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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-13Towards Reducing the Percentage of Surgical Site Infection in Orthopaedic SurgeryNoor Hidayah A, Tuan Mohd Fairuz TI, Zamir Hilmie H, Nur Hafizah MN, Yang Sofia AR, Syed MohdSyafiq SMOrthopedic Department, Hospital Sultanah Nur Zahirah, TerengganuSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Surgical site Infection (SSI) is disastrous in orthopaedic practice as it will cause increased morbidity,mortality, extended hospital in-patient stays, and economic burden on hospital resources. The verificationstudy showed a 3% incidence of SSI, thus this study is needed to reduce the incidence by less than 2% asper international standards.KEY MEASURES FOR IMPROVEMENT:The key indicator for improvement was measured using the percentage of surgical site infection inorthopaedic elective surgery. The standard is less than 2% based on a five years analysis of theprevalence of SSI 2014.PROCESS OF GATHERING INFORMATION:A quality improvement study was conducted from August 2020 to May 2022. Data were collectedretrospectively from existing medical records through the HIS system. Questionnaires were alsodistributed among staff and patients to assess the knowledge. Data analysis was done using Excel.ANALYSIS AND INTERPRETATION:The pre-remedial study showed a 3% incidence of surgical site infection among 434 cases. Lack ofpre-operative rounds (30.8%), improper post-operative wound care (38%), poor skin preparation (27.3%)and high operation theatre (OT) temperature and humidity (3%), were identified as the contributingfactors.STRATEGY FOR CHANGE:A well-organised peri-operative checklist was implemented to ensure a well assessment and managementof the patient%u2019s condition prior, during and post-surgery. A new temperature and humidity monitoring toolwas introduced to optimise the OT environment. The educational series including online CME to staff,informative banners, continuous interactive videos and wound care flyers distributed to the patients priorto discharge, were also organised.EFFECTS OF CHANGE:The remedial action has reduced the percentage of surgical site infection from 3% to 0.65%, whichshowed improvement of Achievable Benefit Not Achieved from 1% to -1.35%.THE NEXT STEP:Regular audits should be done, and actions should be taken. Remedial measures will be strengthened andmonitored regularly and more focused on major contributing factors. Suggestions will be given to applysimilar measures at district hospitals and other primary health care centres.38 | Page