P L Russo1, E Saguil2, M Chakravarthy3, K Y Lee4, M L Ling5, K Morikane6, M Spencer7, W Danker8, N Y C Yu9, C E Edmiston10. 1. Department of Nursing-Midwifery and Nursing Research, Monash University and Cabrini Health, Frankston, VIC, 3199, Australia. 2. Department of Surgery, Philippine General Hospital, Manila, 1000, Philippines. 3. Department of Anesthesia, Fortis Hospitals, Bannerghatta Road, Bangalore, 560002, India. 4. Department of Surgery, KyungHee University Medical Center, Seoul, 02447, South Korea. 5. Department of Infection Prevention, Singapore General Hospital, 149043, Singapore. 6. Department of Clinical Laboratory and Infection Control, Yamagata University Hospital, Yamagata, 990-8560, Japan. 7. Infection Prevention Consultant, Boston, Massachusetts, 02191, USA. 8. Department of Global Health Economics & Market Analysis, Ethicon, Johnson & Johnson Medical Device Co, Newtown, 18940, USA. 9. Department of Health Economics, Johnson & Johnson Medical Pty. Ltd., North Ryde, NSW, 2113, Australia. 10. Department of Surgery, Medical College of Wisconsin, Wisconsin, 53226, USA. Electronic address: cedmisto@mcw.edu.
Abstract
BACKGROUND: Surgical site infections (SSIs) represent a substantial clinical and economic burden on patients and the healthcare system. The prevention of SSIs entails surveillance activities which lead to effective mitigation strategies, which are lacking across Asia Pacific (APAC). This manuscript aims to document gaps and challenges across APAC that affect the undertaking of a successful SSI surveillance activities and to provide recommendations on overcoming such challenges. METHODS: A targeted literature review with relevance to APAC identified a series of salient points pertaining to SSI prevention guidelines, implementation, surveillance and outcomes, which was discussed in July 2019 at the APAC Surgical Site Infection Prevention Symposium. An expert panel, comprising eight multidisciplinary experts from APAC and the USA, subsequently amalgamated the key discussion points from the Symposium and their clinical experiences in developing this article. RESULTS: The barriers to implementing a successful and effective APAC SSI surveillance program were identified as: (a) lack of standardized definitions, reporting methodology and accountability, (b) lack of fiscal resources, (c) reporting variability and under-reporting, and (d) lack of safety culture. Implementing an effective surveillance program in APAC will require countries to develop a well-designed and robust surveillance plan and ensure adequate training for staffs involved. CONCLUSION: To improve SSI prevention in the region, it is imperative to encourage implementation of national programs with standardized methodologies and accountabilities. An ongoing APAC information exchange, including data and methodologies, will enable continuous learning within the APAC region.
BACKGROUND: Surgical site infections (SSIs) represent a substantial clinical and economic burden on patients and the healthcare system. The prevention of SSIs entails surveillance activities which lead to effective mitigation strategies, which are lacking across Asia Pacific (APAC). This manuscript aims to document gaps and challenges across APAC that affect the undertaking of a successful SSI surveillance activities and to provide recommendations on overcoming such challenges. METHODS: A targeted literature review with relevance to APAC identified a series of salient points pertaining to SSI prevention guidelines, implementation, surveillance and outcomes, which was discussed in July 2019 at the APAC Surgical Site Infection Prevention Symposium. An expert panel, comprising eight multidisciplinary experts from APAC and the USA, subsequently amalgamated the key discussion points from the Symposium and their clinical experiences in developing this article. RESULTS: The barriers to implementing a successful and effective APAC SSI surveillance program were identified as: (a) lack of standardized definitions, reporting methodology and accountability, (b) lack of fiscal resources, (c) reporting variability and under-reporting, and (d) lack of safety culture. Implementing an effective surveillance program in APAC will require countries to develop a well-designed and robust surveillance plan and ensure adequate training for staffs involved. CONCLUSION: To improve SSI prevention in the region, it is imperative to encourage implementation of national programs with standardized methodologies and accountabilities. An ongoing APAC information exchange, including data and methodologies, will enable continuous learning within the APAC region.