1109 - Implementation Challenges to Prevent Infections in Colon Surgeries

Monday, June 26, 2023

1:30 PM – 2:30 PM

Location: W308 A-D; Orange County Convention Center

CE: 1

CNE Credits: 1
IPU Credits: 1
AEU Credits: 1
IPCH Credits: 1
CME Credits: 1

Presenter(s)

Maureen P. Spencer, M.Ed, BSN, RN, CIC, FAPIC (she/her/hers)

Infection Preventionist Consultant
Infection Preventionist Consultants
Halifax, Massachusetts

Disclosure(s): Aerobiotix: Speaker/Honoraria (Ongoing); Ethicon: Speaker/Honoraria (Ongoing); Healthy Sole: Consultant/Advisory Board (Ongoing); Premier, Inc: Faculty / Presenter / Author (Ongoing); Zurex Pharma: Consultant/Advisory Board (Terminated, December 31, 2021)

Co-Presenter(s)

Peter B. Graves, BSN, RN, CNOR

Independent perioperative consultant, speaker and writer
Clinical Solution, LLC
Corinth, Texas

Disclosure(s): Aerobiotix, Inc: Speaker/Honoraria (Ongoing); Ansell Healthcare: Consultant/Advisory Board (Ongoing); Avidicare, AB: Speaker/Honoraria (Ongoing); Premier, Inc: Consultant/Advisory Board (Ongoing); TTi Consultants: Consultant/Advisory Board (Ongoing); Zurex Pharma, Inc: Consultant/Advisory Board (Ongoing)
Lena Camperlengo, DrPH, MPH, RN

Senior Director
Premier, Inc
Ocala, Florida

Disclosure(s): Premier, Inc.: Employment (full or part time) (Ongoing)

Moderator(s)

Teresa Daniels, MSN,RN,CIC,CPPS,T-CHEST,FAPIC,CPHQ

Central Kentucky Market Director of Infection Prevention
Lifepoint Health

Disclosure(s): No financial relationships to disclose

Co-Moderator(s)

Stephanie Carraway, MPH, CIC, LTC-CIP CER, FAPIC

Director, Infection Prevention
Moffitt Cancer Center
Tampa, Florida

Disclosure(s): No financial relationships to disclose

Session Description: The use of Implementation Science promotes the incorporation of research findings and other evidence-based guidelines into routine practice and improve the quality and effectiveness of health services. Evidence-based surgical site infections (SSI) prevention strategies have been updated in guidelines and recommendations since 2016 (American College of Surgeons (ACS) and 2017 (Centers for Disease Control and Prevention (CDC)). There has been a limited number of published studies demonstrating actual implementation of these guidelines and the barriers and facilitators to employing SSI prevention strategies.

The results of an observational study set in three large and geographically diverse hospital systems demonstrated the challenges they faced when attempting to employ these recommendations. We evaluated the implementation of seven SSI-reduction recommendations from CDC, ACS and other guidelines that had been published for about five years before the study began. We sought to better understand the barriers and facilitators to implementation in a real-world setting. Each study component was chosen and operationalized in the peri-operative setting to include practices employed in the operating room and post anesthesia care unit. The study included approximately 800 colon surgeries over a 12-month period and included adult, non-emergency, non-trauma, and colon surgeries.

The observational study underscored the challenges in implementing new evidence-based recommendations. More than five years after the SSI guidelines were published, there was inconsistent evidence they were implemented. The lack of standardization measurement techniques, definitions, and policies was noted within these study sites. These three major findings need attention in every healthcare organization when actively implementing evidence-based guidelines focused on reducing SSIs. Without these fundamental steps, any quality improvement initiative will fail to demonstrate measurable and sustainable results. A structured approach to the adoption and implementation of SSI guidelines will be reviewed and discussed in this interactive workshop.

Learning Objectives:

Describe Implementation Science as related to the prevention of colon surgery infections and the incorporation of SSI guidelines into routine practice to improve the quality of perioperative care.
Describe methodology used in a one-year observational study evaluating the implementation of seven components from SSI guidelines for the prevention of colon surgical site infections.
Review the challenges and solutions identified by surgeons, operating room nurses, and study coordinators in the implementation of SSI guidelines during the surgical experience.