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Programme leads to reduction in infections after surgery

Programme leads to reduction in infections after surgery

New Zealanders are now less likely to develop infections after surgery as a result of actions being taken by district health boards (DHBs) to reduce surgical site infections.

The Health Quality & Safety Commission’s surgical site infection (SSI) improvement programme was set up in 2013 to reduce SSIs, which can cause significant harm to patients and lead to long stays in hospital.

Results from the programme, published today in the New Zealand Medical Journal, show a significant reduction in the SSI rate following hip and knee replacements, the programme’s initial areas of focus.

Between August 2015 and June 2017 there were approximately 55 fewer infections compared with historical trends, leading to savings of $2.2 million in avoided treatment.

The improvement programme has seen the Commission work with DHBs across the country to implement a consistent, evidence-based approach for collecting and reporting high-quality data about SSIs.

The programme also promotes ways to reduce SSIs, with DHBs encouraged to use a ‘bundle’ of practice interventions. The bundle consists of:

-making sure that the right dose of antibiotics is given on time before surgery
-sterilising skin with alcohol-based antiseptic before surgery
-clipping hair at the incision site, not shaving.

The subsequent increase in best practice is associated with the nationwide fall in SSIs.

Dr Sally Roberts, clinical lead for the Commission’s infection prevention and control programme, says the benefits of the programme are being felt by providers, patient and their families and whānau.

‘If you think about all the extra days in hospital as a result of surgical site infections, and the distress and disruption this causes to patients and their family and friends, the impact of this reduction in infections is significant.
‘The personal impact of an infection can be devastating. People lose their sick leave, or even their jobs, and can be left with lifelong mobility issues or disfigurement. The results of the programme are encouraging and give us something to build on to reduce harm further in the future.’

Dr Roberts says there are also likely to be a number of unmeasured benefits from the programme.

‘As we’ve only been working with DHBs we’ve only captured results from them. We’ve also been encouraging the private sector to follow the programme so it’s likely the results from programme represent the minimum.

‘It’s also likely providers have been adopting the interventions for procedures beyond hip and knee replacements.’

Following the success in reducing SSI rates following knee and hip surgery, the focus of the programme was expanded to included cardiac surgery in 2015. The Commission is currently publishing the results as part of its quarterly quality and safety markers (QSMs).

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