NURS 340 Public Health Nursing: Healthcare Associated Infection

Questions:

Answers:

Research Question:

• What are the prevalence and incidence of surgical site infection in Saudi Arabia?
• What are the risk factors of surgical site infection in the health care settings?
• What re the effective interventions that need to be introduced in order to manage the surgical site infection in the health care settings?

Research Objectives:

• To study the prevalence and incidence of surgical site infection in Saudi Arabia.
• To identify the risk factors that have contributed to the consequence of surgical site infection in the health care settings.
• To find out the effective strategies that need to be taken in order to manage surgical site infection in health care settings.

Significance of the topic:

Healthcare associated infections are defined as the infection that patients received during treatment in the hospital and it has become one of the most common public health issue in the recent decades (Weiner et al., 2016). Among different healthcare associated infection, prevalence of surgical site infection has been found to be high. People have been found to suffer from mild to severe surgical site infection and in many cases the surgical site has been found to lead to the consequence of life threatening condition as well (Leaper, et al., 2015). Beside such serious situations there are some common sufferings for example, SSI could increase the duration of stay in the hospital after the surgery, could escalate the expense drastically, increases the risk of readmission in the hospital and leads to the jeopardized health outcomes as well (Rasouli et al., 2014). Study has reported that with 27 million surgery per year, approximately 300,000 have been found to be diagnosed with SSI (Al-Mulhim et al., 2014). Research has indicated that SSI increases the risk of death by to 11 folds (AL-Aali, 2016). Thus, it has become a major concern for the health system of Saudi Arabia. Hence it is important to identify the potential factors that leads to the consequence of SSI and introduce effective strategies to resolve the issue and reduce the prevalence of SSI in an effective manner. Such research would help utilize adequate measures in the clinical practice to manage people after surgery and avoid SSI and manage the people that are suffering from SSI to reduce the mortality rate. Due to such significance of the study the topic has been selected for the research.

Introduction:

Health care associated infection refers to the infection that occur during treatment within a healthcare organization and Surgical site infection has been found to be one of the most common healthcare associated infection (Weiner et al., 2016). Surgical site infection is defined as the infection which occurs in the specific parts of the body after surgery. The infection has been found to be superficial and involves only skin, however, in some severe cases the infection may include organs, tissues or other implanted materials as well. SSI could be organ manipulated during surgery or incisional (Leaper, et al., 2015). It has been found that most of the SSI is occurred due to the bacterial flora of the patient. One of the most common microorganism associated with SSI is Staphylococcus aureus. Approximately 20% SSI within patient caused by this organism (AL-Aali, 2016). The risk factors include use of steroid, diabetes, obesity, malnutrition, nicotine use, long duration of postoperative stay and transfusion in perioperative period as well (Martin et al., 2016). In addition, some clinical actions such as inappropriate use of equipment, improper preparation of skin during surgery, inappropriate management of surgical techniques and asepsis are also responsible for increasing risk of SSI (Rasouli et al., 2014). Different studies have been introduced to identify the effective strategies to reduce the risk of SSI and to manage SSI. It has been informed that appropriate management of surgical environment is one of the effective measure to prevent SSI, in this regards using sterile equipment proper use of antimicrobial prophylaxis and appropriate preparation of the skin is important (Berríos-Torres et al., 2017). It is required to limit the duration of antimicrobial administration, otherwise, indiscriminate antimicrobial administration could lead to the consequence of infection due to antibiotic resistance microorganisms (Allegranzi et al., 2016). Additional strategy should include proper dressing of the site of infection, using antibiotic is important in order to dry the place faster and using adhesive drapes impregnated with antiseptic (Leaper et al., 2015). Furthermore, education of the infection management team and other staffs is important and they should be informed about using personal protective equipment and aseptic procedures to prevent the transmission of the infection (Berríos-Torres et al., 2017). Such information from the previous studies would help to prevent and manage SSI and create awareness in individual level. Thus, the study aims to search relevant previous studies and use primary research to address the research questions effectively.

Key terms: Healthcare associated infection, surgical site infection, prevalence, incidence, risk factors, treatment, surgical environment, and antibiotic prophylaxis.

References:

AL-Aali, K. Y., (2016) Evaluation of Surveillance for Surgical Site Infections and Drug Susceptibility Patterns, Taif, Saudi Arabia. Ann Clin Lab Res, 4:2.

Allegranzi, B., Bischoff, P., de Jonge, S., Kubilay, N. Z., Zayed, B., Gomes, S. M., ... & Boermeester, M. A. (2016). New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. The Lancet Infectious Diseases, 16(12), e276-e287.

Al-Mulhim, F. A., Baragbah, M. A., Sadat-Ali, M., Alomran, A. S., & Azam, M. Q. (2014). Prevalence of surgical site infection in orthopedic surgery: a 5-year analysis. International surgery, 99(3), 264-268.

Berríos-Torres, S. I., Umscheid, C. A., Bratzler, D. W., Leas, B., Stone, E. C., Kelz, R. R., ... & Dellinger, E. P. (2017). Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. JAMA surgery, 152(8), 784-791.

Leaper, D. J., Tanner, J., Kiernan, M., Assadian, O., & Edmiston Jr, C. E. (2015). Surgical site infection: poor compliance with guidelines and care bundles. International wound journal, 12(3), 357-362.

Martin, E. T., Kaye, K. S., Knott, C., Nguyen, H., Santarossa, M., Evans, R., ... & Jaber, L. (2016). Diabetes and risk of surgical site infection: a systematic review and meta-analysis. infection control & hospital epidemiology, 37(1), 88-99.

Rasouli, M. R., Restrepo, C., Maltenfort, M. G., Purtill, J. J., & Parvizi, J. (2014). Risk factors for surgical site infection following total joint arthroplasty. JBJS, 96(18), e158.

Weiner, L. M., Webb, A. K., Limbago, B., Dudeck, M. A., Patel, J., Kallen, A. J., ... & Sievert, D. M. (2016). Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011–2014. infection control & hospital epidemiology, 37(11), 1288-1301.