Abstract
Background
The purpose of this study was to assess predictive factors and compliance with surgical
site infection (SSI) prevention guidelines at 2 county hospitals.
Design
Chart review and analysis of laparotomy patients undergoing colorectal, hysterectomy,
or abdominal vascular procedures over two 6-month periods 1 year apart and evaluation
of safety climate using the Safety Attitudes Questionnaire (SAQ).
Results
Overall compliance with all antibiotic prophylaxis guidelines was 62% (n = 442). Gynecologic
surgery was an independent predictor of compliance with antibiotic prophylaxis guidelines
in elective cases, and nonemergency status was an independent predictor when all cases
were considered. Postoperative normothermia was predicted by hospital, procedure length,
initial intraoperative temperature, and service. The SAQ had a 91% response rate.
Contrary to expected, safety domain scores and agreement with statements on collaboration
and teamwork were not predictive of compliance.
Conclusion
Interventions to improve poor compliance with infection prevention guidelines must
be multifaceted, hospital- and service-specific, and resilient during emergencies.
Good safety and teamwork climate are not sufficient.
Keywords
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Article info
Publication history
Published online: June 23, 2010
Received in revised form:
May 28,
2009
Received:
January 5,
2009
Footnotes
This research was supported in part by a grant under the Robert Wood Johnson Foundation Physician Faculty Scholars Program.
Clinical Trials Information: Prevention of Surgical Site Infections, Clinical Trials Identifier: NCT00353613, http://clinicaltrials.gov/ct2/show/NCT00353613?term=kao&rank=2.
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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