Report finds fewer infections following hip and knee replacements

A new report has found that infections following hip and knee replacements have fallen, meaning reduced harm to patients. This is likely due to the efforts of health professionals to reduce infection.

The findings are in an independent evaluation of the Health Quality & Safety Commission’s surgical site infection (SSI) improvement programme. It found the fall in infection rates was likely to be the result of district health boards (DHBs) implementing a ‘bundle’ of interventions recommended by the programme.

These interventions include giving the right dose of antibiotics, on time before surgery, sterilising skin with alcohol-based antiseptic before surgery and clipping hair at the incision site, not shaving.

The programme was set up in 2012 to reduce surgical site infections, which can cause significant harm to patients and lead to long stays in hospital. The programme initially focused on infections following hip and knee replacements but has more recently begun to include cardiac surgery.

The report found:

• the rate of orthopaedic infections per 100 procedures fell from 1.18 in mid-2015 to 0.93 in mid-2017, equating to 55 infections avoided. More recent data indicates the number of infections avoided is now 87
• the odds of an SSI occurring in a procedure that received all three programme interventions were 43 percent lower than in one that has not had all three interventions
• at a minimum the programme breaks even, and at best it delivers a threefold return on investment.

Dr Arthur Morris, clinical lead for the SSI improvement programme, says the report’s findings were encouraging and a good basis for future work. This includes useful feedback from staff in some DHBs about the burden of manual data collection, which the programme is considering as part of its forward planning.

‘This report builds on last year’s interim evaluation, which highlighted the programme’s role in supporting the health sector to build improvement capability.

‘We’re pleased with the results – fewer infections means reduced harm to patients and significant direct cost savings for the sector.

‘These successes would not have been possible without the support of staff within DHBs, particularly infection prevention and control practitioners, surgeons and anaesthetists. This support has been greatly appreciated,’ says Dr Morris.

The programme has received funding from DHBs and ACC.