Authors (including presenting author) :
Lee WS, Wong MK, Tang CC, Wong WL, Lau PH
Affiliation :
Department of Surgery, Kwong Wah Hospital
Keyword 1: :
Evidence-based practice
Keyword 2: :
Surgical site infection
Keyword 4: :
Colorectal surgery
Keyword 5: :
patient engagement
Keyword 6: :
nursing staff adherence to nursing strategies
Introduction :
Surgical site infection (SSI) is an important cause of surgical morbidity and mortality in Colorectal Surgery. SSI remains the most common healthcare-associated infection (20-31%) which can be prevented by using evidence-based interventions. Recognizing the importance of prevention, an evidence-based nursing enhancement project was implemented in Surgical Department of Kwong Wah Hospital in November 2024. It focused both on strengthening patient engagement and staff adherence to best practices with the goal of reducing SSI rates and improving overall surgical outcomes.
Objectives :
To prevent surgical site infection in colorectal surgery
To improve patient outcomes
Methodology :
1.Patient engagement
Nurses conduct thorough comprehensive health assessments, including nutritional status and body mass index, to identify and address patient-specific risk factors. Patients received education on lifestyle modifications such as smoking cessation, dietary advice, and alcohol avoidance to minimize infection risk. Instructional materials and videos were produced and provided to guide patients in preoperative bathing with 4% chlorhexidine gluconate (CHG) for effective skin decolonization. Patients were encouraged to actively participate in their care, with clear instructions on following preoperative recommendations.
2.Healthcare staff training
Healthcare staff underwent specialized training to enhance their knowledge and skills in infection prevention, including the correct use of 2% chlorhexidine wipes for patient skin preparation before surgery, ensuring consistent effective skin decolonization even in emergency operations. Nurses were trained in advanced wound care techniques and the appropriate selection and use of dressing materials.
3.Patient discharge and Follow-Up
Upon discharge, patients received written instructions for home wound care and were educated to recognize early signs of infection. A dedicated hotline was given for patients to seek timely advice on wound-related concerns.
Result & Outcome :
One year after the implementation of the project, leading to a significant reduction in overall SSI rate. Overall SSI incidence rate in colon surgery decreased from 13.1% (2024) to 7.8% (2025) and rectum surgery decreased from 2.1% (2024) t0 1.3% (2025). Conclusion
Adherence to evidence-based nursing strategies has led to a significant reduction in SSI rates and improved patient outcomes in colorectal surgery. Ongoing commitment to best practices is essential for sustaining improvements in patient care and surgical safety.
