Reduction of early surgical site and other care related infections in 3553 hip fracture patients : lessons learned from the 5-year Safe Hands project
(2022) In Antimicrobial Resistance and Infection Control 11(1).- Abstract
Background: Surgical site infection (SSI) after acute hip fracture surgery is a devastating complication associated with increased suffering and mortality. The aim of the study was to investigate early SSI, sepsis, pneumonia and urinary tract infections over five years, before and after the implementation of the Safe Hands project. Methods: This was a single-centre observational study with a 5-year longitudinal design, investigating the effects of an infection-prevention intervention targeting the clinical care pathway of individuals with acute hip fracture. Statistical analyses were based on routinely collected patient outcome data comprising 3553 patients. The study conforms to the criteria of the Strengthening the Reporting of... (More)
Background: Surgical site infection (SSI) after acute hip fracture surgery is a devastating complication associated with increased suffering and mortality. The aim of the study was to investigate early SSI, sepsis, pneumonia and urinary tract infections over five years, before and after the implementation of the Safe Hands project. Methods: This was a single-centre observational study with a 5-year longitudinal design, investigating the effects of an infection-prevention intervention targeting the clinical care pathway of individuals with acute hip fracture. Statistical analyses were based on routinely collected patient outcome data comprising 3553 patients. The study conforms to the criteria of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Results: The incidence of early SSIs decreased from 2.5% in years 1–2 to 1.1% in years 4–5. Similar results were observed for sepsis (2.7% to 1.3%) and urinary tract infections (14.2% to 4.2%). The multivariable regression results suggest that, for every observed year, the odds of early SSIs decreased. Male gender, procedure time, sepsis and preoperative skin damage increased the odds significantly. Conclusions: Our preventive bundle, based on partnership between researchers, managers and clinicians and a strong commitment to change from the involved professions, appear to be effective in reducing the frequency of potentially devastating SSIs and other hospital acquired infections after hip fracture surgery. The use of external and internal facilitators was crucial to enable individual and organisational learning and overcoming barriers to improvements. Trial registration: Clinical Trials.gov ID: NCT02983136 Registered 6 December 2016—Retrospectively registered.
(Less)
- author
- Erichsen Andersson, Annette ; Gillespie, Brigid M. ; Karlsson, Magnus ; Malchau, Henrik ; Nellgård, Bengt LU ; Wikström, Ewa ; Rogmark, Cecilia LU and Tillander, Jonatan
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Hip fracture, Hip surgery, Implementation research, Infection prevention, Knowledge translation, Surgical site infections
- in
- Antimicrobial Resistance and Infection Control
- volume
- 11
- issue
- 1
- article number
- 113
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:36064457
- scopus:85137201415
- ISSN
- 2047-2994
- DOI
- 10.1186/s13756-022-01153-4
- language
- English
- LU publication?
- yes
- id
- ae81cfbc-1fbb-4466-81e9-69c75193810c
- date added to LUP
- 2022-11-11 15:58:50
- date last changed
- 2025-07-12 11:19:06
@article{ae81cfbc-1fbb-4466-81e9-69c75193810c,
abstract = {{<p>Background: Surgical site infection (SSI) after acute hip fracture surgery is a devastating complication associated with increased suffering and mortality. The aim of the study was to investigate early SSI, sepsis, pneumonia and urinary tract infections over five years, before and after the implementation of the Safe Hands project. Methods: This was a single-centre observational study with a 5-year longitudinal design, investigating the effects of an infection-prevention intervention targeting the clinical care pathway of individuals with acute hip fracture. Statistical analyses were based on routinely collected patient outcome data comprising 3553 patients. The study conforms to the criteria of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Results: The incidence of early SSIs decreased from 2.5% in years 1–2 to 1.1% in years 4–5. Similar results were observed for sepsis (2.7% to 1.3%) and urinary tract infections (14.2% to 4.2%). The multivariable regression results suggest that, for every observed year, the odds of early SSIs decreased. Male gender, procedure time, sepsis and preoperative skin damage increased the odds significantly. Conclusions: Our preventive bundle, based on partnership between researchers, managers and clinicians and a strong commitment to change from the involved professions, appear to be effective in reducing the frequency of potentially devastating SSIs and other hospital acquired infections after hip fracture surgery. The use of external and internal facilitators was crucial to enable individual and organisational learning and overcoming barriers to improvements. Trial registration: Clinical Trials.gov ID: NCT02983136 Registered 6 December 2016—Retrospectively registered.</p>}},
author = {{Erichsen Andersson, Annette and Gillespie, Brigid M. and Karlsson, Magnus and Malchau, Henrik and Nellgård, Bengt and Wikström, Ewa and Rogmark, Cecilia and Tillander, Jonatan}},
issn = {{2047-2994}},
keywords = {{Hip fracture; Hip surgery; Implementation research; Infection prevention; Knowledge translation; Surgical site infections}},
language = {{eng}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Antimicrobial Resistance and Infection Control}},
title = {{Reduction of early surgical site and other care related infections in 3553 hip fracture patients : lessons learned from the 5-year Safe Hands project}},
url = {{http://dx.doi.org/10.1186/s13756-022-01153-4}},
doi = {{10.1186/s13756-022-01153-4}},
volume = {{11}},
year = {{2022}},
}