Methods to prevent surgical site infection: An integrative review
DOI:
https://doi.org/10.33448/rsd-v13i5.45783Keywords:
Surgical wound infection; Infection control; Patient safety.Abstract
Healthcare-Related Infections are a serious public health problem, with Surgical Site Infections being the third most common post-operative complication. In Brazil, it accounts for around 17% of infections in patients undergoing surgical procedures. In developed countries, it can affect an average of 1/3 of surgical cases worldwide. Most of them are considered to be undesirable damage to health care, with preventable causes. Objective: To analyze in the scientific literature the strategies for the prevention and control of Surgical Site Infection carried out by the nursing team in hospitals. Methodology: This is an integrative review according to the guidelines outlined by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The time series was from 2018 to 2023 with the identification of 1,761 publications. After applying the eligibility criteria, 14 articles and 7 national and international guidelines were consolidated for analysis. Several studies highlight the role of nurses in conducting SSI prevention actions, either by executing the nursing process or by directing necessary interventions according to actual or potential problems presented by patients. It was noted that the adaptation and implementation of protocols, bundles, checklists and health education are fundamental strategies for standardizing and qualifying the care provided by the nursing team to surgical patients, as well as minimizing and reducing the rates of SSI. It is therefore necessary to strengthen research and development by continuously investing in new technologies, materials and surgical approaches that reduce the risk of SSI.
References
Andersson, R., Søreide, K., & Ansari, D. (2021). Surgical Infections and Antibiotic Stewardship: In Need for New Directions. Scandinavian journal of surgery. SJS: official organ for the Finnish Surgical Society and the Scandinavian Surgical Society, 110 (1), 110–112. https://doi.org/10.1177/1457496919891617
Association of PeriOperative Registered Nurses (2021). Perioperative Nursing: Scope and Standards of Practice. Denver, CO
Brasil (2017). Medidas de Prevenção de Infecção Relacionada à Assistência à Saúde. Brasília: Ministério da saúde. Anvisa.
Brasil (2021). Programa Nacional de Prevenção e Controle de Infecções Relacionadas à Assistência à Saúde (2021 – 2025). Brasília: Ministério da saúde. Anvisa.
Brasil (2024). Nota Técnica Nº 03 / 2024 - Critérios Diagnósticos das infecções relacionadas à assistência à saúde de notificação nacional obrigatória. Brasília: Ministério da saúde. Anvisa.
Araújo, B. S. & Oliveira, A. C. (2023). Adesão às medidas de prevenção de infecção do sítio cirúrgico em hospitais. Acta Paul Enferm, 36, eAPE01714. https://doi.org/10.37689/acta-ape/2023AO017134
Araújo, W. C. O. (2020). Recuperação da informação em saúde: construção, modelos e estratégias. ConCI: Convergências em Ciência da Informação, 3 (2), 100–134. https://doi.org/10.33467/conci.v3i2.13447
Badia, J. M., Rubio-Pérez, I., López-Menéndez, J., Diez, C., Al-Raies Bolaños, B., Ocaña-Guaita, J., Meijome, X. M., Chamorro-Pons, M., Calderón-Nájera, R., Ortega-Pérez, G., Paredes-Esteban, R., Sánchez-Viguera, C., Vilallonga, R., Picardo, A. L., Bravo-Brañas, E., Espin, E., Balibrea, J. M., & Spanish Observatory of Surgical Infection (2020). The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study. International journal of surgery (London, England), 82, 231–239. https://doi.org/10.1016/j.ijsu.2020.08.027
Bashaw, M. A., & Keister, K. J. (2019). Perioperative Strategies for Surgical Site Infection Prevention. AORN journal, 109(1), 68–78. https://doi.org/10.1002/aorn.12451
Batista, J., Cruz, E. D. de A., Alpendre, F. T., Rocha, D. J. M., Brandão, M. B., & Maziero, E. C. S. (2019). Prevalência e evitabilidade de eventos adversos cirúrgicos em hospital de ensino do Brasil. Revista Latino-americana de Enfermagem, 27, e2939. https://doi.org/10.1590/1518-8345.2939.3171
Calderwood, M. S., Anderson, D. J., Bratzler, D. W., Dellinger, E. P., Garcia-Houchins, S., Maragakis, L. L., Nyquist, A. C., Perkins, K. M., Preas, M. A., Saiman, L., Schaffzin, J. K., Schweizer, M., Yokoe, D. S., & Kaye, K. S. (2023). Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update. Infection control and hospital epidemiology, 44(5), 695–720. https://doi.org/10.1017/ice.2023.67
Calegari, I. B., Peixoto, C. de A., Furtado, B. E. P., Raponi, M. B. G., Felix, M. M. dos S., Ferreira, L. A., Barichello, E., & Barbosa, M. H. (2023). Métodos para vigilância de infecção do sítio cirúrgico pós-alta: revisão integrativa. Acta Paulista de Enfermagem, 36, eAPE019631. https://doi.org/10.37689/acta-ape/2023AR019631
Calegari, I. B., Raponi, M. B. G., Pacheco, F. A., Barichello, E., Haas, V. J., & Barbosa, M. H. (2021). Adesão às medidas para prevenção de infecção do sítio cirúrgico no perioperatório: estudo de coorte [Adherence to measures to prevent surgical site infection in the perioperative period: a cohort study] [Adhesión a medidas de prevención de infección de la zona quirúrgica en el perioperatorio: estudio de cohorte]. Revista Enfermagem UERJ, 29(1), e62347. https://doi.org/10.12957/reuerj.2021.62347
Centers for Disease Control and Prevention (2021). Surgical Site Infection Event (SSI). In: National Healthcare Safety Network (NHSN), editor. Patient Safety Component Manual. Atlanta, CDC.
Costa, A. C., Santa-Cruz, F., & Ferraz, Á. A. B. (2020). What’s new in infection on surgical site and antibioticoprophylaxis in surgery? ABCD. Arquivos Brasileiros De Cirurgia Digestiva (são Paulo), 33(4), e1558. https://doi.org/10.1590/0102-672020200004e1558
Curcio, D., Cane, A., Fernández, F., & Correa, J. (2019). Surgical site infection in elective clean and clean-contaminated surgeries in developing countries. International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases, 80, 34–45. https://doi.org/10.1016/j.ijid.2018.12.013
Centro de Vigilância Epidemiológica. (2022). Manual de orientação e critérios diagnósticos. São Paulo, CVE.
Dantas, H. L. de L., Costa, C. R. B., Costa, L. de M. C., Lúcio, I. M. L., & Comassetto, I. (2022). Como elaborar uma revisão integrativa: sistematização do método científico. Revista Recien - Revista Científica De Enfermagem, 12 (37), 334–345. https://doi.org/10.24276/rrecien2022.12.37.334-345
Fossatti, E. C; Mozatto, A. R & Moretto, C. F. (2019). O uso da revisão integrativa na administração: um método possível? RECC – Revista Eletrônica Científica do CRA-PR, 6 (1), 55-72.
Gillespie, B. M., Walker, R. M., McInnes, E., Moore, Z., Eskes, A. M., O'Connor, T., Harbeck, E., White, C., Scott, I. A., Vermeulen, H., & Chaboyer, W. (2020). Preoperative and postoperative recommendations to surgical wound care interventions: A systematic meta-review of Cochrane reviews. International journal of nursing studies, 102, 103486. https://doi.org/10.1016/j.ijnurstu.2019.103486
Gillespie, B. M., Bull, C., Walker, R., Lin, F., Roberts, S., & Chaboyer, W. (2018). Quality appraisal of clinical guidelines for surgical site infection prevention: A systematic review. PloS one, 13 (9), e0203354. https://doi.org/10.1371/journal.pone.0203354
Glowicz, J. B., Landon, E., Sickbert-Bennett, E. E., Aiello, A. E., deKay, K., Hoffmann, K. K., Maragakis, L., Olmsted, R. N., Polgreen, P. M., Trexler, P. A., VanAmringe, M. A., Wood, A. R., Yokoe, D., & Ellingson, K. D. (2023). SHEA/IDSA/APIC Practice Recommendation: Strategies to prevent healthcare-associated infections through hand hygiene: 2022 Update. Infection control and hospital epidemiology, 44(3), 355–376. https://doi.org/10.1017/ice.2022.304
Hernández Cantú, Enoc Isaí, Esparza Dávila, Sandra Paloma, & Reyes Silva, Alan Karim Sayeg. (2020). Eficacia de un modelo de prevención de infección de sitio quirúrgico en un hospital de segundo nivel de atención. Index de Enfermería, 29(1-2), 9-12. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1132-12962020000100003&lng=es&tlng=es.
Horgan, S., Saab, M. M., Drennan, J., Keane, D., & Hegarty, J. (2023). Healthcare professionals' knowledge and attitudes of surgical site infection and surveillance: A narrative systematic review. Nurse education in practice, 69, 103637. https://doi.org/10.1016/j.nepr.2023.103637
Lin, F., Gillespie, B. M., Chaboyer, W., Li, Y., Whitelock, K., Morley, N., Morrissey, S., O'Callaghan, F., & Marshall, A. P. (2019). Preventing surgical site infections: Facilitators and barriers to nurses' adherence to clinical practice guidelines-A qualitative study. Journal of clinical nursing, 28(9-10), 1643–1652. https://doi.org/10.1111/jocn.14766
Manoukian, S., Stewart, S., Dancer, S., Graves, N., Mason, H., McFarland, A., Robertson, C., & Reilly, J. (2018). Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology. The Journal of hospital infection, 100(2), 222–235. https://doi.org/10.1016/j.jhin.2018.06.003
Mengesha, A., Tewfik, N., Argaw, Z., Beletew, B., & Wudu, M. (2020). Practice of and associated factors regarding prevention of surgical site infection among nurses working in the surgical units of public hospitals in Addis Ababa city, Ethiopia: A cross-sectional study. PloS one, 15(4), e0231270. https://doi.org/10.1371/journal.pone.0231270
Moreale, R., Doretto, M., Maccherozzi, M., Marangone, R., Noacco, M., Paiani, A., Razzini, C., Rizzi, G., Romano, A., Sbrizzai, Q., Simeoni, I., & Palese, A. (2019). What interventions are performed in daily practice to prevent surgical site infections in neurosurgical patients? Findings from an explorative survey. Journal of perioperative practice, 29(7-8), 247–253. https://doi.org/10.1177/1750458918770338
Morikane, K., Russo, P. L., Lee, K. Y., Chakravarthy, M., Ling, M. L., Saguil, E., Spencer, M., Danker, W., Seno, A., & Charles, E. E., Jr (2021). Expert commentary on the challenges and opportunities for surgical site infection prevention through implementation of evidence-based guidelines in the Asia-Pacific Region. Antimicrobial resistance and infection control, 10(1), 65. https://doi.org/10.1186/s13756-021-00916-9
Pettis A. M. (2018). Decreasing Surgical Site Infections by Developing a High Reliability Culture. AORN journal, 108(6), 644–650. https://doi.org/10.1002/aorn.12416
Prates, C. G., Stadñik, C. M. B., Bagatini, A., Caregnato, R. C. A., & Moura, G. M. S. S. (2018). Comparação das taxas de infecção cirúrgica após implantação do checklist de segurança. Acta Paul Enferm., 31(2), 116–122. https://doi.org/10.1590/1982-0194201800018
Rarani, S. A., & Kramer, A. (2023). Three steps to reduction surgical site infection: presentation of a comprehensive model. GMS hygiene and infection control, 18, Doc17. https://doi.org/10.3205/dgkh000443
Velosa, A. S. V.; Costa, C. E. O. & Pereira, R. M. S. (2021). Incidência e fatores associados com infecção de sítio cirúrgico em cirurgias limpas. Arquivos Catarinenses de Medicina, 50 (3), 56-96, 2021. http://dx.doi.org/10.1590/1518-8345.2939.3171.
Vieira, T. W., Sakamoto, V. T. M., Moraes, L. C., Blatt, C. R., & Caregnato, R. C. A.. (2020). Validation methods of nursing protocols: an integrative review. Revista Brasileira De Enfermagem, 73, e20200050. https://doi.org/10.1590/0034-7167-2020-0050
Villar, V. C. F. L.; Duarte, S. C. M. & Martins, M. (2020). Segurança do paciente no cuidado hospitalar: uma revisão sobre a perspectiva do paciente. Cadernos de saúde pública, 36, e00223019. https://www.scielo.br/j/csp/a/Yj4QxnXJJxJbsVhrrrCQwQr/.
World Health Organization. (2009). Conceptual framework for the International Classification for Patient Safety. Final technical report. Geneva: World Health Organization; WHO. https://apps.who.int/iris/bitstream/handle/10665/70882/?sequence=4
World Health Organization. (2018). Implementation manual to support the prevention of surgical site infections at the facility level - turning recommendations into practice (interim version). Geneva: WHO. https://apps.who.int/iris/bitstream/handle/10665/330071/WHO-HIS-SDS-2018.18-eng.pdf.
World Health Organization. (2018). Preventing surgical site infections: implementation approaches for evidence-based recommendations. Geneva: WHO. https://apps.who.int/iris/bitstream/handle/10665/273154/9789241514385-eng.pdf.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Gabriella Barros dos Santos; Talita Hevilyn Ramos da Cruz Almeida; Myria Ribeiro da Silva
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
