Study On Surgical Site Infections Cognition And Prevention Behavior In Surgeons

ObjectiveWe want to know the cognition status of surgeons and find out the implementation of prevention and control measures for SSIs,dig out the key problems,and put forward suggestions to reduce the incidence of SSIs.MethodsWe conducted surveys among surgeons from four tertiary hospitals in Shandong province from June 2018 to August 2018,in form of network questionnaire,by convenient sampling(cross-sectional study).The cognitive and behavioral level was evaluated by score and accuracy rate,this study is aimed to find out the influence factors of cognitive level and behavioral level of SSIs in surgeons,we also explored the influence of cognition on behavior of SSIs-controling.After completing the survey,in September 2018,10 doctors from different departments and with different professional titles were selected randomly from the doctors participating in the survey to conduct a telephone interview on the problems existing in the cognition and behavior of the prevention and control of SSIs in clinical practice.We used ’Mike’ network platform to conduct questionnaire survey.The platform automatically collected data and summarized them into a database,and two person checked the database to eliminate invalid samples.Finally,912 questionnaires were collected,889 of which were valid(97.5%effective).We used IBM SPSS 19.0 software for data analysis.The following methods were used in data analyzing:descriptive analysis,variance analysis and chi-square test,etc.Results1.The average cognitive score of surgeons in tertiary hospitals of Shandong province was 9.35±1.52,and the average accuracy rate of cognitive score was 85.00%.Accuracy rate is low in the following questions:’surgical site infections classification’,’implant surgery infection defined time’,’if hair does not disturb the operation is it necessary to carry out skin preparation’ and ’whether infections caused by the drainage tube,(do not need to do another operation)are deep incision infection’,’whether anesthesia methods and time associated with surgical site infection’ are the five most important issues,in which the surgeons’.Hospital ranks,education background,identity and departments are the influence factors that affect the cognitive score.2.There are significant differences in cognitive scores among doctors with different educational backgrounds,professional titles,identities,departments and between different hospital ranks.Surgeons with master degree get the highest score,doctoral students score the lowest.The higher the professional title is,the higher the cognitive score they get.Also,the score of in-service doctors was significantly higher than that of doctors on training.Surgeons in Neurosurgery and emergency department get the highest score,while surgeons in oral surgery and general surgery department get the lowest score.Surgeons in tertiary Class A hospitals tend to get higher scores than those in tertiary Class B hospitals.3.The average score of the behavioral part of surgeons was 8.11±1.50,and the average accuracy rate of the behavioral part was 57.93%.In five issues,what are’methods for skin preparation’,’whether stop using preoperative immune inhibitors before surgery’ and "postoperative blood glucose monitoring frequency among diabetes patients’,’how much days should antimicrobial drug be used after type I incision operation’ and ’whether or not use antibacterial coating suture in tertiary incision surgery’,the surgeons’ accuracy is very low.Hospital ranks and departments are the influence factors that affect the behavioral scores among surgeons.4.There are significant differences in cognitive scores among surgeons with different educational backgrounds and in different departments.The higher the degree is,the higher the behavior score is.In different departments,doctors in neurosurgery and emergency surgery department scored the highest,while doctors in pediatric surgery and ophthalmology department scored the lowest.Surgeons in tertiary Class A hospitals tend to get higher scores than those in tertiary Class B hospitals.5.The problems in surgeons’ cognition are as follows:young surgeons do not pay much attention to infection-related knowledge,neither are they willing to learn those knowledge actively.Also,and their methods to control surgical site infections remain the same compared to long times ago,the training on infection-related knowledge is uneven.Most importantly,in clinical practice,there lack specific guidelines on how to antibiotics.In behavior level,the problems are:hand hygiene measures are not carried out correctly or frequently.Perioperative aseptic management is poorly executed,especially during dressing change process.Some doctors need to improve their operation skills.Conclusion and SuggestionsConclusion:Surgeons in tertiary hospitals of Shandong province know well about knowledge of SSIs and have a good grasp of the definition,classification and determination of SSIs.Surgeons with Doctor degree,doctors in training,residents and and surgeons in tertiary class B hospitals are the key groups with low knowledge rate.Urology,oral surgery and general surgery are the key departments with low knowledge rate.Surgeons have obvious problems in the cognition of ’classification of surgical site infection’ and ’ if hair does not disturb the operation is it necessary to carry out skin preparation’.Surgeons’ correct rate in behaviors to control SSIs is relatively low.Undergraduates,surgeons in training,attending doctors and surgeons in tertiary class B hospitals are the key groups with problems.Cardiac surgery,burn surgery,plastic surgery,obstetrics,pediatric surgery and ophthalmology are the key departments,and their correct rate of SSIs control is significantly lower than the average level.Surgeons have obvious problems in ’use of antimicrobial sutures’,’skin preparation methods’,’use of immunosuppressive agents’,’postoperative blood glucose test frequency in diabetes patients’ and ’postoperative antibiotic usage’.Suggestions:(1)For young doctors,strengthen the knowledge level of SSIs and surgery ability.For Senior doctors,innovate the knowledge of SSIs control.(2)Concem on departments with much contaminated operations,conduct differentiated training,and implement the infection doctor-liable system.(3)Strengthen perioperative aseptic management.(4)Make doctors use antibiotics and immunosuppressive agents under guidelines,improve the method of skin preparation,popularize antimicrobial sutures,and strengthen postoperative blood glucose management.