J.F. Navarro-Gracia , F.J. Gómez-Romero , F.J. Lozano-García , R. Ortí-Lucas , J.A. Delgado-De los Reyes , M. Fernández-Prada , R. Herruzo-Cabrera
{"title":"2017-2021 年西班牙医院零手术感染项目（ZSIP）的成效。前瞻性队列研究。","authors":"J.F. Navarro-Gracia , F.J. Gómez-Romero , F.J. Lozano-García , R. Ortí-Lucas , J.A. Delgado-De los Reyes , M. Fernández-Prada , R. Herruzo-Cabrera","doi":"10.1016/j.jhin.2024.11.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The Zero Surgical Infection Project (ZSIP) in Spain is a nationwide programme to prevent surgical site infections (SSIs), sponsored by the Ministry of Health. The programme includes the application of a bundle of five key preventive measures (5PM): peri-operative antibiotic prophylaxis (PAP), skin antisepsis (SA), hair removal (HR), normothermia and normoglycaemia.</div></div><div><h3>Aim</h3><div>To assess the effectiveness of the 5PM, applied in a set of Spanish public hospitals between 2017 and 2021, under standard conditions of surgical health care in Spain.</div></div><div><h3>Methods</h3><div>This prospective cohort study of 33,240 patients from the ZSIP Registry (National Database Network) included surveillance of SSI data of selected surgical interventions, compliance data and other risk factors. Compliance with the 5PM bundle was verified through a specific checklist. The intervention and comparison groups were patients who were compliant with the 5PM bundle and patients who were not compliant with the 5PM bundle, respectively. Adjusted odds ratios (OR) and preventive fractions (PF) were calculated using logistic regression.</div></div><div><h3>Findings</h3><div>The overall SSI rates for patients in the compliant group and non-compliant group were 4.77% and 6.90%, respectively. Overall compliance with the 5PM bundle was 35.9%, and the compliance rates were highest for PAP (87.2%), SA (82.2%) and HR (78.7%). Compliance with the 5PM bundle had a PF of 32% and adjusted OR of 0.68 (95% confidence interval 0.60–0.76).</div></div><div><h3>Conclusion</h3><div>The ZSIP, implemented between 2017 and 2021 in Spain, had a significant level of effectiveness against SSIs.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"156 ","pages":"Pages 78-86"},"PeriodicalIF":3.9000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of the Zero Surgical Infection Project (ZSIP) in Spanish hospitals 2017–2021: a prospective cohort study\",\"authors\":\"J.F. Navarro-Gracia , F.J. Gómez-Romero , F.J. Lozano-García , R. Ortí-Lucas , J.A. Delgado-De los Reyes , M. Fernández-Prada , R. Herruzo-Cabrera\",\"doi\":\"10.1016/j.jhin.2024.11.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The Zero Surgical Infection Project (ZSIP) in Spain is a nationwide programme to prevent surgical site infections (SSIs), sponsored by the Ministry of Health. The programme includes the application of a bundle of five key preventive measures (5PM): peri-operative antibiotic prophylaxis (PAP), skin antisepsis (SA), hair removal (HR), normothermia and normoglycaemia.</div></div><div><h3>Aim</h3><div>To assess the effectiveness of the 5PM, applied in a set of Spanish public hospitals between 2017 and 2021, under standard conditions of surgical health care in Spain.</div></div><div><h3>Methods</h3><div>This prospective cohort study of 33,240 patients from the ZSIP Registry (National Database Network) included surveillance of SSI data of selected surgical interventions, compliance data and other risk factors. Compliance with the 5PM bundle was verified through a specific checklist. The intervention and comparison groups were patients who were compliant with the 5PM bundle and patients who were not compliant with the 5PM bundle, respectively. Adjusted odds ratios (OR) and preventive fractions (PF) were calculated using logistic regression.</div></div><div><h3>Findings</h3><div>The overall SSI rates for patients in the compliant group and non-compliant group were 4.77% and 6.90%, respectively. Overall compliance with the 5PM bundle was 35.9%, and the compliance rates were highest for PAP (87.2%), SA (82.2%) and HR (78.7%). Compliance with the 5PM bundle had a PF of 32% and adjusted OR of 0.68 (95% confidence interval 0.60–0.76).</div></div><div><h3>Conclusion</h3><div>The ZSIP, implemented between 2017 and 2021 in Spain, had a significant level of effectiveness against SSIs.</div></div>\",\"PeriodicalId\":54806,\"journal\":{\"name\":\"Journal of Hospital Infection\",\"volume\":\"156 \",\"pages\":\"Pages 78-86\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hospital Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S019567012400392X\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S019567012400392X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Effectiveness of the Zero Surgical Infection Project (ZSIP) in Spanish hospitals 2017–2021: a prospective cohort study
Background
The Zero Surgical Infection Project (ZSIP) in Spain is a nationwide programme to prevent surgical site infections (SSIs), sponsored by the Ministry of Health. The programme includes the application of a bundle of five key preventive measures (5PM): peri-operative antibiotic prophylaxis (PAP), skin antisepsis (SA), hair removal (HR), normothermia and normoglycaemia.
Aim
To assess the effectiveness of the 5PM, applied in a set of Spanish public hospitals between 2017 and 2021, under standard conditions of surgical health care in Spain.
Methods
This prospective cohort study of 33,240 patients from the ZSIP Registry (National Database Network) included surveillance of SSI data of selected surgical interventions, compliance data and other risk factors. Compliance with the 5PM bundle was verified through a specific checklist. The intervention and comparison groups were patients who were compliant with the 5PM bundle and patients who were not compliant with the 5PM bundle, respectively. Adjusted odds ratios (OR) and preventive fractions (PF) were calculated using logistic regression.
Findings
The overall SSI rates for patients in the compliant group and non-compliant group were 4.77% and 6.90%, respectively. Overall compliance with the 5PM bundle was 35.9%, and the compliance rates were highest for PAP (87.2%), SA (82.2%) and HR (78.7%). Compliance with the 5PM bundle had a PF of 32% and adjusted OR of 0.68 (95% confidence interval 0.60–0.76).
Conclusion
The ZSIP, implemented between 2017 and 2021 in Spain, had a significant level of effectiveness against SSIs.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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