Bárbara Soule em entrevista


Bárbara Soule, Consultora JCI, responde a algumas questões sobre o curso Evidence based principles and practices for preventing surgical site infections a decorrer nos dias 8 e 9 de maio no Hospital CUF Descobertas.


"SSIs are a significant part of the historical and current global public health issue of healthcare-associated infections". Why does this happen?

Thousands of surgical procedures are performed each year around the world, approximately 1 for every 25 persons. A percentage of patients having surgical procedures will develop a surgical site infection. Historically, surgical technique and equipment was often suboptimal, e.g., not always sterile, so infections occurred. Today, even with excellent sterile technique and equipment, some patients still develop infection. This may be due to the physiological status of the host and their immune, chronic disease age and technique of the surgical team. The lack of use of evidence-based practices to prevent infection during each stage of the surgical process is a major contributing factor to surgical site infections (SSI).

The course's main goal is to share the best practices on how to prevent surgical site infections. What can participants expect from the course?

The course will cover evidence-based practices that have been published and recommended by the World Health Organization (WHO), the Centers for Disease Prevention and Control (CDC) in the US and other respected professional organizations such as the American College of Surgeons (ACS) and Surgical Infection Society (SIS).  The guidelines and recommendations will be described along with practical strategies for implementation. The course is interactive and addresses local challenges. Some practical application is included and participants will leave with some new knowledge, validation of best practices and one or two new skills.

As an experienced Infection Prevention and Control consultant can you identify the biggest challenge regarding the prevention of surgical site infections?

I believe the biggest challenge to preventing SIS is the lack of implementation of known evidence-based practices. Often knowledge is very strong, but there are gaps in implementation.  Effective implementation requires strong leadership and support both in the operating theater, from surgeons, anesthesiologists and nursing directors. Leaders of the organization must commit to patient safety, well-trained staff and the provision of adequate and correct resources for the staff to carry out the recommended work. Getting leaders on board is critical so they can help ensure training and resources are available and make low infection rates a leadership and patient safety priority. Organizations with limited resources can still implement many evidence-based practices that don’t require significant resources but involve creativity and commitment.

To measure is a keyword along the program. Why is this so important in this specific environment?

Measuring the incidence and prevalence of surgical site infections (SSI) is critical to direct attention and effort to identifying strengths and gaps in practice, and focus on where improvements are needed. Proactive surveillance of both process and outcome measures for SSI is necessary in any environment that performs surgical procedures. Measuring processes of care that should be in place to prevent SSI can lead to improvement strategies and are sometimes easier to measure than outcomes. Of course, knowing infection rates of different types of surgery is a critical surveillance goal and should be an ongoing priority of the infection prevention and control program.

The audience includes from surgeons to hospital managers. Is this a multidisciplinary mission?

Preventing SSIs is definitely a multidisciplinary mission. Not only is the surgeon and his or her technique and care of the patient significant, but also the nursing and technician staff in the operating theater, the environmental services staff that clean the OT environment, the nursing staff who assess the patient preoperatively and care for him or her postoperatively and other support services such as the laboratory and the facilities team who ensure proper humidity, temperature and ventilation through the OT utilities.   Leaders in the OT and the overall organization help drive best practices. Experience shows that a well-functioning team in the OT reduces errors, some of which can lead to SSI.