The BASIC Trial: Improving Implementation of Evidence-based Approaches and Surveillance to Prevent Bacterial Transmission and Infection
Trustees of Dartmouth College
Summary
Surgical site infections (SSIs) are associated with increased patient morbidity, mortality, and healthcare costs. ESKAPE (Enterococcus, S. aureus, Klebsiella, Acinetobacter, Pseudomonas, and Enterobacter spp.) pathogens are particularly pathogenic because they have increased capacity to acquire resistance and virulence traits. The investigators have proven that a multifaceted program involving improved basic perioperative preventive measures can generate substantial reductions in S. aureus transmission and significant reductions in SSIs (88% reduction as compared to usual care). In this study, the investigators aim to examine the relative effectiveness of each component of this program in controlling ESKAPE transmission and reducing SSIs and to identify an optimal implementation strategy for national dissemination. Randomization occurs at the site level, and sites adopt preventative programs. This work will improve perioperative patient safety for the 51 million patients who undergo surgery each year.
Description
The investigators propose to test the implementation of a multifaceted, evidence-based, peri-operative surgical site infection (SSI) preventive program that leverages basic preventive measures optimized by pathogen cluster detection software (surveillance) to reduce ESKAPE (Enterococcus, S. aureus, Klebsiella, Acinetobacter, Pseudomonas, and Enterobacter spp.) transmission and SSIs. SSIs increase patient morbidity, prolong hospitalization, and increase the risk of death. ESKAPE pathogens are particularly problematic because they have increased capacity to acquire resistance and virulence trait…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Site Inclusion and Exclusion Criteria. * 250 patients (125 case pairs) per site in the active phase (N=3,000) * 250 patients (125 case pairs) per site in the sustainability phase (N=3,000) * Total N=6,000 * orthopedic total joint and spine procedures Site Inclusion Criteria: * operating room conducting orthopedic total joint and spine * Surgeons performing orthopedic total joint or spine Site Exclusion Criteria: \- medical centers actively enrolling patients in a bacterial transmission or infection prevention trial Patient Inclusion Criteria: \- all elective patients undergoing orthoped…
Interventions
- BehavioralTechnical assistance or team-based coaching
Main comparison in delivering peri-operative preventive strategies against transmission and infection is one on one technical assistance or team-based coaching.
Locations (2)
- Mayo ClinicRochester, Minnesota
- Trustees of Dartmouth CollegeHanover, New Hampshire