Francesco M. Labricciosa, MD, Specialist in Hygiene and Preventive Medicine
Surgical Site Infections (SSIs) represent the most common healthcare-associated infections along the surgical pathway and up to 55% of them are preventable by implementing a range of measures before, during and after surgery. However, although several clinical guidelines for the prevention of SSIs have been published, still adherence to evidence-based recommendations is often poor. Introducing guidelines into daily practice is very challenging.
In an Editorial recently published in the Intensive and Critical Care Nursing, the authors claim that scientific evidence alone may not be sufficient to promote a behavioural change.
To overcome barriers to implementing guidelines, it is crucial to understand the contextual and cultural factors that may hinder the adoption of infection prevention and control (IPC) practices. Only adapting guidelines to a local context can promote and improve compliance with best practices.
Despite healthcare workers (HCWs) recognise the importance of guidelines and possess the needed skills, the hospital environment in which they work is not always favourable or motivating enough, or IPC practices are too often perceived as marginal compared to other clinical tasks.
A possible solution may be directly involving HCWs in adapting recommendations and guidelines into local protocols or pathways. This approach can lead to significant changes in practice. In the context of a multimodal strategy, one of the most commonly used methods to implement the prevention of SSIs is the bundle.
Moreover, according to the authors, to increase adherence with IPC programs and ensure their long-term sustainability, it is essential performing frequent evaluations of implemented IPC strategies to assess the effectiveness of an action plan and providing prompt feedback to HCWs.
The authors concluded that hospitals with a safety culture can promote education, encourage communication, and involve their HCWs, through a collaborative and multidisciplinary climate to improve compliance with IPC practices.
Global Alliance for Infections in Surgery 