Sometimes you don’t think about it. But there are steps which, during surgery, take on fundamental importance due to the possible risk of complications. And then it is necessary to also reflect on the infections that can occur in the area where the surgeon creates the passage through the skin to intervene on the pathology that is the subject of the operation.
These are surgical site infections, which can have a clinical and economic impact that should not be underestimated, with possible risks for the patient’s health and for the centre’s activity.
A conference was dedicated to the topic in Florence, entitled “Prevention of surgical site infections”, coordinated by Francesco Venneri, Director of the Clinical Risk Management and Patient Safety Center at the Tuscany Region.
Why focus on prevention
According to experts, by acting on these types of healthcare-related infections, various results can be achieved. Firstly, the morbidity and mortality of these events can be reduced, with repercussions on patient safety and the quality of care. Thanks to the adoption of guidelines (WHO, CDC) and prevention bundles (pre-, intra- and post-operative measures) clinical outcomes can be improved, reducing post-operative complications and improving the patient’s quality of life.
On the system front, a containment of healthcare costs can be achieved given that in the presence of surgical infections, hospital stays are prolonged and costs for drugs, additional diagnostic procedures and re-operations increase. Finally, thanks to this approach we can contribute to the fight against antibiotic resistance: correct and targeted use of perioperative antibiotic prophylaxis (administered at the right times) helps to counteract the spread of resistant bacteria.
All this indicates how much and how prevention represents a systemic approach (surveillance + aseptic measures) fundamental to guarantee a safe operating environment and reduce the risk of contamination of the surgical wound.
“It is essential to share these messages and these strategies with all the stakeholders of the topic, in order to promote in healthcare facilities a policy of attention to the phenomenon and containment of clinical risk for the purposes of reducing litigation through knowledge of current scientific evidence and formulating a specific best practice that can allow accurate monitoring of the phenomenon”
comments Venneri.
Proposals and expectations
The sharing of regional level recommendations and guidelines for Tuscany that are based on the evidence of the relevant scientific societies is the first step to improve the situation. It is then necessary to focus on the identification of common priority actions for the prevention of surgical site infections and shared indicators for monitoring and continuous improvement, with a view to arriving at a sort of regional “synthesis document”.
In this sense, the round table of the “Risk Managers” of the public health companies of the Tuscany Region on the topic of prevention of surgical site infections highlighted the need to implement the practices for the safety of care already in place in the context of clinical risk management on the topic of prevention of healthcare-related infections. What to do?
“We need to develop a new bundle dedicated precisely to the prevention of these infections”
commented Venneri, highlighting how
“respect and application of the actions envisaged by the bundle can strategically contribute to their reduction”.
Furthermore, it emerged that it is important to involve political decision makers in accepting suggestions from professionals through risk managers such as
“provide for the presence of the risk manager figure already in the context of the evaluation commissions for the purchases of technologies and medical devices”
is the expert’s emphasis. All this, acting on the awareness of the healthcare workers themselves.
In conclusion, there has been recognition by several experts working in the Tuscany Region of how important strategies for reducing the incidence of surgical site infections are in the broader fight against healthcare-related infections. Everything must go through the involvement of the citizen, of young medical university students, of all front line operators and as reiterated by Venneri
“also strategic directions, according to a multi-professional and interdisciplinary modus operandi, where a systemic approach with the contribution of all the actors in the process is essential to achieve objectives of quality and safety of care”.
