Evidence map›Paper›PMID 31182142›Full record

ArticleTrials2019

The effect of implementing an aseptic practice bundle for anaesthetists to reduce postoperative infections, the Anaesthetists Be Cleaner (ABC) study: protocol for a stepped wedge, cluster randomised, multi-site trial.

Alan F Merry, Derryn A Gargiulo, Ian Bissett, David Cumin, Kerry English, Christopher Frampton, Richard Hamblin, Jacqueline Hannam, Matthew Moore, Papaarangi Reid and 4 more

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Alan F MerryDepartment of Anaesthesiology, School of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. a.merry@auckland.ac.nz.ORCID http://orcid.org/0000-0001-7100-009X
Derryn A GargiuloDepartment of Anaesthesiology, School of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
Ian BissettDepartment of Surgery, School of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
David CuminDepartment of Anaesthesiology, School of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
Kerry EnglishDepartment of Anaesthesia, Auckland City Hospital, PO Box 92024, Auckland, 1142, New Zealand.
Christopher FramptonDepartment of Psychological Medicine, University of Otago, PO Box 4345, Christchurch, 8140, New Zealand.
Richard HamblinHealth Quality & Safety Commission, PO Box 25496, Wellington, 6146, New Zealand.
Jacqueline HannamDepartment of Pharmacology and Clinical Pharmacology, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
Matthew MooreDepartment of Anaesthesiology, School of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
Papaarangi ReidTe Kupenga Hauora Māori, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
Sally RobertsLabPLUS, Auckland City Hospital, PO Box 110031, Auckland, 1070, New Zealand.
Elsa TaylorStarship Children's Health, Auckland District Health Board, PO Box 9389, Auckland, 1149, New Zealand.
Simon J MitchellDepartment of Anaesthesiology, School of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
ABC Study Group
University of Auckland · NZAuckland City Hospital · NZUniversity of Otago · NZ

Funding

Australian and New Zealand College of Anaesthetists 18/012
6 · The paper itself

Abstract

backgroundPostoperative infection is a serious problem in New Zealand and internationally with considerable human and financial costs. Also, in New Zealand, certain factors that contribute to postoperative infection are more common in Māori and Pacific populations. To date, most efforts to reduce postoperative infection have focussed on surgical aspects of care and on antibiotic prophylaxis, but recent research shows that anaesthesia providers may also have an impact on infection transmission. These providers sometimes exhibit imperfect hand hygiene and frequently transfer the blood or saliva of their patients to their work environment. In addition, intravenous medications may become contaminated whilst being drawn up and administered to patients. Working with relevant practitioners and other experts, we have developed an evidence-informed bundle to improve key aseptic practices by anaesthetists with the aim of reducing postoperative infection. The key elements of the bundle are the filtering of compatible drugs, context-relevant hand hygiene practices and enhanced maintenance of clean work surfaces.

methodsWe will seek support for implementation of the bundle from senior anaesthesia and hospital leadership and departmental "champions". Anaesthetic teams and recovery room staff will be educated about the bundle and its potential benefits through presentations, written material and illustrative videos. We will implement the bundle in operating rooms where hip or knee arthroplasty or cardiac surgery procedures are undertaken in a five-site, stepped wedge, cluster randomised, quality improvement design. We will compare outcomes between approximately 5000 cases before and 5000 cases after implementation of our bundle. Outcome data will be collected from existing national and hospital databases. Our primary outcome will be days alive and out of hospital to 90 days, which is expected to reflect all serious postoperative infections. Our secondary outcome will be the rate of surgical site infection. Aseptic practice will be observed in sampled cases in each cluster before and after implementation of the bundle. DISCUSSION: If effective, our bundle may offer a practical clinical intervention to reduce postoperative infection and its associated substantial human and financial costs.

trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12618000407291 . Registered on 21 March 2018.

Indexed as

AnesthetistsRandomized Controlled Trials as TopicCluster AnalysisData CollectionHand HygieneHumansInfection ControlMulticenter Studies as TopicOutcome Assessment, Health CarePostoperative ComplicationsResearch DesignSample SizeSurgical Wound InfectionAnaesthesiaCluster randomisedPatient safetyPostoperative infectionPreventionStepped wedgeSurgery

Identifiers

PMID31182142
PMCPMC6558820
OpenAlexW2952475625

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.