Surgical site infections (SSIs) are serious postoperative complications that may lead to undesired patient outcomes. Previous research has used survey and chart audit methods to describe wound care practices. However, little research has been published using contemporaneous observations to describe the surgical wound management practices of nurses. The aim of this study was to prospectively describe surgical nurses' postoperative wound care practices and the extent to which observed surgical wound practices aligned with evidence-based guideline recommendations.
In this cross-sectional prospective study, we observed a convenience sample of 60 nurses from four surgical units using a specifically developed observational audit tool. Inter-rater reliability for this tool was assessed during the observation period.
Of 60 observed episodes of wound care, post-procedure hand hygiene (n=49, 81.7%) was less evident compared with pre-procedure hand hygiene practice (n=57, 95%). Over one-third of nurses observed did not correctly use clean gloves (n=16, 38.1%) and one in five did not properly use sterile gloves (n=4, 22%). More than half of surgical nurses (n=37, 61.7%) did not educate patients on post-discharge wound management. Fewer than a quarter (n=14, 23.3%) of wound care events were recorded on both wound assessment charts and patients' progress notes. Inter-rater reliability testing indicated good agreement (intra-class correlation coefficient 0.859; 95% CI: 0.771-0.923; p<0.0005).
Despite surgical wound care guideline recommendations on aseptic technique compliance, patient education, wound assessment and documentation practices, there is a clear gap between recommended and observed wound care practice. This study highlights an area where clinical practice is not reflective of evidence-based recommendations, suggesting that to minimise SSI as an adverse event, practice should be evaluated and strategies incorporating evidence into practice are explored.
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 May 2017.
All research outputs
#14,914,220
of 22,947,506 outputs
Outputs from Journal of Wound Care
#618
of 936 outputs
Outputs of similar age
#242,851
of 420,952 outputs
Outputs of similar age from Journal of Wound Care
#7
of 15 outputs
Altmetric has tracked 22,947,506 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 936 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one is in the 32nd percentile – i.e., 32% of its peers scored the same or lower than it.
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We're also able to compare this research output to 15 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 53% of its contemporaries.
