Awareness and Level of Knowledge About Surgical Site Infections and Risks of Wound Infection Among Medical Physicians in King Abdulaziz University Hospital: Cross-Sectional Study

The Level of Awareness Among Surgical Physicians Regarding Surgical Site Infections and the Risks Associated With Wound Infections in Makkah

Background and aims: Surgical site infections (SSIs) are a significant contributor to mortality rates globally; therefore, to avoid these lethal complications, it is critical to incorporate patient safety and high-quality treatment approaches. This study aims to assess surgical physicians' awareness of SSIs and risks of wound infections in Makkah City, Saudi Arabia. Methods: A descriptive cross-sectional study was performed among surgical physicians and interns in Makkah city hospitals through an online questionnaire from February 2023 to March 2023.  Results: 122 surgical physicians were enrolled in the study. The age of the majority of participants was between 20 and 30 (52.5%). According to the data, 55.7% of respondents had fair knowledge. Conclusion: Only 4.1% of physicians had a good level of knowledge. Thus, we recommend Makkah hospitals offer academic sessions to surgical physicians about preventive measures for high-quality care of SSIs in order to raise their levels of awareness and knowledge.

Surgical Site Bacterial Infection in a General Hospital, Al-Jouf Region, Saudi Arabia: A Retrospective Study

Background Surgical site infection (SSI) is a major healthcare problem with a great impact on patient morbidity, mortality, and healthcare cost all over the world. It accounts for 20% of healthcare-associated infections (HAIs), with higher frequency in low- and middle-income countries where it affects about 30% of the patients undergoing surgery. Aim The current study aims to assess the prevalence of SSI in a general hospital in Sakaka, Al-Jouf region, Saudi Arabia. The types of bacteria causing SSI were also determined. Subjects and methods A retrospective cross-sectional study was done by reviewing the hospital records of patients who got SSI during the period between 2020 and 2022. Data collection was done during 2022 and 2023 after taking ethical approval and permission from the hospital management. Results The number of patients who underwent surgical procedures during 2020, 2021, and 2022 were 689, 867, and 1119, respectively. Most of the cases were cholecystectomy and appendectomy. The cases that developed surgical site infection after cholecystectomy and/or appendectomy during 2021 and 2022 were 15.45% and 9.29% cases, respectively, and they were mainly associated with appendectomy. A culture and sensitivity test revealed methicillin-resistant Staphylococcus aureus (MRSA) and Klebsiella pneumonia. Nearly all patients have received ciprofloxacin for seven days and improved with treatment. Conclusion The number of cases that developed SSI has decreased gradually due to the application of infection control measures and strict follow-up.

Healthcare professionals' knowledge and attitudes of surgical site infection and surveillance: A narrative systematic review

AIM

This systematic review reports on healthcare professionals' knowledge and attitudes of surgical site infection and surgical site infection surveillance as well as interventions aimed at enhancing healthcare professionals' knowledge and attitudes.

BACKGROUND

Surgical site infection is a serious adverse outcome following surgery. Despite the presence of international guidelines, the prevention of surgical site infections remains a challenge for patients and hospitals. It is critical that healthcare professionals have sufficient knowledge on surgical site infection and on their role in implementing evidence-based prevention strategies.

DESIGN

This review is reported using the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines.

METHODS

A search was undertaken in the following databases: Academic Search Complete, CINAHL, ERIC, MEDLINE, PsycARTICLES, PsycINFO and Web of Science for studies published between January 2010 and March 2022. Studies that examined healthcare professionals' knowledge and attitudes in relation to surgical site infection, surgical site infection surveillance and risk factors for their development were included. We also included studies that examined interventions that aimed to enhance healthcare professionals' knowledge and attitude in relation to surgical site infection, surveillance, and risk factors. We also described the impact of such interventions on the incidence of surgical site infections.

RESULTS

A total of 26 studies were included. Results were synthesised narratively according to the review objectives. Findings from this review show that knowledge of what surgical site infection is and its prevention was poor amongst healthcare professionals, while attitudes were positive particularly in relation to healthcare professionals' role in prevention. Only three studies examined the effects of interventions on healthcare professionals' knowledge of surgical site infection and surgical site infection prevention. Of those, two used multimodal educational interventions and found statistically significant improvement in knowledge.

CONCLUSIONS

Overall knowledge of surgical site infection and its prevention is poor amongst healthcare professionals, while attitudes were positive particularly in relation to healthcare professionals' role in prevention. There is a need for more experimental research to evaluate interventions which aim to address healthcare professionals' knowledge and attitudes towards surgical site infection prevention and surveillance. Such studies should include all healthcare professionals involved in the care of a surgical patient.

TWEETABLE ABSTRACT

Knowledge and attitudes of surgical site infection prevention amongst healthcare professionals.

Preventing Surgical Site Infections: Are Safety Climate Level and Its Strength Associated With Self-reported Commitment To, Subjective Norms Toward, and Knowledge About Preventive Measures?

OBJECTIVES

Surgical site infections (SSIs) represent a major source of preventable patient harm. Safety climate in the operating room personnel is assumed to be an important factor, with scattered supporting evidence for the association between safety climate and infection outcome so far. This study investigated perceptions and knowledge specific to infection prevention measures and their associations with general assessments of safety climate level and strength.

METHODS

We invited operating room personnel of hospitals participating in the Swiss SSI surveillance program to take a survey (response rate, 38%). A total of 2769 responses from 54 hospitals were analyzed. Two regression analyses were performed to identify associations between subjective norms toward, commitment to, as well as knowledge about prevention measures and safety climate level and strength, taking into account professional background and number of responses per hospital.

RESULTS

Commitment to perform prevention measures even when situational pressures exist, as well as subjective norm of perceiving the expectation of others to perform prevention measures were significantly (P < 0.05) related to safety climate level, while for knowledge about preventative measures this was not the case. None of the assessed factors was significantly associated with safety climate strength.

CONCLUSIONS

While pertinent knowledge did not have a significant impact, the commitment and the social norms to maintain SSI prevention activities even in the face of other situational demands showed a strong influence on safety climate. Assessing the knowledge about measures to prevent SSIs in operating room personnel opens up opportunities for designing intervention efforts in reducing SSIs.

Bacteriological profile of wound swab and their antibiogram pattern in a tertiary care hospital, Saudi Arabia

OBJECTIVES

To assess the microbial profile of wound infection and their antibiogram pattern.

METHODS

A retrospective study was carried out at King Abdulaziz University Hospital, Jeddah Saudi Arabia between December 2021 and July 2022 comprising data related to demographic, microbial profile and antibiotic sensitivity pattern of wound infection-suspected cases.

RESULTS

A total of 305 wound swabs were collected; of which 56.1% showed microbial growth. Among 187 microbial isolates, 62% were gram-negative bacteria, 30.5% were gram-positive bacteria and 7.5% were fungi. Staphylococcus aureus was the prevailing isolates 17.1%, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa, each with 13.9% and Escherichia coli with 12.8 %. Providencia sp with 0.1% was the least isolated bacteria. Out of 173 bacterial isolates, 46.8% were sensitive to antimicrobial agents tested, while 53.2% were resistant to one and more drug tested. Of these isolates, 22% were found to be the MDR bacteria. The highest MDR percentages was noted among Acinetobacter baumannii (70%) followed by Klebsiella pneumoniae (53.9%), Escherichia coli (25%) and Pseudomonas aeruginosa (19.2%) and the least by (12.5%) by Staphylococcus aureus. CONCLUSION: The microbial isolation rates from wound infection was high, with Staphylococcus aureus being the most prevalent. Considerable antimicrobial resistance rate to the commonly used antibiotics was discovered. Thus, regular monitoring of microbial profile and their antimicrobial sensitivity pattern in the study region in attempt to contain antimicrobial resistance is highly recommended.

Alzahrani N, Alaqeel F. Awareness and knowledge of postoperative surgical site infections in patients from Saudi Arabia: A multi-regional cross-sectional study

Background:

Knowledge regarding surgical site infections (SSIs) can help reduce hospital stay, morbidity, and mortality associated with SSI.

Objectives:

This study aimed to determine the knowledge and awareness of SSI among patients undergoing surgeries across Saudi Arabia.

Methods:

This multi-center cross-sectional study included adult patients (aged >18 years) who underwent surgery at six centers located across the five regions of Saudi Arabia. A 36-item questionnaire was used to elicit data regarding demographics, patient's health status, procedures, and hospitalization history and awareness and knowledge about SSIs.

Results:

A total of 375 patients were included (equally for all five regions of Saudi Arabia). Most patients were male (55.7%) and aged 18–34 years (44%). Most respondents (49.1%) had poor awareness; being illiterate and from the Northern region were significant factors (P = 0.001). Patients with no history of surgery (P = 0.001) or SSI (P = 0.003) also had poor awareness levels. In terms of knowledge, 45.8% and 35.2% of the participants had fair and poor knowledge, respectively, with the level of knowledge being significantly associated with region (P = 0.001). Patients those aged >65 years had poor knowledge (P = 0.033), while of males had good knowledge (P = 0.02). Patients with no history of surgery had poor knowledge of SSIs (P = 0.003). Only 32.8% of the patients recalled having been educated by healthcare workers. About 42% learned of SSIs from sources outside the hospital, with internet/social media platforms accounting for 48.4% of such sources.

Conclusion:

A significant proportion of the patients included in this study had poor awareness and knowledge of SSIs. The study highlights the need for strengthening the preoperative patient education in Saudi Arabia to reduce the likeliness of SSIs.

Patients' knowledge, awareness, and attitude regarding patient safety at a teaching hospital, Riyadh, Saudi Arabia

Aims:

Our primary objective is to investigate the baseline status of patients' awareness, knowledge, and attitudes to patient safety. The secondary objective of this research is to determine factors that influence patients' knowledge regarding patient safety.

Methods:

We performed a cross-sectional study with a targeted sample of 410 patients at King Khalid University Hospital, Riyadh, Saudi Arabia. Self-administered paper-based questionnaires were distributed to outpatient clinics on February 2, 2019 until March 20, 2019. Finally, the data were analyzed by (SPSS).

Results:

There were 450 questioners distributed, and 410 were completed and returned (91% response rate). Most of the patients were below the age of 50 (77.9%), 54.8%, of them were females, and almost half received higher education (54.1%). Among the respondents who are taking drugs, 21.6% do not have any knowledge about the side effects of their drugs, and 47.8% of patients said that their physicians do not tell them the side effects of their prescribed drugs. Whereas 20.7% of patients claimed that they experienced a medical error, 66.3% did not report the errors, and the reason was not knowing how to report or to whom in 54.4% of the patients. In regards of infection control, 47% of the participants misunderstood means to prevent the spread of the infections and how it could be transmitted.

Conclusion:

Patients' knowledge about patient safety need to be improved. We suggest educating the patients by providing training programs for patients, and we recommend further studies.