Infection prevention
Closing the loop: the surgical pathway IPC nurse
Following the relocation of Royal Papworth Hospital to the Cambridge Biomedical Campus in 2019, an increase in surgical site infections (SSIs) prompted a comprehensive, multidisciplinary investigation. While the initial rise was attributed to environmental transition, further analysis revealed a complex web of contributing factors. Eleonora Iervella discusses how a pioneering new role has made a significant impact.
This article presents the introduction of a pioneering role, the Surgical Pathway IPC Nurse, designed to address a critical gap in perioperative infection control by providing consistent leadership across the entire surgical journey. Since the role’s implementation, the hospital has seen significant improvements in communication, education, and staff engagement, alongside a 59% reduction in SSIs (from 9.5% to 3.9%). By highlighting key lessons learned, targeted
interventions, and organisational challenges, this article argues for the adoption of the Surgical Pathway IPC Nurse as a national best practice to close longstanding gaps in IPC governance within surgical care.
Background Royal Papworth Hospital is a specialist cardiothoracic centre, internationally recognised for its expertise in heart and lung transplantation, pulmonary thromboendarterectomy (PTE), and respiratory Extracorporeal Membrane Oxygenation (ECMO). In 2019, the hospital relocated from Papworth Everard to the Cambridge Biomedical Campus, aiming to enhance patient outcomes through advanced infrastructure and closer academic collaboration. However, following the move, the hospital
experienced an unexpected rise in surgical site infections (SSI), prompting a re-evaluation across the surgical pathway. This incident revealed that while IPC responsibilities were in place at various points, no single role held oversight of the entire perioperative journey leaving significant gaps in continuity, surveillance, and practice. To address this, Royal Papworth pioneered
the Surgical Pathway IPC Nurse role, a strategic post embedded across wards, theatres, and postoperative care, providing visible leadership
About Royal Papworth
Royal Papworth Hospital NHS Foundation Trust is the UK’s leading heart and lung hospital, treating around 50,000 patients each year. The Trust is currently rated ‘outstanding’ by the Care Quality Commission (CQC), from an inspection carried out in 2019. It became the first hospital Trust in the country to receive the top rating of ‘outstanding’ in each of the five main domains that the CQC assesses.
20
www.clinicalservicesjournal.com I June 2025 Founded as a tuberculosis colony in 1918,
Royal Papworth Hospital has established an international reputation for excellence in research and innovation. Since carrying out the UK’s first successful heart transplant in 1979 and the world’s first heart-lung and liver transplant in 1986, the hospital now performs more heart, heart-lung and lung transplants each year than any other UK centre.
and closing the loop on IPC across the entire surgical continuum.
A day in the life: inside the Surgical Pathway IPC Nurse role The Surgical Pathway IPC Nurse functions as a highly visible clinical leader, operating across all stages of the surgical journey. The role is dynamic, patient-centred, and rooted in multidisciplinary collaboration. Each day begins with a review of data, audit outcomes, and staff feedback. Activities are prioritised based on risk, with targeted focus on areas of concern such as recent infections, audit non-conformities, or recurring environmental and non-environmental issues. Routine tasks include:
l Conducting wards and theatres walkarounds to observe IPC practices in action.
l Coaching staff in real-time on correct techniques, dress code, and aseptic protocols.
l Delivering workshops, drop-in training, and educational updates on Evidence Based Practices (EBP).
l Engaging with staff across all levels to promote shared responsibility for IPC.
The presence of a dedicated IPC nurse in these settings has significantly boosted staff morale, increased interest in IPC, and promoted a culture of vigilance and learning. The role also includes systematic engagement with three key stakeholder groups: l Executive teams, to ensure IPC risks are communicated and addressed strategically.
l Clinical staff, to co-develop and refine best practices.
l Estates and facilities, to address environmental concerns.
Tailored communications, regular briefings, and joint planning sessions with these groups
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