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. 2022 Feb 1;275(2):e345-e352.
doi: 10.1097/SLA.0000000000004909.

Use of Feedback Data to Reduce Surgical Site Infections and Optimize Antibiotic Use in Surgery: A Systematic Scoping Review

Shalini Ahuja  1 , Nathan Peiffer-Smadja  2 , Kimberly Peven  3 , Michelle White  4   5 , Andrew J M Leather  4 , Sanjeev Singh  6 , Marc Mendelson  7 , Alison Holmes  2 , Gabriel Birgand  2 , Nick Sevdalis  1 ; ASPIRES study co-investigators
Affiliations

Use of Feedback Data to Reduce Surgical Site Infections and Optimize Antibiotic Use in Surgery: A Systematic Scoping Review

Shalini Ahuja et al. Ann Surg. .

Abstract

Objective: Surgical site infection (SSI) prevention remains significant, particularly in the era of antimicrobial resistance. Feedback on practices and outcomes is known to be key to reduce SSI rates and optimize antibiotic usage. However, the optimal method, format and frequency of feedback for surgical teams remains unclear. The objective of the study is to understand how data from surveillance and audit are fed back in routine surgical practice.

Methods: A systematic scoping review was conducted, using well-established implementation science frameworks to code the data. Two electronic health-oriented databases (MEDLINE, EMBASE) were searched to September 2019. We included studies that assessed the use of feedback as a strategy either in the prevention and management of SSI and/or in the use of antibiotics perioperatively.

Results: We identified 21 studies: 17 focused on SSI rates and outcomes and 10 studies described antimicrobial stewardship for SSI (with some overlap in focus). Several interventions were reported, mostly multimodal with feedback as a component. Feedback was often provided in written format (62%), either individualized (38%) or in group (48%). Only 25% of the studies reported that feedback cascaded down to the frontline perioperative staff. In 65% of the studies, 1 to 5 implementation strategies were used while only 5% of the studies reported to have utilized more than 15 implementation strategies. Among studies reporting antibiotic usage in surgery, most (71%) discussed compliance with surgical antibiotic prophylaxis.

Conclusions: Our findings highlight the need to provide feedback to all levels of perioperative care providers involved in patient care. Future research in this area should report implementation parameters in more detail.

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Conflict of interest statement

NS is the director of London Safety and Training Solutions Ltd and MW is on Board of Directors of Mercy Ships International, which provides free surgical procedures. The other authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram.
FIGURE 2
FIGURE 2
Implementation strategies in the included studies.
FIGURE 3
FIGURE 3
Implementation outcomes assessed in the included studies.
See this image and copyright information in PMC

References

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