American journal of surgery · 2025
Hands-on training for preoperative skin preparation improves compliance with manufacturer instructions for use.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Schaps Diego, Schultz Michael, Woody Regina, Masoud Sabran, Mantyh Christopher
Аннотация
BACKGROUND: Surgical site infections (SSIs) drive morbidity and costs. In 2022, our SSI rate rose to a National Surgical Quality Improvement Program (NSQIP) rating of "needs improvement." We implemented a program to improve pre-operative skin preparation compliance.
METHODS: One-time hands-on training session for surgical residents and operating room nurses emphasizing chlorhexidine gluconate and isopropyl alcohol (CHG/IPA) compliance. Compliance was directly observed from August 2022 to November 2023 (N = 1032). Institutional SSI incidence was evaluated using NSQIP semiannual reports.
RESULTS: Complete compliance improved from 13.3 % to 39.4 %(p < 0.0001). Adjusted odds of compliance were 3.4-fold higher overall(p < 0.0001), 3.7-fold higher for general surgery(p = 0.0003), and 9.8-fold higher for colorectal surgery(p < 0.0001). Institutional NSQIP SSI ratings improved from "needs improvement" to "as expected," but reverted to "needs improvement."
CONCLUSIONS: Single hands-on training significantly improved compliance and was associated with improved SSI ratings. However, the effect was not durable, highlighting need for ongoing education and sustained surveillance to achieve lasting improvement.
METHODS: One-time hands-on training session for surgical residents and operating room nurses emphasizing chlorhexidine gluconate and isopropyl alcohol (CHG/IPA) compliance. Compliance was directly observed from August 2022 to November 2023 (N = 1032). Institutional SSI incidence was evaluated using NSQIP semiannual reports.
RESULTS: Complete compliance improved from 13.3 % to 39.4 %(p < 0.0001). Adjusted odds of compliance were 3.4-fold higher overall(p < 0.0001), 3.7-fold higher for general surgery(p = 0.0003), and 9.8-fold higher for colorectal surgery(p < 0.0001). Institutional NSQIP SSI ratings improved from "needs improvement" to "as expected," but reverted to "needs improvement."
CONCLUSIONS: Single hands-on training significantly improved compliance and was associated with improved SSI ratings. However, the effect was not durable, highlighting need for ongoing education and sustained surveillance to achieve lasting improvement.