Surgical Site Infection and Healthcare Delivery

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Author, Year of Publication	Purpose	Sample	Design	Level of Evidence	Findings	Limitations
Butterworth, Gilheany & Tinley (2010)	To analyze how podiatric surgery may be affected by the pace at which postoperative infections take place	A convenient sample size made up of podiatric surgeons randomly sampled from Australia (N=9)	A standard patient questionnaire designwas used to gather quantitative data within a period of six months	VI: evidence was gathered by comparing a current empirical study with that of real hospital admissions and discharges	A 3.1 percent infection rate was recorded. Besides, hospital readmissions accounted for about 0.25 percent of the infection rate.	Lack of exploration of the link between variables outlined in the two tables. Coding error not addressed in the study
Lee et al. (2012)	To examine the development and link between hematopoietic stem cell transplantation, morbidity and mortality rates	A suitable sample size of pediatric HSCT recipients (N=176) and others diagnosed with respiratory complications (N=84)	Retrospective Study in 28 days study immediately after pediatric HSCT recipients had received an implant	VI: evidence gathered from a comparative study involving healthy patients and those already infected by Respiratory Viruses (RVs).	Five RV types were detected in nine patients who had already been affected by Respiratory Virus. Only a single case of RV infection detected a viral culture The conventional culture method is less effective than multiplex PCR	Difficult to undertake a simultaneous assessment of both multiplex PCR and viral cultures. All risk factors were not adjusted bearing in mind that the 28 days period was quite short
Rajkumari et al (2014)	To investigate the rates at which SSIs take place, their results in healthcare recipients receiving care when in pain.	A suitable sample size comprised a total of 2,287 patients. 852 were found to be suitable for the study after undergoing the screening process.	A prospective observational study was preferred in this paper. A 16-month period of continuous monitoring of patients through the help of hospital infection control nurses, microbiologists, and surgeons. This was necessary in order to investigate the development of Surgical Site Infections (SSIs).	VI: evidence from a single observational and/or experimental study	Out of the 852 patients, 4.4 percent of confirmed cases were detected. Orthopedic trauma patients also experience Surgical Site Infections (SSIs).	Lack of a comparative study that investigates variables impacting the progress of Surgical Site Infections (SSIs).
Tang, Fend, Chen, Zhang, Ji & Luo (2014)	To assess the application of closed blood conservation devices in reducing the threat posed to minors after undergoing cardiac surgery	Children who had already gone through open-heart operation and also been admitted at PICU. (N=130).	A randomized controlled trial using a 2-sided test. A sealed envelope method was used to select and allocate patients to a random group.	VI: evidence derived from the outcomes of 2 independent groups investigated at the same time	Using a closed blood conservation device minimizes the possibility of catheter-related infections arising from intraluminal fluid	The research was carried out in a single location. There was an insufficient study cohort Sampling took place only on the outer layer of the catheter tip

Summary

The research question being addressed in this study is “what is the main challenge faced by medical surgeons in the course of delivering care services to patients?” The search strategy for the required articles began by identifying the relevant medical databases such as Ebscohost, Elsevier, and Science Direct. Keywords such as surgical, site, infection, problems, challenges, and surgery were typed and searched through the available databases.

The designs used in the studies above were varied. For instance, in a study by Butterworth, Gilheany, and Tinley (2010), a standard patient questionnaire design was employed to obtain quantitative data for a period of six months. Lee et al. (2012) used a retrospective study design that ran for 28 days. This took place immediately after pediatric HSCT recipients had received an implant while Rajkumari et al (2014) used a retrospective observational study design. On the other hand, Tang, Fend, Chen, Zhang, Ji and Luo (2014) employed a randomized controlled trial study design. All the above research studies fall within the same level of evidence because they are quantitative research studies.

In regards to finding, a 3.1 % of infection rate was recorded (Butterworth et al., 2010). The authors also note that hospital readmissions accounted for about 0.25 percent of the infection rate. Tang et al (2014) found out that a closed blood conservation device can significantly reduce the transfer of infections. The other two studies also give similar findings. Hence, the studies fully answer the research question stated above.

All the samples used in the four studies were randomly selected. However, a sample size of 9 participants was rather low for a countrywide study cohort (Butterworth et al., 2010) because of the large population being represented. The screening method used to obtain final participants was a more effective sampling method in a study by Rajkumari et al (2014). This made it possible for the researchers on the most productive elements in the study.

Limitations of the studies included lack of variety in terms of research settings (Tang et al., 2014), inadequate or missing comparative studies, and poor exploration of all variables affecting the research studies (Butterworth et al., 2010). Subsequent studies can overcome these limitations by expanding the study zone, investigating both dependent and independent variables as well as using a fairly large sample size.

Based on the findings, the evidence found on this topic is indeed strong enough to suggest a change in medical-surgical practice to protect both surgeons and patients from being infected. Unless both parties are protected against infections during operations, then the medical process can be least beneficial.

References

Butterworth, P., Gilheany, M.F. & Tinley, P. (2010). Postoperative infection rates in foot and ankle surgery: A clinical audit of Australian podiatric surgeons, January to December 2007. Australian Health Review, 34(2), 180-185.

Lee, J. H., Jang, J., Lee, S. H., Kim, Y., Yoo, K. H., Sung, K., &… Koo, H. H. (2012). Respiratory viral infections during the first 28 days after transplantation in pediatric hematopoietic stem cell transplant recipients. Clinical Transplantation, 26(5), 736-740.

Rajkumari, N., Gupta, A. K., Mathur, P., Trikha, V., Sharma, V., Farooque, K., & Misra, M. C. (2014). Outcomes of surgical site infections in orthopedic trauma surgeries in a tertiary care centre in India. Journal Of Postgraduate Medicine, 60(3), 254- 259.

Tang, M., Fend, M., Chen, L., Zhang, J., Ji, P. & Luo, S. (2014). Closed Blood Conservation Device for Reducing Catheter-Related Infections in Children After Cardiac Surgery. Critical Care Nurse, 34(5), 53-61.

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Surgical Site Infection and Healthcare Delivery

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