gms | German Medical Science

German Congress of Orthopedic and Trauma Surgery (DKOU 2018)

23.10. - 26.10.2018, Berlin

Systematic review on implementation of infection prevention measures in orthopedics and traumatology

Meeting Abstract

  • presenting/speaker Benedikt Marche - Kliniken der Stadt Köln in Merheim, Klinik für Orthopädie und Unfallchirurgie, Köln, Germany
  • Meike Strybos - Kliniken der Stadt Köln in Merheim, Institut für Hygiene, Köln, Germany
  • Christiane Kugler - Albrecht-Ludwigs-Universität Freiburg, Bereich Pflegewissenschaft, Freiburg, Germany
  • Frauke Mattner - Kliniken der Stadt Köln in Merheim, Institut für Hygiene, Köln, Germany
  • Robin Otchwemah - Kliniken der Stadt Köln in Merheim, Institut für Hygiene, Köln, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2018). Berlin, 23.-26.10.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. DocAT24-731

doi: 10.3205/18dkou386, urn:nbn:de:0183-18dkou3868

Published: November 6, 2018

© 2018 Marche et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objectives: Prevention of hospital acquired infections is one of the major concerns of patients and physicians at the same time. As part of the HYGArzt-Project (“Proof Of Effectivity And Efficiency Of Implementation Of Infection Prevention (IP) Measures By The Physician Responsible For Infection Prevention Matters In Traumatology/Orthopedics”), the objective of this study was to identify effective implementation strategies for IP measures in orthopedics and trauma surgery.

Methods: A Systematic review was conducted following PRISMA guidelines. A literature search was performed in PubMed and The Cochrane Library between 1951 and June 2017. We searched for all papers dealing with infection in orthopedic and trauma surgery, which were then scanned for implementation contents. All types of research or studies were considered eligible. Exclusion criteria were language other than English or German, and insufficient reporting of implementation methods. Risk of bias was not assessed.

Results: The literature search resulted in 7642 citations. 13 records were eligible for analysis (all published between 2004-2017 and featuring elective orthopedics cohorts). Studies were primarily of before-after type featuring various designs from single interventions to multi-measure bundles. Described methods of implementation were heterogeneous. Positive results were reported in 10 out of 13 studies, outcome parameters were increase of adherence/compliance (iA/C) or decrease in surgical site infection rate (dSSI%); one study showed failure at improving outcome. Building of an interdisciplinary team (considered in 7/13 studies; successful in 7/7 studies [concerning dSSI% 3/3 studies, concerning iA/C 4/4]), standardized perioperative antibiotic prophylaxis guidelines (considered in 7/13 studies, successful in 7/7, [concerning dSSI% 2/2, concerning iA/C 5/5]) and paper-based or electronic information material (for patient and/or staff; considered in 8/13 studies; successful in 8/8 [concerning dSSI% 4/4, concerning iA/C 5/5]) were the most frequently used implementation methods. Reporting and measured variables of outcome were inconsistent (SSI% in 6/13 studies; adherence/compliance in 10/13, both in 4/13).

Conclusions: The evidence on the effectiveness of implementation measures for IP improvement in orthopedics and traumatology is scarce. Despite the limited number of eligible studies, successful implementation measures were identified.