MI, Pares, D, et al. Surgical site infection in elective operations for colorectal cancer after the application of preventive measures. Arch Surg (Chicago) 2011;146:606–612.CrossRefGoogle ScholarPubMed
Awad, SS. Adherence to surgical care improvement project measures and post-operative surgical site infections. Surg Infect 2012;13:234–237.CrossRefGoogle ScholarPubMed
Arriaga, AF, Lancaster, RT, Berry, WR, et al. The better colectomy project: association of evidence-based best-practice adherence rates to outcomes in colorectal surgery. Ann Surg 2009;250:507–513.Google ScholarPubMed
Saint, S, Kowalski, CP, Banaszak-Holl, J, Forman, J, Damschroder, L, Krein, SL. The importance of leadership in preventing healthcare-associated infection: results of a multisite qualitative study. Infect Control Hosp Epidemiol 2010;31:901–907.CrossRefGoogle ScholarPubMed
Henderson, DM, Staiger, TO, Peterson, GN, et al. A collaborative, systems-level approach to eliminating healthcare-associated MRSA, central-line-associated bloodstream infections, ventilator-associated pneumonia, and respiratory virus infections. J Healthc Qual 2012;34:39–47.CrossRefGoogle ScholarPubMed
Pronovost, PJ. Navigating adaptive challenges in quality improvement. BMJ Qual Saf 2011;20:560–563.CrossRefGoogle ScholarPubMed
Cabana, MD, Rand, CS, Powe, NR, et al. Why don’t physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999;282:1458–1465.CrossRefGoogle Scholar
Tartari, E, Weterings, V, Gastmeier, P, et al. Patient engagement with surgical site infection prevention: an expert panel perspective. Antimicrob Resist Infect Control 2017;6:45.CrossRefGoogle Scholar
Dixon-Woods, M, Bosk, CL, Aveling, EL, Goeschel, CA, Pronovost, PJ. Explaining Michigan: developing an ex post theory of a quality improvement program. Milbank Q 2011;89:167–205.CrossRefGoogle ScholarPubMed
Hunt, TK, Hopf, HW. Selection of bundle components. Arch Surg (Chicago) 2011;146:1220–1221.CrossRefGoogle ScholarPubMed
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