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National survey of variations in practice in the prevention of surgical site infections in adult cardiac surgery, United Kingdom and Republic of Ireland

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journal contribution
posted on 23.11.2020, 11:01 by D Aktuerk, JM Ali, A Badran, D Balmforth, D Bleetman, CS Brown, R Suelo-Calanao, J Cartwright, L Casey, L Chiwera, D Fudulu, M Garner, G Gradinariu, A Harky, A Hussain, S Hutton, EP Kew, M Loubani, K Mani, J Martin, M Rochon, N Moawad, S Mohamed, M Muretti, GJ Murphy, GM Olivieri, I Paglinawan, JC Quijano-Campos, V Rizzo, S Robertson, LJ Rogers, M Roman, K Salmon, J Sanders, S Taludker, J Tanner, R Vaja, A Zientara, S Green, R Miles, T Lamagni, P Harrington
Background
Currently no national standards exist for the prevention of surgical site infection (SSI) in cardiac surgery. SSI rates range from 1% to 8% between centres.

Aim
The aim of this study was to explore and characterize variation in approaches to SSI prevention in the UK and the Republic of Ireland (ROI).

Methods
Cardiac surgery centres were surveyed using electronic web-based questionnaires to identify variation in SSI prevention at the level of both institution and consultant teams. Surveys were developed and undertaken through collaboration between the Cardiothoracic Interdisciplinary Research Network (CIRN), Public Health England (PHE) and the National Cardiac Benchmarking Collaborative (NCBC) to encompass routine pre-, intra- and postoperative practice.

Findings
Nineteen of 38 centres who were approached provided data and included responses from 139 consultant teams. There was no missing data from those centres that responded. The results demonstrated substantial variation in over 40 aspects of SSI prevention. These included variation in SSI surveillance, reporting of SSI infection rates to external bodies, utilization of SSI risk prediction tools, and the use of interventions such as sternal support devices and gentamicin impregnated sponges.

Conclusion
Measured variation in SSI prevention in cardiac centres across the UK and ROI is evidence of clinical uncertainty as to best practice, and has identified areas for quality improvement as well as knowledge gaps to be addressed by future research.

History

Citation

Journal of Hospital Infection, 2020, https://doi.org/10.1016/j.jhin.2020.09.016

Author affiliation

Department of Health Sciences, University of Leicester

Version

AM (Accepted Manuscript)

Published in

Journal of Hospital Infection

Publisher

Elsevier BV

issn

0195-6701

Acceptance date

11/09/2020

Copyright date

2020

Available date

19/09/2021

Language

en

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