Last updated 25/03/2014

Surgery

For the first time New Zealand has a sophisticated patient safety initiative that will reduce harm caused to patients by surgical site infections (SSIs).

Healthcare associated infections (HAIs) such as SSIs are a significant problem worldwide, with up to 10 per cent of patients admitted to modern hospitals acquiring one or more HAI.

SSIs can cause emotional and financial stress, serious illness, longer hospital stays, long-term disabilities, and can result in loss of life. The consequences for health services, and more importantly the patient, mean that the prevention of SSIs is extremely important.

The good news is that a significant number of SSIs are preventable. To address this, in 2012 the Health Quality & Safety Commission (the Commission) launched the Surgical Site Infection Improvement (SSII) Programme – New Zealand’s first national quality improvement programme to reduce the incidence of SSIs.

During its first year the SSII Programme has focused on reducing SSIs in hip and knee arthroplasty.

In collaboration with district health boards (DHBs) throughout the country, the Programme has developed and implemented a consistent, evidence-based approach for collecting and reporting high quality data about hip and knee arthroplasty surgeries. This will enable comprehensive data to be fed back to clinicians to encourage performance improvements by pinpointing practice that may require attention.

Further to this the SSII Programme promotes and encourages culture change and practice improvements that better support the prevention of SSIs.

A bundle of quality improvement interventions for reducing SSIs in hip and knee arthroplasty have been identified as a high priority for the New Zealand context and will be implemented within DHBs.

These interventions support consistency in measurement and provide DHBs with guidance on the practice change that will have the greatest impact on reducing rates of SSI.

The bundle of interventions selected for hip and knee arthroplasty are:

  • An antibiotic prophylaxis intervention
  • A skin preparation intervention
  • A clipping not shaving intervention.

Combined, these components will ensure that a cycle of continuous quality improvement for reducing SSIs can be achieved in a sustainable way, contributing to national and international efforts to improve patient safety.

Over the next one to two years the SSII Programme will focus on infections following cardiac bypass graft surgeries (CABG) and caesarean sections. The Programme has been intentionally spread over three to five years to ensure that a quality system, national adoption, culture and practice change can be achieved in a sustainable way.

Championing the SSI programme nationally and locally (i.e. at DHB level) are a range of clinical leaders including surgeons, clinical microbiologists, perioperative nurses and infection prevention control practitioners. Their support and input is pivotal to the success of the programme.

With all DHBs now on board, over time, the programme will:

  • improve patient safety and experience
  • reduce costs associated with SSIs – freeing up scarce health sector resources
  • free up valuable bed days
  • enable DHBs to meet and report against the Quality & Safety Markers.

The SSI Improvement programme is delivered by a joint lead agency – Auckland and Canterbury DHBs – on behalf of the Commission.

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