Samar Saeed Morsi1, Abeer Omar2, Gautam Hebbar3, Mariam Al-Fadhli4, Wafaa S Hamza5. 1. PhD, Associate Professor at Department of Microbiology and Immunology, Faculty of Medicine, Zagazig University, Egypt, Consultant of Infection Control, Al-Razi Orthopedic Hospital, Kuwait, Sabah health region, P.O. Box: 12414 Alshamiya, Kuwait. 2. PhD, Head of Surveillance Department, at Infection Control Directorate, Ministry of Health, Sabah health region, P.O. Box: 12414 Alshamiya, Kuwait. 3. MPH, Epidemiologist at Infection Control Directorate, Ministry of Health, Sabah health region, P.O. Box: 12414 Alshamiya, Kuwait. 4. PhD, Former Director of Infection Control Directorate, Ministry of Health, Sabah health region, P.O. Box: 12414 Alshamiya, Kuwait. 5. PhD, Associate Professor at Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Egypt, Consultant of Infection Control at Infection Control Directorate, Ministry of Health, Kuwait, Sabah health region, P.O. Box: 12414 Alshamiya.
Abstract
INTRODUCTION: Prevention strategies are critical to reduce infection rates in joint arthroplasty. This study aimed to investigate the effectiveness of a set of evidence-based practices to reduce surgical site infection (SSI) rates after knee and hip arthroplasty (HPRO & KPRO). METHODS: A quasi-experimental study design (comparing pre- and post-intervention phases) was applied. Interventions were selected, adapted, and implemented in knee and hip arthroplasty procedures as a prospective practice. They consisted of 13 processes throughout the surgical encounter, including preoperative, intraoperative, and postoperative elements. RESULTS: Regarding hip arthroplasty procedures, the overall SSI rate during the pre-intervention period was 11.9%, which was reduced significantly to 5.1% (57% reduction) in the intervention period (p=0.042). For knee arthroplasty procedures, the overall baseline SSI rate during the pre-intervention period was 2.7%, which was reduced to 2.0% (26% reduction) in the intervention period. However, this reduction was not statistically significant (p=0.561). Combined methicillin-resistant Staphylococcus aureus (MRSA) screening with appropriate decolonization and targeted prophylaxis were associated with a 50% reduction in SSI caused by MRSA in knee arthroplasty. CONCLUSIONS: The implementation of multidimensional evidence-based practices was associated with a reduction in SSI following knee and hip arthroplasties. GERMS.
INTRODUCTION: Prevention strategies are critical to reduce infection rates in joint arthroplasty. This study aimed to investigate the effectiveness of a set of evidence-based practices to reduce surgical site infection (SSI) rates after knee and hip arthroplasty (HPRO & KPRO). METHODS: A quasi-experimental study design (comparing pre- and post-intervention phases) was applied. Interventions were selected, adapted, and implemented in knee and hip arthroplasty procedures as a prospective practice. They consisted of 13 processes throughout the surgical encounter, including preoperative, intraoperative, and postoperative elements. RESULTS: Regarding hip arthroplasty procedures, the overall SSI rate during the pre-intervention period was 11.9%, which was reduced significantly to 5.1% (57% reduction) in the intervention period (p=0.042). For knee arthroplasty procedures, the overall baseline SSI rate during the pre-intervention period was 2.7%, which was reduced to 2.0% (26% reduction) in the intervention period. However, this reduction was not statistically significant (p=0.561). Combined methicillin-resistant Staphylococcus aureus (MRSA) screening with appropriate decolonization and targeted prophylaxis were associated with a 50% reduction in SSI caused by MRSA in knee arthroplasty. CONCLUSIONS: The implementation of multidimensional evidence-based practices was associated with a reduction in SSI following knee and hip arthroplasties. GERMS.
Entities:
Keywords:
Evidence-based practice; hip arthroplasty; knee arthroplasty; methicillin-resistant Staphylococcus aureus; surgical site infection
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