Using Prophylactic Antibiotics for Reducing Risk of SSIs in Operation Theatres

STUDENT
Assessment – Written report
CHCPOL003 Research and apply evidence to practice
Research Topic 1
Infection control and prevention
(You may choose a different topic, but your educator must agree with the topic you have chosen.)
Topic 1 – Background
Read before starting your assignment
You are a new enrolled nurse working in a clinic located in a remote area. The clinic building is an older
structure and lacks the use of clinical and client information, such as posters. It has been identified that
many of the staff are efficient in their roles but have some out-of-date ideas in their nursing practice.
The clinic manager has asked you to research the most current information about a specific topic, such
as:
Infection control
Plan the research activity
1. In order to complete this assessment, you need to identify TWO (2) areas related to the
topic, where research can help support and improve your own practice as an EN.
E.g topic: Infection control and prevention (or as agreed with your educator)
Infection control and prevention to reduce the risk in surgical sites in operation theatres
Surgical site infections (SSIs) account for hospital-acquired infections with 14% to 17% and 38%
nocosomial infections in the surgical patients (Li et al. 2013). These infections contribute to substantial
amount of infection and morbidity and emergence of antibiotic-resistant microorganisms. SSI are caused
due to multiple factors comprising of patient-related and procedure-related and most importantly,
influenced by quality of operating theatres. A salubrious and safe operating theatre is required that can be
achieved by infection control and prevention. Therefore, for SSI prevention in operating theatres, infection
control and prevention is of paramount importance demanding multidisciplinary approach including
nurses and commitment for improving the quality of operating theatres.
The most common site for hospital-acquired infections include surgical operating theatres and nurses play
an important role in infection prevention. They promote the health and well-being of the patients through
infection control and prevention. Nurses can intervene and can minimize the spreading of the disease and
ensuring that their nursing practice is evidence-based research and patient education. They advocate for
the patients and are placed in unique position for improving the patients’ standards of care. Therefore,
nurses play a vital role in creating a safe environment for the patients that are cornerstone in making
operation theatres free from infection (Anderson et al. 2014).
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STUDENT
Assessment – Written report
CHCPOL003 Research and apply evidence to practice
2. Identify the reason(s) for undertaking your research from the list below.
 You may select several reasons.
 Provide a brief rationale for each.
E.g reasons: Comparison / hypothesis testing / trend identification / own knowledge
extension / strengthen quality of own practice.
Nurses have the duty to reduce the risk of SSIs in operation theatres through infection control
and prevention by utilizing their knowledge and skills of nursing practice and thereby,
facilitating patient recovery and minimizing infection related complications for better patient
outcomes. Patient safety is the prime duty of nurses and infection control and prevention acts
as the main realm in it (Sievert et al. 2013). Through this research, one would be able to
understand the standards for prevention of HAIs to reduce risk of SSIs in operation theatres.
3. Write a clear statement highlighting your research question or hypothesis, e.g. “Is there a
difference between hand washing protocols and actual practice”.
It may include:
 Nursing interventions applicable to the topic
 Client perceptions of the provision of this topic
 Models of nursing care that utilise the topic
 Political issues confronting nursing practice and health care provision in relation to
the topic
An example of a question (the student can NOT use this example), would be:
Does hand washing among healthcare workers reduce hospital-acquired infections?
Question: Does antibiotics prophylaxis reduces the rates of SSIs in operation
theatres.
An example of a hypothesis (the student can NOT use this example), would be:
Hospital acquired infections are more likely to be passed on by hand washing with water
than when hands are washed with soap.
Hypothesis: Using antibiotic prophylaxis before the surgery will help in reducing
the rates of SSIs in operation theatres.
SSIs are prevalent in the healthcare systems and its prevention and control is the major
focus for the multidisciplinary team including nurses. In the recent years, many
interventions have been developed with an aim of reducing the risk of SSIs in operation
theatres through infection control and prevention. These interventions are designed to
deliver prevention at three levels: pre-intra and post-operatively. Pre-operative phase is
the time between the need for surgery and operation start time when the patient is
brought to the operation table. It is the point when the operation staffs before proceeding
with the surgery make preparation occurring in this phase. Use of intra-operative
prophylactic antibiotics are largely focused on skin decontamination using antiseptics and
soaps, prevention of micro-organisms movement into wounds barriers through barriers
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STUDENT
Assessment – Written report
CHCPOL003 Research and apply evidence to practice
use and as a result, patient health outcomes are optimized promoting best recovery
(Allegranzi et al. 2016). The use of prophylactic antibiotics acts as both barrier and
decontamination methods for the operating staffs and people at the operation theatres.
Prophylactic antibiotics are the best way for preventing SSIs administered at the
appropriate time like 20 minutes before the surgery. Research has suggested that
prophylactic antibiotics administration before the surgery has provided to largely
decrease the incidence of post-operative infections like SSIs especially at the inoculums
where the bacteria count is high. Appropriate administration time of antibiotics can help
to prevent and control surgical site infections in the operation theatres.
Nursing intervention: The intervention would be using antibiotics 30 minutes the surgery
procedure or incision by nurses and operating staffs. One or two doses re-administration
is recommended depending on the duration of the surgery that greatly reduces the
chances of incidence of SSIs in the operation theatres.
Client perspective: Apart from skin antisepsis, the prophylactic antibiotic administration
adopted by operating staffs greatly reduces the chances of SSI infections promoting
patient safety. There was better recovery phase with reduced chances of hospital re-
admissions and decrease in spread of surgical site infection thereby controlling HAIs and
postoperative infections outbreak.
Political issues: Non-compliance to prophylactic antibiotic administration, lack of nursing
staff and financial constrains in antibiotic selection
4. Establish and define the general research objective.
Tips:
 A research objective summarises what is to be achieved by the study.
 Ensure your objective is S.M.A.R.T and relevant, logical, feasible, observable and
measurable.
 The objective should be clearly phrased – use verbs, e.g. to assess, to establish, to
determine, to compare, etc.
The aim of this research is to explore the effectiveness of prophylactic antibiotics administered 30
minutes before the surgery for the prevention and reducing the incidence of risk of SSIs in
operation theatres in 3 months.
Specific Measurable Achievable Realistic Timely
Reduce
incidence of
risk of SSIs
explore the
effectivenes
s of
prophylacti
c antibiotics
In
operation
theatres
setting
30 minutes
before
surgery
3 months
5. Identify ONE (1) other discipline that could be connected to this research activity.
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STUDENT
Assessment – Written report
CHCPOL003 Research and apply evidence to practice
 Briefly explain your choice of discipline.
Patient safety is the chosen discipline that is associated with reduction in risk of SSIs in operation
theatres through infection prevention and control. Infection control is a vital component in every
healthcare system occupying a unique position in patient safety and in prevention of HAIs. Nurses
provide patient care that is within their professional nursing practice by performing interventions
and actions for infection prevention and control. Therefore, infection prevention and control
promote positive health outcomes and fast recovery ensuring patient safety (Zimmerman et al.
2013).
6. In order to gather information about the research topic, you will need to access credible
sources of data and evidence.
 List two (2) sources you intend to use for this assignment.
 Copy the link address of the source and paste it next to the source’s name – this will
provide the proof to your assessor that you accessed it.
o E.g. PubMed - http://www.ncbi.nlm.nih.gov/pubmed
 Source 1: PubMed- https://www.ncbi.nlm.nih.gov/pubmed/
 Source 2: Cochrane Library- http://www.cochranelibrary.com/
HINT: This is a good time to contact your educator and discuss your research topic
and verbally gain confirmation that you and your partner are still on track.
Gather information for your research
7. Evaluate and select a maximum of two (2) methods of gathering information you think
would be most appropriate to answer your research question.
 Briefly explain why you have chosen a particular method over another, e.g. more time
efficient.
Tips:
Methods of gathering include search engine using correct key words, literature reviews,
systematic reviews, interviews, surveys, seminars, and surveys.
For meeting the research objectives, authentic databases like Google Scholar was used for
searching articles regarding prophylactic antibiotic administration for preventing SSIs.
Various key search items like “infection control”, “prophylactic antibiotic administration”,
“SSI prevention”, were used for retrieving articles that are related to the objective
question. Boolean operators like AND and OR were used and articles that were published
in English were included for the study.
8. You are now to gather information for your research topic using a systematic approach.
Stages for your information gathering activity
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