SSI

Real world observations to prevent SSIs

Guest Blogger Surgical Site Infection ,

This week we welcome Dr Jude Robinson as a guest blogger to Reflections to discuss a paper on surgical site infection prevention.

I feel very honored to have been asked to be a guest speaker on the esteemed IPC partners journal club. I love critiquing papers, and I honestly don’t give myself enough time to do this on a regular basis, probably the same position as many of us with our busy clinical roles. I have really enjoyed preparing for this, so I hope you are able to join Register. I have used a recognised critical appraisal framework to support me with this journal review Qualitative Studies Checklist.

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Bundles of success in SSI prevention?

Jon Otter (@jonotter) Surgical Site Infection , , ,

Surgical site infection (SSI) frustrates me. When we undertake elective procedures, we have much more control over processes and patient flows than in most other aspects of hospital life. We have a range of evidence-based interventions, and we know that if we get them right, the risk of SSI is reduced hugely. And yet, preventable SSIs continue to occur because we don’t always get the bundle of interventions implemented. And so patients suffer harm, our theatres and precious beds have to do subsequent procedures related to SSI, costs ramp up, and we have to use more and more antibiotics. I gave a webinar last week providing an overview of the bundle of interventions at our disposal to reduce the risk of SSI.

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Having a nose into nasal photodisinfection

Jon Otter (@jonotter) Photodisinfection , , , ,

When’s the last time you picked your nose? If you’re an adult, it was very probably earlier today – the average adult picks their nose around 4 times per day (eew). And that’s picking – touching is much more frequent: on average, we touch our eyes, mouth, nose, or chin a staggering 20 times per hour (with some estimates even higher). We’ve known for a while that nasal decolonisation is a vital component in reducing the risk of staphylococcal infection. But using mupirocin as the nasal decolonisation agent has important limitations in terms of spectrum of microbiological efficacy, compliance, and antibiotic resistance. I’ve recently come across a newer technology for nasal decolonisation: nasal photodisinfection. It’s been around for ages, but hasn’t really been adopted widely. This blog provides an overview of three studies that suggest nasal photodisinfection may have a role in reducing the risk of SSI, and in preventing and treating SARS-CoV-2 infection.

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HCAI and AMR point prevalence from Ukraine

Jon Otter (@jonotter) HCAI , , , , , , ,

JHI have just published an interesting point prevalence HCAI and AMR study from Ukraine. Headlines are that rates of both HCAI and AMR are higher than you’d hope to see, especially with rates of resistant to carbapenems in Gram-negative bacteria and meticillin in S. aureus.

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Setting our IPC priorities for the next 3-5 years

Jon Otter (@jonotter) General , , , ,

In honour of Infection Prevention and Control Week (#IIPW) 2021, I thought I put up a quick post based on a talk I did on Friday last week about the ‘Future of Healthcare and of Infection Prevention and Control’ (you can download my slides here). I used it as an opportunity to put across my strategic priorities for the next 3-5 years. And COVID-19 is bottom of the list – keep reading to find out why…

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Counting the cost of HCAI

Jon Otter (@jonotter) Cost , , , , ,

A Journal of Hospital Infection special edition focusses on the cost of HCAI, publishing the results of the Scottish from the Evaluation of Cost of Nosocomial Infection (ECONI) Study. 

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What does good surgical wound closure look like?

Jon Otter (@jonotter) Surgical Site Infection , , ,

I love and hate SSI prevention in equal measure. On the one hand, we have good evidence and strong guidelines around SSI prevention – but on the other hand, implementing these interventions to prevent SSI can be enormously tricky in practice. One key factor in preventing SSI is creating a well-closed wound in theatre. Surprisingly, there’s precious little data on how to measure what a well-closed surgical wound looks like. This qualitative study presents some potential indicators to measure good surgical wound closure in order to prevent SSI.

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Fear and hierarchy as drivers for antimicrobial prescribing

Jon Otter (@jonotter) antibiotic stewardship , , ,

Surgical antimicrobial prophylaxis (SAP) is one of the areas of strength in the infection prevention literature: we have high quality evidence that it works, and evidence-based guidance on how to do it effectively. And yet, you don’t have to spend long in an operating theatre to see that it’s not always done according to local guidelines. So, why are these evidence-based guidelines for SAP not implemented effectively? A short review in the Journal of Hospital Infection highlights social factors, specifically fear and hierarchy, as important drivers of antimicrobial prescribing.

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A rapid reflection from Infection Prevention 2017: HCAI ranking according to DALY

Jon Otter (@jonotter) Pneumonia , , , , , , , ,

I am heading home from an outstanding Infection Prevention 2017. There was a fair bit of discussion about hospital-associated pneumonia (HAP). HAP does not get the attention it deserves and there is more that we can and should be doing to prevent it. Although, we need to keep an eye out for unintended consequences in tackling HAP.

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SSIs – time to de-invest in laminar flow?

Jon Otter (@jonotter) Surgical Site Infection , ,

Laminar flow is a very embedded technology for the prevention of SSI in some types of surgery (especially hip and knee arthroplasty). However, it seems from a recent Lancet ID review that this widely adopted practice is way ahead of the evidence supporting it: the bottom line finding of the review is we should stop wasting time and money on laminar flow theatres for some procedures, and focus on basic prevention initiatives (especially getting antibiotic prophylaxis right) in all surgical categories.

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