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Adherence to international and national recommendations for the prevention of surgical site infections in elective surgery at two tertiary hospitals in Oman

Al Ismaili, Salim 2017. Adherence to international and national recommendations for the prevention of surgical site infections in elective surgery at two tertiary hospitals in Oman. PhD Thesis, Cardiff University.
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Abstract

Surgical site infections are the most common healthcare acquired infections among surgical patients. The lives of surgical patients who develop surgical site infections are characterised by prolonged hospital stays and increased morbidity, mortality and increased medical healthcare costs. Consequently, it is recommended that surgical team staff should adhere to specific recommendations and practices to prevent surgical site infections. The risk of contracting surgical site infections depends on surgically related factors such as the duration of one’s pre-operative hospital stay, the use of antibiotics in surgery, pre-operative skin preparation with an appropriate antiseptic, the use of aseptic techniques, preoperative hair removal with clippers, and reducing of human traffic flow in operating theatres. In addition to this, patient related factors such as nutritional status, obesity, age, and underlying illnesses like diabetes mellitus are other potential sites of risk. The present study aims to both comprehensively assess adherence to existing guidelines, and compare current preoperative strategies with evidence-based guidelines for the prevention of surgical site infections. Findings from quantitative research underscore that, although perioperative healthcare providers follow the surgical site infection prevention guidelines, they do not fully adhere to current recommended practices. More specifically, findings indicate a lack of adherence to preventative guidelines for surgical site infection, such as duration of antibiotic prophylaxis, preoperative hair removal of the patient with the use of razors (which is no longer recommended), preoperative showering without the use of proper antiseptic agents, and use of incorrect preoperative skin cleaning techniques during the preparation of the incision site. Furthermore, this study identifies issues concerning adherence to other measures recommended intraoperatively, including, frequent opening of the operating room door and movement of people in the operating room during surgical procedures, having higher numbers of surgical team staff in the operating room than required for most surgical procedures, the wearing of jewellery in operating theatres, improper usage of surgical masks and caps, as well as using personal mobile phones in operating rooms. The results of this study show that adherence with infection control recommendations in the operating theatre need to be carefully monitored, and risk factors that contribute to health care professionals’ non-adherence with recommended practices also need to be identified to improve the quality of routine surgical practice for the safety of the surgical patient.

Item Type: Thesis (PhD)
Date Type: Submission
Status: Unpublished
Schools: Cardiff University Centre for Human Development Science (CHDS)
Healthcare Sciences
Date of First Compliant Deposit: 29 November 2018
Last Modified: 29 Nov 2018 09:57
URI: http://orca.cf.ac.uk/id/eprint/117161

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