Overcoming barriers in the prevention of surgical site infections: a master plan employing task-based interprofessional training

Surgical site infections (SSIs) occur when a patient is receiving surgical treatment for a medical problem. Robust prevention guidelines do exist that, when properly implemented, can help reduce their incidence. To strengthen and build the capacity of health care organizations, the World Health Organization has, therefore, defined core components for infection prevention and control that specify how national authorities, as well as hospitals, can prevent infections in the long term. Although the WHO recommends that all of these components should be implemented, it also specifically points to the adaptation of evidence-based guidelines, monitoring and feedback, the use of multi-modal improvement initiatives, and active surveillance in particular for making a difference in reducing SSI rates. Essential is a focus on educating and training healthcare professionals who work in the operating rooms (ORs). Even though the global surgical societies are well aware of the harmful impact SSIs have on patient outcomes, there is a paucity of scientific information about the factors that inhibit the adoption of the said guidelines. Furthermore, knowledge about training healthcare personnel in preventing SSIs in the ORs in low- and middle-income countries(LMICs) is scant. In this dissertation we, therefore, addressed the following two main questions: What factors hinder the implementation of surgical site infection guidelines in the operating rooms of low-middle income countries? How can we design a high-quality and feasible training plan to prevent surgical site infection prevention in low-middle income countries?