INFECTION CONTROL
Surgical site infection: raising the profile and promoting prevention
On the agenda of a recent meeting was the need for healthcare organisations to improve surgical site infection prevention and for healthcare workers to understand its impact on patients. Louise Frampton reports.
The Northumbria Healthcare NHS Foundation Trust is one of the country’s top performing foundation trusts, looking after the wellbeing of around half a million people across Northumberland and North Tyneside – one of the largest geographical areas of any NHS Trust in England. Each year, the organisation hosts a two-day educational conference, Quality Improvement for Surgical Teams (QIST), aimed at orthopaedic surgeons, anaesthetists, nurses, managers, commissioners, pharmacists and allied health professionals, who are seeking to share best practice and strategies for improving patient outcomes. This article looks at some of the highlights
from the second day of the conference, which included discussion of strategies for the prevention of surgical site infection (SSI), the impact of SSIs on the patient, as well as current guidance. In his opening welcome, on the second
day of QIST, medical director David Evans explained that a great deal of time is spent working on quality at the trust. In recent years, Northumbria has won a number of accolades for patient safety and quality – including a patient safety award for improving quality of care for hip fracture patients from the British Medical Journal. Northumbria has also been named
‘overall best trust’ and awarded five other accolades at the Patient Experience Network national awards. Most recently it won the Board Leadership award at the Health Service Journal (HSJ) awards for its transformational approach to improving quality and services for patients.
262 The trust has a zero-tolerance approach
to infection and has significantly reduced the incidence of SSI. However, David Evans explained that, when the trust first started looking at infection, there was a belief (shared by many healthcare professionals across the UK) that such infections were ‘inevitable’. “It took a long time to change this attitude,
but we have shown that these problems can be tackled and overcome. It is a long journey,” he commented. David Evans emphasised three key
aspects of improvement – the need to sustain initiatives, the use of data, and teamwork. Teamwork has been crucial to fast-tracking
patients and reducing SSI at Northumbria. This has included teamwork, not just within the hospital, but also across the community, with the patient participating as a central part of the team. “Getting it right first time must be the focus of improvement efforts,” he asserted.
The patient experience As part of the drive to mobilise staff to improve quality and patient safety, it is important to understand the human impact that SSI can have – while statistics around SSI are often cited, hearing an emotional account of the devastating effects provides a stark reminder of why ‘getting it right first time’ is so important. “As we do not get to meet patients
after they leave hospital, we do not fully understand the impact of SSI on a person’s life,” said Gail Lowdon, surveillance lead, Northumbria. “However, it is all about the patient.” She delivered a presentation that
introduced a patient’s story – Nora, who experienced an SSI following hip replacement surgery. Delegates watched a video of her moving account of the impact that the infection had on her life. “I wanted a better quality of life. I had
arthritis in both hips and found it very difficult to walk even 10 yards. I wanted to be independent, to be able to drive, to go dancing, to visit friends, all of which I found difficult to do without the help of my daughter. I had the operation on 23 April 2013 and was in hospital for six days,” Nora explained. “At first, it appeared that I had made a
Meta-analysis of SSI incidence included any type of surgery, as well as patients of all ages and any gender.
good recovery and I had no pain in my hips. However, when the district nurse came to take out the stitches she wasn’t happy with the wound. She referred me to my doctor, who prescribed me a course of antibiotics. When the district nurse returned, she found that it was getting worse – it was smelly, red and angry looking. I had another course of antibiotics; then I was told I would have to go back into hospital.
MAY 2016 THE BIOMEDICAL SCIENTIST
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