Expert commentary on the challenges and opportunities for surgical site infection prevention through implementation of evidence-based guidelines in the Asia–Pacific Region

Abstract

Introduction Surgical site infections (SSIs) are a significant source of morbidity and mortality in the Asia–Pacific region (APAC), adversely impacting patient quality of life, fiscal productivity and placing a major economic burden on the country’s healthcare system. This commentary reports the findings of a two-day meeting that was held in Singapore on July 30–31, 2019, where a series of consensus recommendations were developed by an expert panel composed of infection control, surgical and quality experts from APAC nations in an effort to develop an evidence-based pathway to improving surgical patient outcomes in APAC. Methods The expert panel conducted a literature review targeting four sentinel areas within the APAC region: national and societal guidelines, implementation strategies, postoperative surveillance and clinical outcomes. The panel formulated a series of key questions regarding APAC-specific challenges and opportunities for SSI prevention. Results The expert panel identified several challenges for mitigating SSIs in APAC; (a) constraints on human resources, (b) lack of adequate policies and procedures, (c) lack of a strong safety culture, (d) limitation in funding resources, (e) environmental and geographic challenges, (f) cultural diversity, (g) poor patient awareness and (h) limitation in self-responsibility. Corrective strategies for guideline implementation in APAC were proposed that included: (a) institutional ownership of infection prevention strategies, (b) perform baseline assessments, (c) review evidence-based practices within the local context, (d) develop a plan for guideline implementation, (e) assess outcome and stakeholder feedback, and (f) ensure long-term sustainability. Conclusions Reducing the risk of SSIs in APAC region will require: (a) ongoing consultation and collaboration among stakeholders with a high level of clinical staff engagement and (b) a strong institutional and national commitment to alleviate the burden of SSIs by embracing a safety culture and accountability.

Healthcare professionals' knowledge and attitudes towards surgical site infection and surveillance: A quasi‐experimental study

“…To the best of our knowledge, this is the first study to look at both knowledge and attitudes of healthcare professionals on SSI in a study using a pre-test and posttest design. (Anderson et al, 2014;Hegarty et al, 2019;Morikane et al, 2021;Sartelli et al, 2018).…”

“…( 2019 ) also reported that the majority of surgical multidisciplinary staff have positive attitudes towards SSI surveillance and believe that are responsible for the prevention of SSI. Recently, other researchers have concluded that continuous engagement in SSI surveillance as part of a complex intervention at an organisational level improves awareness by clinicians of patient safety and results in better outcomes (Morikane et al., 2021 ; Zucco et al., 2019 ).…”

“…Cognitive participation was critical in ISSIP intervention where leadership, surgeons and surveillance scientists were major drivers and champions of this initiative. Involvement of champions from clinical areas, hospital management, surgeons and surveillance scientist has been beneficial in other past studies (Anderson et al., 2014 ; Hegarty et al., 2019 ; Morikane et al., 2021 ; Sartelli et al., 2018 ).…”

“…level improves awareness by clinicians of patient safety and results in better outcomes(Morikane et al, 2021;Zucco et al, 2019).…”

Implementation Strategies for Preventing Healthcare-Associated Infections across the Surgical Pathway: An Italian Multisociety Document

“…Overcoming barriers to evidence-based-practice implementation by promoting compliance with recommended measures, and thus translating evidence into clinical practice, is crucial [ 22 , 23 ].…”