Health Care-Associated Infections

BACKGROUND: The incidence of postoperative infections in surgery can be reduced by 20% to 34% through adoption of "safe" patient care practices. Moreover, some of the recently highlighted epidemiologic features of infections in surgery, such as the increasing prevalence of antibiotic-resistant organisms, are strongly associated with questionable clinical choices. In recent years, several governments and scientific institutions have launched initiatives aimed at improving the safety of surgery, a key component of which is the availability of surveillance data. METHODS: In 2003, an audit was performed in the Emilia-Romagna region of Italy on a random sample of general, orthopedic, and gynecologic surgical units to explore the knowledge, perceptions, and practices of surgeons and nurses regarding control of surgical site infections (SSI). RESULTS: The Emilia-Romagna regional audit found good agreement between the infectioncontrol standards and knowledge (70%), claimed practices (73%), and observed practices (78%). Surgical hand antisepsis was applied consistently, and surgical attire was used widely, but surgeons and nurses paid little attention to keeping operating room doors closed and limiting the number of people. Handwashing and sterile technique for postoperative incision care were the recommendations least frequently followed. CONCLUSIONS: Greater attention to proven methods of infection control and availability of surveillance data should reduce the incidence of SSI.