NDLI: Qualitative outcomes of Clean Cut: implementation lessons from reducing surgical infections in Ethiopia

Content Provider	Springer Nature : BioMed Central
Author	Mattingly, Aviva S. Starr, Nichole Bitew, Senait Forrester, Jared A. Negussie, Tihitena Bereknyei Merrell, Sylvia Weiser, Thomas G.
Abstract	Background Clean Cut is a six month, multi-modal, adaptive intervention aimed at reducing surgical infections through improving six critical perioperative processes: 1) handwashing/skin preparation, 2) surgical gown/drape integrity, 3) antibiotic administration, 4) instrument sterility, 5) gauze counts, and 6) WHO Surgical Safety Checklist use. The aim of this study was to elucidate themes across Clean Cut implementation sites in Ethiopia to improve implementation at future hospitals. Methods We conducted semi-structured interviews of 20 clinicians involved in Clean Cut at four hospitals. Participation was limited to Clean Cut team members and included surgeons, anesthetists, operating room (OR) nurses, ward nurses, OR managers, quality improvement personnel, and hospital administrators. Audio recordings were transcribed and coded using qualitative software. A codebook was inductively and iteratively derived between two researchers, tested for inter-rater reliability, and applied to all transcripts. We conducted thematic analysis to derive our final qualitative results. Results The interviews revealed barriers and facilitators to the implementation of Clean Cut, as well as strategies for future implementation sites. Key barriers included material resource limitations, feelings of job burden, existing gaps in infection prevention education, and communication errors during data collection. Common facilitators included strong hospital leadership support, commitment to improved patient outcomes, and organized Clean Cut training sessions. Future strategies include resource assessments, creating a sense of responsibility among staff, targeted training sessions, and incorporating new standards into daily routine. Conclusions The findings of this study highlight the importance of engaging hospital leadership, providers and staff in quality improvement programs, and understanding their work contexts. The identified barriers and facilitators will inform future initiatives in the field of perioperative infection prevention.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-019-4383-8.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-019-4383-8
Journal	BMC Health Services Research
Issue Number	1
Volume Number	19
Language	English
Publisher	BioMed Central
Publisher Date	2019-08-17
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Ethiopia Quality improvement Surgical infection Resource limited
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Improving HIV outcomes in resource-limited countries: the importance of quality indicators

Implementation of surgical debriefing programs in large health systems: an exploratory qualitative analysis

Scaling up noncommunicable disease care in a resource-limited context: lessons learned and implications for policy

Qualitative drivers of postoperative prophylactic antibiotics use and resistance in Ethiopia

Obstacles to implementation of an intervention to improve surgical services in an Ethiopian hospital: a qualitative study of an international health partnership project

Implementation through translation: a qualitative case study of translation processes in the implementation of quality improvement collaboratives

Clean Cut (adaptive, multimodal surgical infection prevention programme) for low‐resource settings: a prospective quality improvement study

Audit and group feedback in nursing home physician groups: lessons learned from a qualitative study

A new typology for understanding context: qualitative exploration of the model for understanding success in quality (MUSIQ)

Qualitative outcomes of Clean Cut: implementation lessons from reducing surgical infections in Ethiopia

Similar Documents

Improving HIV outcomes in resource-limited countries: the importance of quality indicators

Implementation of surgical debriefing programs in large health systems: an exploratory qualitative analysis

Scaling up noncommunicable disease care in a resource-limited context: lessons learned and implications for policy

Qualitative drivers of postoperative prophylactic antibiotics use and resistance in Ethiopia

Obstacles to implementation of an intervention to improve surgical services in an Ethiopian hospital: a qualitative study of an international health partnership project

Implementation through translation: a qualitative case study of translation processes in the implementation of quality improvement collaboratives

Clean Cut (adaptive, multimodal surgical infection prevention programme) for low‐resource settings: a prospective quality improvement study

Audit and group feedback in nursing home physician groups: lessons learned from a qualitative study

A new typology for understanding context: qualitative exploration of the model for understanding success in quality (MUSIQ)

Qualitative outcomes of Clean Cut: implementation lessons from reducing surgical infections in Ethiopia