SURGICAL SITE INFECTION (SSI) SYNOPSIS, INCLUDING MODIFIABLE AND NON-MODIFIABLE RISK FACTORS Estimated 45,000 SSIs occur annually in Australia leading to approximately 900 deaths.
Reducing surgical site infections (SSIs) involves a combination of measures before, during, and after surgery. These include preoperative measures, with preoperative antibiotics, skin preparation and hair removal.
Intraoperative measures including deploying sterile and proper surgical technique, including maintaining normothermia or body temperature within ranges that optimise immune function and wound healing.
Postoperative measures include surgical wound management, using appropriate dressing changes, and anti-bacterial sutures. The mobilisation of the patient is continued to improve circulation and promote healing, as well as the monitoring and surveillance of signs of infection.
Some of these measures are discussed by Professor Philip Russo, a healthcare researcher and the Director of Research at Nursing and Midwifery at Monash University in Melbourne.
Professor Russo has dedicated the last decade to studying healthcare-associated infection and infection prevention and control. His focus has been on surgical site infections, which are common in hospital settings.
He talks about surgical site infections classified as either superficial, involving only the subcutaneous tissue, or deep, which may involve muscle, bone, or organs. These infections occur after a surgical procedure, manifesting as redness, soreness, and fever around the surgical site. While superficial infections are generally easier to treat with a short course of antibiotics and are often managed outside the hospital, deep and organ space infections are more serious and can be life-threatening. They often require long courses of antimicrobial therapy and may necessitate additional surgical intervention, leading to extended hospital stays and increased morbidity and mortality.
Talking to the Australian Health Journal, Professor Russo states there is a particular concern in joint operations, such as hip or knee replacements, as infections in these areas can have severe consequences, including the removal of the infected joint, prolonged treatment, and significant costs for both hospitals and patients. Despite the substantial impact of surgical site infections, Australia lacks a national surveillance program for these infections, making it challenging to obtain accurate data. However, an estimate suggests that around 45,000 surgical site infections occur annually in Australia, resulting in approximately 900 deaths.
To better understand the prevalence of surgical site infections, Professor Russo and his team conducted a point prevalence survey in 19 acute large hospitals across Australia. The survey revealed that approximately 10% of patients had an infection, with surgical site infections accounting for around 28% of these cases, making them the most common type of infection found in adults in acute care hospitals in 2017-2018.
Professor Russo also highlights various risk factors that contribute to the development of surgical site infections, including non-modifiable factors such as age, gender, and immune status, as well as modifiable factors like diabetes, obesity, and tobacco use. By addressing these risk factors before and during surgery, the likelihood of infection can be reduced.
Through his research, Professor Russo aims to raise awareness about the significant impact of surgical site infections and the importance of implementing preventive measures to reduce their occurrence and improve patient outcomes.
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Health-Tech Connections
Challenges in health care delivery have compounded, with clinical staff being exposed to the Omicron COVID variant. Reduced staffing has brought on its challenges to most already-strained state health care systems and the people working in them.
However, over the past 2 years of the pandemic, technology has played an increasing role on the front end for patients and consumers at home and clinicians in the medical setting. Much more is planned in technology that will deliver efficiency, reduce risk and make available new models of care. This has the potential to touch the working lives of all stakeholders and
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Australia’s Nursing Crisis Snapshot
“Nursing, already under pressure, is reaching breaking point due to the pressures of COVID-19 and a disjointed healthcare system, including the acute, primary and aged care sectors”, says Kylie Ward, Australian College of Nursing CEO adding, “We must act now to protect our nurses and healthcare; the time has come for a national reckoning on nursing in Australia.”
Australian nurses cannot continue to work under the extreme pressure they are currently operating under – the impacts are mounting.
The almost 400,000 Australian nurses are a constant presence in every one of our major life milestones, national emergencies and global crises. The nurse of today holds a science degree, possesses highly technical training, valuable medical opinions, front-row expertise, is an effective trainer, and is skilled in population and systemic thinking. But the pandemic is inflicting a major emotional and physical toll on nurses.
In this “Perspectives” special, Australian Health Journal spoke with 4 nurses on the challenges they or nurses in their circle have experienced, the key issues as well some of the opportunities. These nurses come from national leadership & policy, large scale workforce management, a final year student completing over a year on placement across 6 Melbourne Hospitals and a NSW based ICU nurse stranded in Mexico, unable to return to a critical role in nursing to an already strained team due to incoming quotas.
While the issues are challenging, there are strategies that can be put into place to ease the pressure, to support nurses, and nursing care in Australia. These are discussed by the the 4 nurses.
– Adjunct Professor Kylie Ward FACN CEO, Australian College of Nursing
– Adjunct Professor Alanna Geary FACN ACN Chair of Workforce Sustainability Policy Chapter & Chief Nursing & Midwifery Officer, Metro North Health
– Natalie Reyes, NSW based ICU Nurse Currently stranded in Mexico
– Hayley Pollock, Final Year Bachelor of Nursing Student & ACN Emerging Nurse Leader
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Future of minimally invasive surgery
Macquarie University Hospital is the first hospital in Australia to have three robotic surgical systems. It remains the busiest centre for robotic urology in New South Wales and has rapidly growing programs in other areas. What is behind the Hospital’s success?
Conjoint Associate Professor Walter Kmet, CEO of Macquarie University Hospital, says that the story of robotics at the Hospital is driven by its academic health sciences identity.
