Effectiveness and feasibility of an evidence-based intraoperative infection control program targeting improved basic...

Area of Science:

• Infection Control
• Surgical Safety
• Public Health

Background:

• Surgical site infections (SSIs) and transmission of Staphylococcus aureus (S. aureus) remain significant challenges in healthcare settings.
• Operating room heterogeneity and compliance with interventions can limit the effectiveness of infection control programs.

Purpose of the Study:

• To evaluate the impact of an optimized intraoperative infection control program on S. aureus transmission and SSI rates.
• To address limitations of operating room heterogeneity and compliance in clinical practice.

Main Methods:

• A post-implementation prospective case-cohort study was conducted in 23 operating rooms at a large teaching hospital.
• A multifaceted, evidence-based program focusing on hand hygiene, vascular care, and environmental cleaning was implemented.
• Bacterial transmission monitoring provided monthly feedback for intervention optimization, with S. aureus transmission and SSI as primary and secondary outcomes.

Main Results:

• Optimization was associated with a significant decrease in S. aureus transmission, from 24% to 9% (IRR 0.39, P < .001).
• Surgical site infection rates also decreased substantially, from 8% to 3% (adjusted IRR 0.45, P = .009).

Conclusions:

• An optimized intraoperative infection control program is effective and feasible for reducing S. aureus transmission.
• Improvements in basic preventive measures can significantly lower the incidence of surgical site infections.