Table 1.
Four elements of the SSI-bundle.
Table 2.
Index surgeries: Thirteen surgical procedures selected by the DHPSP.
Fig 1.
Statistical analysis: Four analyses comparing the influence of bundle-compliance on the SSI-risk.
Comparisons made in Models 1 to 4 schematically represented. A stack of four boxes represents the entire bundle, a stack of three boxes represents the partial bundle. Compliance with a single bundle element is presented as a blue box with a Y (= Yes). Non-compliance with a bundle element is presented in a white box with an N (= No). Only bundles being completely reported were included (N = 62 486 for entire bundle, N = 99 371 for the partial bundle). Bundles with missing data concerning compliance were excluded. Key: * Model 4: The partial bundle does not include the bundle element hygiene discipline (‘minimising operating room door movements’), but is only composed of the bundle elements PAP-LG, hair removal and normothermia. † Model 2: Level of compliance entered as a categorical variable produces 4 Odds Ratios (ORs), comparing full compliance with the four other levels of compliance separately. ‡ Model 3: Level of compliance entered as a continuous variable produces 1 Odds ratio (OR), signifying the reduced risk for each single point increase in compliance-level.
Table 3.
Baseline characteristics of surgeries with bundles not reported, partially reported, entirely reported but not fully compliant, and entirely reported with full compliance.
Table 4.
Reporting of and compliance with the bundle and its elements.
Fig 2.
Compliance with the bundle elements and with the bundle over time. Compliance with each bundle element was calculated using surgeries for which the element was reported, i.e. not missing (n = 72 457 for hygiene discipline, n = 112 215 for normothermia, n = 130 622 for hair removal, and n = 139 089 for PAP-LG). Bundle compliance was calculated within the group of surgeries for which (non-)compliance was reported for the entire bundle (n = 62 486). * Data from 2014 are incomplete because of the mandatory delay in follow-up of one year, which caused a delay in reporting the data. PAP-LG = Peri-operative Antibiotic Prophylaxis according to Local Guidelines.
Table 5.
Bundle compliance and compliance with individual bundle elements: Odds ratios (ORs) for the risk of an SSI.