Adherence to surgical site infection guidelines in Italian heart surgery units
Abstract number: 1734_143
Pan A., Ambrosini L., Lorenzotti S., Soavi L., Signorini on behalf of the GIS-INFCARD investigators L.
Objective: data regarding adherence to surgical site infection (SSI) prevention guidelines in Italian cardiac surgery units are lacking.
Methods: a multiple choice questionnaire, structured into 8 sections following the Centers for Disease Control 1999 surgical site infection (SSI) guidelines was prepared and sent to 24 units participating to a National study group (GIS-INFCARD) Answers were stratified based upon strength of recommendations: class IA (10 questions), class IB (52 questions), class II (11 questions).
Results: 17 of the 24 units answered to the questionnaire. The responding centres performed in 2005 10249 surgical procedures, that represent about 20% of all heart surgery procedure in Italy. Adherence to class IA recommendations varied between 0 and 100%. The lowest level of adherence was related to hair removal, that is performed systematically in all male patients (0% adherence), contrary to guidelines recommendations. Timing and method of hair removal were adherent to guidelines in 29 and 41% of questionnaires, respectively. While 94% of units had written guidelines on antibiotic prophylaxis, timing of antibiotic administration was adequate in 65% of units only. Adherence to class IA recommendations was 69±34%, with 5 units (29%) showing a ≥80% adherence. Answers to class IB recommendations were consistent with guidelines in 29 to 100% of questions, with an average of 65±26%; one single unit (6%) showed a ≥80% adherence. Adherence to class II recommendations was 71±28%.
Conclusions: Adherence to CDC SSI guidelines in Italy is fair. Organisational improvements, especially regarding hair removal and timing of antibiotic prophylaxis, should be implemented in most hospitals. Low level of adherence to timing of antibiotic prophylaxis despite the existence of National guidelines since 2003 indicates that new instruments to improve antibiotic prescribing need to be searched for.
|Session name:||European Society of Clinical Microbiology and Infectious Diseases|
|Location:||ICC, Munich, Germany|
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