The effect of implementing an aseptic practice bundle for anaesthetists to reduce postoperative infections, the Anaesthetists Be Cleaner (ABC) study: protocol for a stepped wedge, cluster randomised, multi-site trial.

Show simple item record Merry, Alan en Gargiulo, Derryn en Bissett, Ian en Cumin, David en English, Kerry en Frampton, Christopher en Hamblin, Richard en Sturge, Jacqueline en Moore, Matthew en Reid, Mary-Jane en Roberts, Sally en Taylor, Elsa en Mitchell, Simon en ABC Study Group en 2019-09-22T21:53:30Z en 2019-06-10 en
dc.identifier.citation Trials 20(1):342 10 Jun 2019 en
dc.identifier.issn 1745-6215 en
dc.identifier.uri en
dc.description.abstract BACKGROUND:Postoperative infection is a serious problem in New Zealand and internationally with considerable human and financial costs. Also, in New Zealand, certain factors that contribute to postoperative infection are more common in Māori and Pacific populations. To date, most efforts to reduce postoperative infection have focussed on surgical aspects of care and on antibiotic prophylaxis, but recent research shows that anaesthesia providers may also have an impact on infection transmission. These providers sometimes exhibit imperfect hand hygiene and frequently transfer the blood or saliva of their patients to their work environment. In addition, intravenous medications may become contaminated whilst being drawn up and administered to patients. Working with relevant practitioners and other experts, we have developed an evidence-informed bundle to improve key aseptic practices by anaesthetists with the aim of reducing postoperative infection. The key elements of the bundle are the filtering of compatible drugs, context-relevant hand hygiene practices and enhanced maintenance of clean work surfaces. METHODS:We will seek support for implementation of the bundle from senior anaesthesia and hospital leadership and departmental "champions". Anaesthetic teams and recovery room staff will be educated about the bundle and its potential benefits through presentations, written material and illustrative videos. We will implement the bundle in operating rooms where hip or knee arthroplasty or cardiac surgery procedures are undertaken in a five-site, stepped wedge, cluster randomised, quality improvement design. We will compare outcomes between approximately 5000 cases before and 5000 cases after implementation of our bundle. Outcome data will be collected from existing national and hospital databases. Our primary outcome will be days alive and out of hospital to 90 days, which is expected to reflect all serious postoperative infections. Our secondary outcome will be the rate of surgical site infection. Aseptic practice will be observed in sampled cases in each cluster before and after implementation of the bundle. DISCUSSION:If effective, our bundle may offer a practical clinical intervention to reduce postoperative infection and its associated substantial human and financial costs. TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry, ACTRN12618000407291 . Registered on 21 March 2018. en
dc.format.medium Electronic en
dc.language eng en
dc.relation.ispartofseries Trials en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri en
dc.rights.uri en
dc.rights.uri en
dc.subject ABC Study Group en
dc.subject Humans en
dc.subject Surgical Wound Infection en
dc.subject Postoperative Complications en
dc.subject Data Collection en
dc.subject Cluster Analysis en
dc.subject Sample Size en
dc.subject Infection Control en
dc.subject Research Design en
dc.subject Multicenter Studies as Topic en
dc.subject Randomized Controlled Trials as Topic en
dc.subject Hand Hygiene en
dc.subject Anesthetists en
dc.subject Outcome Assessment, Health Care en
dc.title The effect of implementing an aseptic practice bundle for anaesthetists to reduce postoperative infections, the Anaesthetists Be Cleaner (ABC) study: protocol for a stepped wedge, cluster randomised, multi-site trial. en
dc.type Journal Article en
dc.identifier.doi 10.1186/s13063-019-3402-8 en
pubs.issue 1 en
pubs.begin-page 342 en
pubs.volume 20 en
dc.rights.holder Copyright: The authors en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Clinical Trial Protocol en
pubs.subtype research-article en
pubs.subtype Journal Article en
pubs.elements-id 774973 en Medical and Health Sciences en Medical Sciences en Molecular Medicine en Pharmacology en Pharmacy en School of Medicine en Anaesthesiology en Clinical Sciences Admin en Surgery Department en Te Kupenga Hauora Maori en Science en Science Research en Maurice Wilkins Centre (2010-2014) en
dc.identifier.eissn 1745-6215 en
pubs.record-created-at-source-date 2019-06-12 en
pubs.dimensions-id 31182142 en

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