Poster: Transferability of an Infection Prevention Concept for the Reduction of Nosocomial Infections Especially Surgical Site Infections

Introduction:
The “HygArzt” project investigated the effectiveness, efficiency of infection prevention measures (IPM) implemented by an infection prevention link physician (PLP) in the trauma surgery/orthopaedics department. In the first phase of the project, the IPM implemented in a pilot hospital led to increases in adherence for all indications of hand hygiene and dressing change as well as to a reduction in the rate of nosocomial infections (NI), especially postoperative wound infections (SSI).

Objectives:
In a second phase, based on the process analyses and the results of the pilot hospital, a modular training program for PLP was developed and it was investigated whether the concept could be transferred to other study hospitals.

Methods:
In the intervention phase, the PLP was trained in IPM according to the "train-the-trainer approach" (patient decolonization before surgery, standardized wound care, etc.), which he/she subsequently implemented in his/her department. In the post-phase, HHA rates as well as NI and SSI rates were collected again.

Results:
To examine the impact of implemented IPM on infection rates (NI, SSI), pre- and post-data were compared. In the pre-phase (237 surgeries), NI rate (N=12) was 5.1% (CI 95% 2.4; 7.8) and SSI rate (N=5) was 2.1% (CI 95% 0.3; 3.9). In the post-phase (177 surgeries), a NI rate (N=7) of 4.1% (CI 95% 1.3; 7.0) was found and no SSI. The introduction of the dressing change concept significantly increased HHA of all indications (pre=72.2%; post=95.6%, p<.001). The strongest increase in HHA occurred in the indication "hand disinfection between unclean and clean phase" (pre=49.3%; post=86.5%, p<.001). HHA also increased for the other indications "before preparation for dressing change" (pre=77.0%; post=98.3%, p<,001); "directly before dressing change" (pre=78.9%; post=98.3%, p<.001,); "after dressing change" (pre=83.5%; post=100%, p<.001).

Conclusion:
By implementing the IPM, infection rates were also slightly reduced and HHA significantly increased for all indications of dressing change in the study hospital. This suggests that the developed bundle of IPM can be transferred to other trauma surgery departments through tailored training. Continuous process analysis could identify individual weaknesses in patient care and adapt intervention concepts.