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Examining barriers to implementing a surgical-site infection bundle.

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Implementing surgical-site infection (SSI) prevention bundles is complex. Successful strategies require tailoring to specific hospital settings and sustained interprofessional collaboration to overcome varied barriers.

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Area of Science:

  • Healthcare quality improvement
  • Infection prevention
  • Surgical safety

Background:

  • Surgical-site infections (SSIs) pose significant risks to patient outcomes.
  • Evidence-based bundles can reduce SSIs, but implementation challenges are common.
  • Sustaining these practices requires overcoming multifaceted barriers.

Purpose of the Study:

  • To explore the implementation processes of SSI prevention bundles in diverse US hospital settings.
  • To identify facilitators and barriers to the successful adoption and sustainability of SSI bundles.

Main Methods:

  • Qualitative study utilizing in-depth, semistructured interviews.
  • Thematic analysis of interview transcripts from 30 hospital personnel across 6 US hospitals.
  • Inclusion of participants from academic tertiary-care, academic-affiliated community, and unaffiliated community hospitals.

Main Results:

  • Bundle complexity and variability in barriers across services were key challenges.
  • No single implementation strategy proved universally effective; tailored approaches were necessary.
  • Sustained interprofessional collaboration emerged as a critical facilitator for successful implementation.

Conclusions:

  • Implementing SSI prevention bundles is complex and requires context-specific strategies.
  • Adaptations to implementation approaches are essential for different settings and populations.
  • Improving bundle adoption, fidelity, acceptability, and sustainability hinges on addressing setting-specific barriers.