Surgical site infections: a need to galvanise efforts to reduce occurrence

Surgical site infections (SSIs) account for around 16% of all healthcare-associated infections causing considerable mortality and morbidity and huge increases in the costs of care. The impact on patients can continue for months, may require re-hospitalisation and re-operation, with all the consequent costs for hospitals. Many hospitals and surgical teams do not have access to their own infection rates. If they did, it is highly likely to have a proactive impact on practice to mitigate and reduce SSIs.

One of the complications of perioperative care is that it is team-based, multi-site and multidisciplinary. Patients are admitted to an area or day care ward, transported to theatre, operated on, recovered, and finally may even be sent to a different ward for post-operative care. Each specialty area and leader, has its own way of doing things, which may or may not be based on evidence and protocol. Their practice is often different to that practised in the theatre or an adjacent ward.

Practice may be led by the surgeon or team leader but time pressures and lack of recognition means that staff do not sit together to devise evidence-based practice standards on shared issues such as patient warming. Ward staff are rarely included in the team-based discussions if they do occur, and it is an uncommon event to see ward and theatre staff communicating about quality and practice development.