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In Uganda, a Vivid Illustration of How the Basics Dramatically Reduce SSIs

World Health Organization program helps hospital cut its rate in half.

Published: May 6, 2016

SAFETY TRAINING An OR staff at Uganda's Kisiizi Hospital practices using a WHO checklist.

In the battle against surgical site infections, a recent initiative in Uganda serves as a reminder as to just how important the basics —hand hygiene, for example — can be.

As part of a World Health Organization (WHO) program, Kisiizi Hospital in southwest Uganda cut its SSI rate in half, based on a 2014 study of more than 650 patients. How? By closing OR doors, limiting OR traffic, having patients bathe before surgery, improving surgical skin prep with a locally produced alcohol-based antiseptic, waiting for skin to dry before cutting, and by using appropriate surgical antibiotic prophylaxis.

And of course by emphasizing hand hygiene — WHO marks May 5 every year as hand hygiene day. In addition to training hospital staff, WHO's Surgical Unit-Based Safety Program (SUSP) sends representatives to schools, community health centers and surrounding communities to promote hand hygiene. Kisiizi is one of 5 African hospitals participating in the program, along with facilities in Kenya, Zambia and Zimbabwe.

"Hand hygiene has been a critical part of the success at Kisiizi," says Benedetta Allegranzi, MD, who leads the WHO program Clean Care is Safer Care. "The fact that they produced their own alcohol-based hand rub is even more impressive."

Another marker of success: Since implementing the program, Kisiizi has reduced post-operative antibiotic administration from 93% of patients to 24%.

"A few simple steps can prevent many of these infections," says Wondi Alemu, MD, WHO's representative in Uganda. "Not only does that spare patients needless suffering, it's also a substantial cost-saving to families, hospitals and Uganda's health system."

Jim Burger

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