585588 editorial2015
BJI0010.1177/1757177415585588Journal of Infection PreventionJournal of Infection Prevention
Journal of
Infection Prevention
Editorial
Collaboration in the prevention of surgical site infection: the OneTogether project
Journal of Infection Prevention 2015, Vol. 16(3) 99–100 DOI: 10.1177/1757177415585588 © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav jip.sagepub.com
Dawn Stott
The Association for Perioperative Practice (AfPP) was founded in 1964 as the National Association of Theatre Nurses. Our founding member, Daisy Ayris, was a passionate ambassador for excellence in patient care. Daisy saw the merit of bringing together likeminded clinicians and received an MBE in recognition of her work. During the last 50 plus years AfPP has continued Daisy’s legacy by shaping and developing perioperative care by supporting its members, all theatre practitioners, to be the very best at what they do. The Association has developed a UK-wide reputation for setting and leading on standards of perioperative care. At the heart of its ethos is a clear focus on patient safety and AfPP believes that enhancing practitioners’ knowledge along with awareness of best practice standards, guidelines and key issues, has a major impact on perioperative care. With our vision to lead perioperative excellence, when 3M Infection Prevention Division approached us to join the ‘One Together’ project, a multi-year programme with a goal of driving individual small actions to collectively generate a significant impact on the incidence of healthcare associated infections (HAIs), we were happy to join the team. The OneTogether project is a partnership between leading professional organisations with an interest in the prevention of surgical site infection (SSI), and has been initiated as a quality improvement collaborative with the aim of promoting and supporting the adoption of best practice to prevent SSI across the surgical patient pathway. The founding partners in OneTogether are:
there as an open source of information to support best practice. The evaluation of the project is based on:
•• The Association for Perioperative Practice (AfPP), •• The Infection Prevention Society (IPS) •• The College of Operating Department Practitioners (CODP) •• The Royal College of Nursing (RCN)
Using a workshop approach we asked the groups to look at each of the domains of infection prevention shown above and asked the participants to review:
All partners signed up to a memorandum of understanding at the beginning of the journey to ensure we all had the same vision around quality assurance when developing process and pieces of work to support the initiative. All outputs from the collaboration are in the public domain and are
•• Quality, significance and the value of the outputs •• Enhanced communication and collaboration with partner organisations •• Evaluation of conferences/workshops •• Feedback from members of the partner organisations At the inaugural SSI prevention expert conference in November 2013 we brought together operating theatre staff and infection prevention specialists to discuss current practice and the barriers to good infection prevention. The event was held at the 3M facilities in Bracknell and nearly 100 practitioners from the four organisations attended the session. Workshops were held to ascertain current practice; challenges with compliance and overcoming challenges. The results of this feedback have been used to develop an audit tool supporting the five main infection risks along the surgical site pathway: •• •• •• •• •• •• ••
Skin preparation Instrument management Temperature management Surgical environment Prophylactic antibiotics Wound management Surveillance of SSI
•• The availability of evidence and policy •• Ownership of practice Corresponding author: Dawn Stott, Chief Executive, The Association for Perioperative Practice, Harrogate, UK. Email: [email protected]
100 •• Barriers to implementation of best practice •• Small and large actions that could support excellent and consistent care This issue of JIP includes the paper that emerged from this first event, which discusses the findings and the collaborative approach of the OneTogether Project (Wilson et al 2015). The outcome of this first workshop has provided the collaboration with a ‘marker in the sand’ to develop a tool which would support practitioners at the work face. Following the production of the draft toolkit a second expert conference was held at the 3M premises in Bracknell and again we welcomed nearly 100 delegates. Again, the event was attended by theatre personnel and infection prevention specialists and we asked them to work in groups to produce a toolkit that would support the implementation of existing infection prevention guidance. A draft toolkit was provided and guidance around the self-assessment concept was provided in packs and on posters. We asked the groups to self-assess policy and adherence to policy and calculate this as an overall compliance score in order to share the evidence at an interactive voting session. As a result of the findings from this conference the collaboration has moved forward with the self-assessment tool; making changes to the format, updating the structure of the table to ensure relevant comments can be added against each audit point and have developed a ‘traffic light’ approach to results i.e. no = red; partial = amber; yes = green. We are now moving to the pilot stage and we are pleased that we have various hospitals across Britain who have committed to their involvement with the pilot programme. We will then use the information gathered to publish our second OneTogether update. Quality and safety in healthcare is a key priority for patients and those delivering care to patients. It only takes one small action from all practitioners to help prevent SSIs – big changes can be overwhelming but small dedicated goals – micro ambitions – are achievable. Don’t look too
Journal of Infection Prevention 16(3) far ahead or too deeply because you may miss that one small thing that can make a huge difference. Don’t spend too much time thinking about how you are going to achieve your goal because you will never achieve anything if you ponder the how and the why for too long. The future aims and objectives of the OneTogether collaboration are to: •• Use the information gathered from the pilot programme to publish our second OneTogether update •• Develop a warming charter that can be used for guidance •• Encourage a wider collaboration into the group through engagement with other medical colleagues, other professional bodies, etc. The OneTogether collaborative is an organisation that has a primary interest in protecting patients in operating theatres. AfPP’s vision is to ‘Lead Perioperative Excellence’ and through the OneTogether Collaboration we are able to support an efficient and effective way of improving practice and patient outcomes. We now need to engage with the wider surgical team – consultants, anaesthetists, medical directors, senior nurses etc., to ensure our work continues to address issues of inconsistent care and making the links to national guidance. We are all in this together and everyone on the team needs to take responsibility for their actions – think about what you can do to make a difference – life is best filled by learning as much as you can about whatever interests you, sharing ideas and being enthusiastic so I urge you to look closely at your practice and identify ways to make a difference within your hospital – those small changes could save lives. Reference Wilson J, Topley K, Stott D, Neachell J and Gallagher R (2015) The OneTogether collaborative approach to reduce the risk of surgical site infection: identifying the challenges to assuring best practice. Journal of Infection Prevention 2015, 16(3): 118–125.
BJI0010.1177/1757177415585588Journal of Infection PreventionJournal of Infection Prevention
Journal of
Infection Prevention
Editorial
Collaboration in the prevention of surgical site infection: the OneTogether project
Journal of Infection Prevention 2015, Vol. 16(3) 99–100 DOI: 10.1177/1757177415585588 © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav jip.sagepub.com
Dawn Stott
The Association for Perioperative Practice (AfPP) was founded in 1964 as the National Association of Theatre Nurses. Our founding member, Daisy Ayris, was a passionate ambassador for excellence in patient care. Daisy saw the merit of bringing together likeminded clinicians and received an MBE in recognition of her work. During the last 50 plus years AfPP has continued Daisy’s legacy by shaping and developing perioperative care by supporting its members, all theatre practitioners, to be the very best at what they do. The Association has developed a UK-wide reputation for setting and leading on standards of perioperative care. At the heart of its ethos is a clear focus on patient safety and AfPP believes that enhancing practitioners’ knowledge along with awareness of best practice standards, guidelines and key issues, has a major impact on perioperative care. With our vision to lead perioperative excellence, when 3M Infection Prevention Division approached us to join the ‘One Together’ project, a multi-year programme with a goal of driving individual small actions to collectively generate a significant impact on the incidence of healthcare associated infections (HAIs), we were happy to join the team. The OneTogether project is a partnership between leading professional organisations with an interest in the prevention of surgical site infection (SSI), and has been initiated as a quality improvement collaborative with the aim of promoting and supporting the adoption of best practice to prevent SSI across the surgical patient pathway. The founding partners in OneTogether are:
there as an open source of information to support best practice. The evaluation of the project is based on:
•• The Association for Perioperative Practice (AfPP), •• The Infection Prevention Society (IPS) •• The College of Operating Department Practitioners (CODP) •• The Royal College of Nursing (RCN)
Using a workshop approach we asked the groups to look at each of the domains of infection prevention shown above and asked the participants to review:
All partners signed up to a memorandum of understanding at the beginning of the journey to ensure we all had the same vision around quality assurance when developing process and pieces of work to support the initiative. All outputs from the collaboration are in the public domain and are
•• Quality, significance and the value of the outputs •• Enhanced communication and collaboration with partner organisations •• Evaluation of conferences/workshops •• Feedback from members of the partner organisations At the inaugural SSI prevention expert conference in November 2013 we brought together operating theatre staff and infection prevention specialists to discuss current practice and the barriers to good infection prevention. The event was held at the 3M facilities in Bracknell and nearly 100 practitioners from the four organisations attended the session. Workshops were held to ascertain current practice; challenges with compliance and overcoming challenges. The results of this feedback have been used to develop an audit tool supporting the five main infection risks along the surgical site pathway: •• •• •• •• •• •• ••
Skin preparation Instrument management Temperature management Surgical environment Prophylactic antibiotics Wound management Surveillance of SSI
•• The availability of evidence and policy •• Ownership of practice Corresponding author: Dawn Stott, Chief Executive, The Association for Perioperative Practice, Harrogate, UK. Email: [email protected]
100 •• Barriers to implementation of best practice •• Small and large actions that could support excellent and consistent care This issue of JIP includes the paper that emerged from this first event, which discusses the findings and the collaborative approach of the OneTogether Project (Wilson et al 2015). The outcome of this first workshop has provided the collaboration with a ‘marker in the sand’ to develop a tool which would support practitioners at the work face. Following the production of the draft toolkit a second expert conference was held at the 3M premises in Bracknell and again we welcomed nearly 100 delegates. Again, the event was attended by theatre personnel and infection prevention specialists and we asked them to work in groups to produce a toolkit that would support the implementation of existing infection prevention guidance. A draft toolkit was provided and guidance around the self-assessment concept was provided in packs and on posters. We asked the groups to self-assess policy and adherence to policy and calculate this as an overall compliance score in order to share the evidence at an interactive voting session. As a result of the findings from this conference the collaboration has moved forward with the self-assessment tool; making changes to the format, updating the structure of the table to ensure relevant comments can be added against each audit point and have developed a ‘traffic light’ approach to results i.e. no = red; partial = amber; yes = green. We are now moving to the pilot stage and we are pleased that we have various hospitals across Britain who have committed to their involvement with the pilot programme. We will then use the information gathered to publish our second OneTogether update. Quality and safety in healthcare is a key priority for patients and those delivering care to patients. It only takes one small action from all practitioners to help prevent SSIs – big changes can be overwhelming but small dedicated goals – micro ambitions – are achievable. Don’t look too
Journal of Infection Prevention 16(3) far ahead or too deeply because you may miss that one small thing that can make a huge difference. Don’t spend too much time thinking about how you are going to achieve your goal because you will never achieve anything if you ponder the how and the why for too long. The future aims and objectives of the OneTogether collaboration are to: •• Use the information gathered from the pilot programme to publish our second OneTogether update •• Develop a warming charter that can be used for guidance •• Encourage a wider collaboration into the group through engagement with other medical colleagues, other professional bodies, etc. The OneTogether collaborative is an organisation that has a primary interest in protecting patients in operating theatres. AfPP’s vision is to ‘Lead Perioperative Excellence’ and through the OneTogether Collaboration we are able to support an efficient and effective way of improving practice and patient outcomes. We now need to engage with the wider surgical team – consultants, anaesthetists, medical directors, senior nurses etc., to ensure our work continues to address issues of inconsistent care and making the links to national guidance. We are all in this together and everyone on the team needs to take responsibility for their actions – think about what you can do to make a difference – life is best filled by learning as much as you can about whatever interests you, sharing ideas and being enthusiastic so I urge you to look closely at your practice and identify ways to make a difference within your hospital – those small changes could save lives. Reference Wilson J, Topley K, Stott D, Neachell J and Gallagher R (2015) The OneTogether collaborative approach to reduce the risk of surgical site infection: identifying the challenges to assuring best practice. Journal of Infection Prevention 2015, 16(3): 118–125.
