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NP-005 Self-assessment on the implementation of recommendations of the perioperative process: infectious risk management in surgery setting
  1. Ela Murrja,
  2. Sara Pugliese,
  3. Francesco Casoli,
  4. Milena Casciari,
  5. Serena Natalini,
  6. Alessandro Caraffa,
  7. Angela Giuliani,
  8. Cristina Paolucci,
  9. Massimo Farina,
  10. Alessandro D’Arpino


Background and Importance Surgical site infections (SSIs) are among the most common complication in surgery. They are associated with longer postoperative hospital stays, may necessitate additional surgical procedures, require long antimicrobial treatment leading to an increased antimicrobial resistance contributing to a costly healthcare. It’s necessary to adopt a healthcare policy aimed at a more rational use of antimicrobials to limit antimicrobial resistance.

Our aim was to develop a self-assessment on the implementation of the recommendations, in order to identify key gaps and provide guidance and recommendations for improving IPC (infection prevention and control) practices.

Materials and Methods A multidisciplinary collaboration has involved infectious disease specialists, hospital pharmacists, microbiologists, intensivists, emergency surgeons, nurses. It was conducted a thorough self-assessment on the four following surgery areas: general surgery, emergency surgery, Orthopedic Surgery, Cardiosurgery Unit during July 2021 – March 2022.

A summary results of the recommendations core components self-assessment was provided by a scored checklist attributed to a specific level of recommendations implementation (score 0: not applicable; 1: no implementation; 2: ≤50%; 3: >50%; 4: 100% implementation).

The checklist report 13 macro-requisites to which a score is assigned; for each requirement was reported the number of improvement actions.

Results Following the assessment, 31 improvement actions were identified. The comparison versus total average of values shows 4 macro requirements under threshold: Screening per S. Aureus; Preoperative bathing; mechanical bowel preparation and the use of oral antibiotics and the maintenance of adequate circulating volume control/normovolemia.

This self-assessment reported 8 improvement actions in Emergency Surgeon: 10 in Orthopedic Surgery, 6 actions in General Surgery and 7 improvement actions in Cardio Surgery.

Furthermore, were highlighted important shortcomings such as antimicrobial prophylaxis for the prevention of SSI in colorectal surgery: scored 1,3 (NA); screening per S. Aureus in orthopedic surgery: score 1.

Conclusion The assessment allowed the identification of the priority areas intervention, in order to set innovative strategic actions to improve safety in the perioperative process.

In the future it will be possible to implement strategies with proven effectiveness and a global approach. The aim is to overcome and refining guidelines by providing a comprehensive range of evidence-based recommendations for the prevention of SSIs.

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