Examining barriers to implementing a surgical-site infection bundle

Kimberly C Dukes; Heather Schacht Reisinger; Marin Schweizer; Melissa A Ward; Laura Chapin; Timothy C Ryken; Trish M Perl; Loreen A Herwaldt

doi:10.1017/ice.2023.114

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Examining barriers to implementing a surgical-site infection bundle

Journal article

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Examining barriers to implementing a surgical-site infection bundle

Kimberly C Dukes, Heather Schacht Reisinger, Marin Schweizer, Melissa A Ward, Laura Chapin, Timothy C Ryken, Trish M Perl and Loreen A Herwaldt

Infection control and hospital epidemiology, Vol.45(1), pp.13-20

01/2024

DOI: 10.1017/ice.2023.114

PMCID: PMC10782202

PMID: 37493031

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Abstract

BACKGROUNDSurgical-site infections (SSIs) can be catastrophic. Bundles of evidence-based practices can reduce SSIs but can be difficult to implement and sustain. OBJECTIVEWe sought to understand the implementation of SSI prevention bundles in 6 US hospitals. DESIGNQualitative study. METHODSWe conducted in-depth semistructured interviews with personnel involved in bundle implementation and conducted a thematic analysis of the transcripts. SETTINGThe study was conducted in 6 US hospitals: 2 academic tertiary-care hospitals, 3 academic-affiliated community hospitals, 1 unaffiliated community hospital. PARTICIPANTSIn total, 30 hospital personnel participated. Participants included surgeons, laboratory directors, clinical personnel, and infection preventionists. RESULTSBundle complexity impeded implementation. Other barriers varied across services, even within the same hospital. Multiple strategies were needed, and successful strategies in one service did not always apply in other areas. However, early and sustained interprofessional collaboration facilitated implementation. CONCLUSIONSThe evidence-based SSI bundle is complicated and can be difficult to implement. One implementation process probably will not work for all settings. Multiple strategies were needed to overcome contextual and implementation barriers that varied by setting and implementation climate. Appropriate adaptations for specific settings and populations may improve bundle adoption, fidelity, acceptability, and sustainability.

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Details

Title: Subtitle: Examining barriers to implementing a surgical-site infection bundle
Creators: Kimberly C Dukes - University of Iowa
Heather Schacht Reisinger - University of Iowa
Marin Schweizer - University of Wisconsin–Madison
Melissa A Ward - University of Iowa
Laura Chapin - Boston Scientific (United States)
Timothy C Ryken - Dartmouth–Hitchcock Medical Center
Trish M Perl - The University of Texas Southwestern Medical Center
Loreen A Herwaldt - University of Iowa
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.45(1), pp.13-20
DOI: 10.1017/ice.2023.114
PMID: 37493031
PMCID: PMC10782202
NLM abbreviation: Infect Control Hosp Epidemiol
eISSN: 1559-6834
Publisher: Cambridge University Press
Language: English
Electronic publication date: 07/26/2023
Date published: 01/2024
Academic Unit: Infectious Diseases; Epidemiology; Center for Social Science Innovation; General Internal Medicine; Neurosurgery; Community and Behavioral Health; Internal Medicine
Record Identifier: 9984447959302771

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