A surgical site infection (SSI) surveillance module completed in 2014 highlighted that infection rates for breast surgery inpatients and readmissions at an acute trust had increased to 2.2%, from 0.5% in 2012. The national benchmark for 2014 established by Public Health England (PHE) was 1.0%. This demonstrated a greater than fourfold absolute increase in SSI for breast surgery during these periods. The infection rate could have been due to chance, but warranted investigation. The results were presented to the breast team and used to drive practice transformation through audit and observation, identifying areas of change to improve patient safety. The project used a recognised 8-step model for leading change developed by John Kotter, a professor at Harvard Business School and world-renowned change expert. The project presented opportunities to promote infection prevention while implementing care improvement strategies and behaviour change in partnership with the breast team.

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Surgical site infection (SSI), which can range from superficial infection to life-threatening problems, puts extra strain on healthcare resources and can have a significant impact on patient quality of life. The majority of SSIs are preventable, with different members of the multidisciplinary team (MDT) playing their part at every stage of the patient journey from preoperative assessment to post-discharge follow up. Effective communication and cooperation between members of the MDT is key. This article provides an overview of the input at different stages along the patient journey.

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Mel Burden, Infection Prevention and Control Nurse Specialist, Royal Devon and Exeter Hospital, shares her experiences of volunteering as a nurse in Benin and South Africa, and reflects on the professional challenges.