Decreasing Prosthetic Joint Surgical Site Infections: An Interdisciplinary Approach

Mejia, Elisa; Williams, Anne; Long, Martha

doi:10.1016/j.aorn.2014.03.017

Cited by 6 publications

(7 citation statements)

References 22 publications

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“…Strategies relying on a decreased bacterial load and creating a bacteria-free environment around an implant during the perioperative period are widely implemented in clinical practice [44,45]. There is sufficient evidence supporting systemic [46] and in some cases local antibiotic prophylaxis [47].…”

Section: Rationale and Basic Concepts Of Pji Preventionmentioning

confidence: 99%

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Silver Nanocoating Technology in the Prevention of Prosthetic Joint Infection

et al. 2016

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Prosthetic joint infection (PJI) is a feared complication of total joint arthroplasty associated with increased morbidity and mortality. There is a growing body of evidence that bacterial colonization and biofilm formation are critical pathogenic events in PJI. Thus, the choice of biomaterials for implanted prostheses and their surface modifications may significantly influence the development of PJI. Currently, silver nanoparticle (AgNP) technology is receiving much interest in the field of orthopaedics for its antimicrobial properties and a strong anti-biofilm potential. The great advantage of AgNP surface modification is a minimal release of active substances into the surrounding tissue and a long period of effectiveness. As a result, a controlled release of AgNPs could ensure antibacterial protection throughout the life of the implant. Moreover, the antibacterial effect of AgNPs may be strengthened in combination with conventional antibiotics and other antimicrobial agents. Here, our main attention is devoted to general guidelines for the design of antibacterial biomaterials protected by AgNPs, its benefits, side effects and future perspectives in PJI prevention.

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Section: Rationale and Basic Concepts Of Pji Preventionmentioning

confidence: 99%

“…Attempts at formulating evidence-based standards for good clinical and logistic practice in orthopaedic operating rooms have been made [45,49]. There is a growing pressure on surgeons to improve their surgical skills in order to minimize the surgery-related factors.…”

Section: Rationale and Basic Concepts Of Pji Preventionmentioning

confidence: 99%

Silver Nanocoating Technology in the Prevention of Prosthetic Joint Infection

et al. 2016

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“…Six quantitative studies used a pretest–posttest design to evaluate the implementation of interventions, with sample sizes ranging from 197 to 35,543. 24 , 25 , 27 – 29 One quantitative study with 602 participants used a cross-sectional survey to identify the problems that were associated with SSI before implementing intervention. 28 In one qualitative study, a total of 18 health care professionals from a large tertiary center were interviewed using semistructured interviews.…”

Section: Resultsmentioning

confidence: 99%

“…Study authors described using strategies targeted to the different phases of the patient journey: from preoperative care through to providing patient-centered education during the early postoperative period. 25 , 27 , 34 The majority of studies described team collaborations that were circumscribed by role: where team members focused on specific tasks, by whom, and in what phase of care in order to mitigate the risk of SSI. The use of such approaches reinforces the notion that each clinician brings with them their particular expertise and is responsible for their respective contributions to patient care.…”

Section: Discussionmentioning

confidence: 99%

Reducing the risk of surgical site infection using a multidisciplinary approach: an integrative review

Gillespie¹,

Kang²,

Roberts³

et al. 2015

JMDH

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PurposeTo identify and describe the strategies and processes used by multidisciplinary teams of health care professionals to reduce surgical site infections (SSIs).Materials and methodsAn integrative review of the research literature was undertaken. Searches were conducted in April 2015. Following review of the included studies, data were abstracted using summary tables and the methodological quality of each study assessed using the Standards for Quality Improvement Reporting Excellence guidelines by two reviewers. Discrepancies were dealt with through consensus. Inductive content analysis was used to identify and describe the strategies/processes used by multidisciplinary health care teams to prevent SSI.Results and discussionIn total, 13 studies met the inclusion criteria. Of these, 12 studies used quantitative methods, while a single study used qualitative interviews. The majority of the studies were conducted in North America. All quantitative studies evaluated multifaceted quality-improvement interventions aimed at preventing SSI in patients undergoing surgery. Across the 13 studies reviewed, the following multidisciplinary team-based approaches were enacted: using a bundled approach, sharing responsibility, and, adhering to best practice. The majority of studies described team collaborations that were circumscribed by role. None of the reviewed studies used strategies that included the input of allied health professionals or patient participation in SSI prevention.ConclusionPatient-centered interventions aimed at increasing patient participation in SSI prevention and evaluating the contributions of allied health professionals in team-based SSI prevention requires future research.

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“…Also, 14 studies (12%) evaluated a pediatric population, [33][34][35][36][37][38][39][40][41][42][43][44][45][46] and 111 (88%) evaluated an adult, mixed (adult and pediatric), or undefined population. We quantified the studies by surgical specialty: 21 cardiothoracic, 33,36,37,39,40,[46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61] 22 orthopedic, 34,41,42,[62][63][64][65][66][67][68][69][70][71][72][73][74]...…”

Section: Demographic Characteristicsmentioning

confidence: 99%

Implementation strategies to reduce surgical site infections: A systematic review

Ariyo

Zayed

Riese

et al. 2019

Infect. Control Hosp. Epidemiol.

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Background:Surgical site infections (SSIs) portend high patient morbidity and mortality. Although evidence-based clinical interventions can reduce SSIs, they are not reliably delivered in practice, and data are limited on the best approach to improve adherence.Objective:To summarize implementation strategies aimed at improving adherence to evidence-based interventions that reduce SSIs.Design:Systematic reviewMethods:We searched PubMed, Embase, CINAHL, the Cochrane Library, the WHO Regional databases, AFROLIB, and Africa-Wide for studies published between January 1990 and December 2015. The Effective Practice and Organization Care (EPOC) criteria were used to identify an acceptable-quality study design. We used structured forms to extract data on implementation strategies and grouped them into an implementation model called the “Four Es” framework (ie, engage, educate, execute, and evaluate).Results:In total, 125 studies met our inclusion criteria, but only 8 studies met the EPOC criteria, which limited our ability to identify best practices. Most studies used multifaceted strategies to improve adherence with evidence-based interventions. Engagement strategies included multidisciplinary work and strong leadership involvement. Education strategies included various approaches to introduce evidence-based practices to clinicians and patients. Execution strategies standardized the interventions into simple tasks to facilitate uptake. Evaluation strategies assessed adherence with evidence-based interventions and patient outcomes, providing feedback of performance to providers.Conclusions:Multifaceted implementation strategies represent the most common approach to facilitating the adoption of evidence-based practices. We believe that this summary of implementation strategies complements existing clinical guidelines and may accelerate efforts to reduce SSIs.

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Decreasing Prosthetic Joint Surgical Site Infections: An Interdisciplinary Approach

Cited by 6 publications

References 22 publications

Silver Nanocoating Technology in the Prevention of Prosthetic Joint Infection

Silver Nanocoating Technology in the Prevention of Prosthetic Joint Infection

Reducing the risk of surgical site infection using a multidisciplinary approach: an integrative review

Implementation strategies to reduce surgical site infections: A systematic review

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