I wanted to quickly write and introduce you to the passionate and energetic Lilian Chiwera. Lilian is leading on a new project that aims to raise awareness of and better embed surgical site surveillance in healthcare. Her enthusiasm is infectious and she has swept many of us up in her wake, so grab a cup of tea and read why this piece of work is so important and why we should all want to step up and see how we could get involved.

Lilian Chiwera is a independent Surgical Site Infection (SSI) surveillance & prevention expert with experience setting up and coordinating a very successful SSI surveillance service at Guys & St Thomas’ NHS Foundation Trust (GSTT) from 2009 – 2022. Currently working in Digital Transformation, Lilian is exploring how best infection prevention and SSI prevention can be aligned with current digital transformation agendas. Blogs via: https://www.lilycompassion.com/

“I think I can officially declare that I’m now married to surgical site infection (SSI) prevention! There is no day or hour which passes by when I don’t think about what we can do to prevent avoidable SSIs and promote patient safety in our organisations. Yes, my passion for this important patient safety initiative is overflowing. I am honoured and humbled to have so many people supporting our latest push for SSI Prevention Day (SSIPD) initiatives.”

I must thank Elaine for asking me to write this blog. I have always looked up to Elaine, she is fun, very knowledgeable and always inspiring us through her fabulous blogs. When Elaine asked me to write this blog, I thought… where do I even begin. Elaine coached me on how to write blogs and I have never looked back. Check my previous blogs here and a fabulous selfie I took at the 2022 Infection Prevention Society Conference in Bournemouth, UK.

Given the number of people now supporting these initiatives I thought it was prudent for me to open this up to our SSI Prevention Day Group. I was not disappointed! Everyone came all signed up to do everything possible to support our call to action. It was no surprise therefore when Karen Ousey was so quick out of the blocks to write the piece below, thank you Karen!

Why surgical site prevention?

“Surgical site infections (SSIs) are among the most common and costly health care-associated infections, leading to adverse patient outcomes and death. The continued global discussions identifying the importance of reducing and preventing anti-microbial resistance and embedding antimicrobial stewardship strategies into practice highlights the significance of raising awareness for prevention of SSI for clinical staff and patients alike. Despite there being published SSI guidelines, there is still a lot of work needed to ensure improved compliance with implementation of evidence-based SSI prevention measures. Recently there have been some awareness campaigns that are attempting to raise awareness of wound infection. These include the International Stop Wound Infection Day (ISWID) held virtually on the 3^rd Thursday of October annually which embraces Europe, Oceania and the Americas. The campaign features a range of free to access resources relevant to different countries and short videos from global wound care key opinion leaders and recordings demonstrating skills such as taking a wound swab. This campaign led by the International Wound Infection Institute states: Wound infection is a significant problem in both acute surgical wounds, leading SSIs, and non-healing, chronic wounds. Antimicrobial resistance is also a growing public health challenge worldwide which was identified as one of the top 10 threats to global health by the World Health Organisation in 2019. The ISWID campaign has been running for 2 years (2021 and 2022) and has seen lots of interactions from clinical staff across the world through social media posts and people being able to download free resources relating to prevention of wound infection.” Karen Ousey

It’s clear from Karen’s piece above that there is already lots of work going on around tackling wound infections. My desire has always been to ensure that we promote this important patient safety initiative together! In other words, an annual SSIPD can only be effective if all key stakeholders are involved and actively participate. Key stakeholders include all healthcare professionals and consumers of healthcare – covering a broad spectrum of specialisms i.e., Infection Prevention and Control (IPC) and SSI Surveillance and Prevention (SSISP) societies and collaboratives as well as patient safety advocates, journalists, musicians, quality improvement, human factors experts, psychologists, and many others. I therefore hope to see more stakeholders, in addition to those already signed up (see figure 1) collaborating with us on this important patient safety initiative.

Figure 1: Confirmed and proposed supporters

So, what are we really proposing?

Raise the profile of SSIs via:

1. An annual SSI Prevention Day (SSIPD)/week
2. Annual regulatory style SSIP inspection tool that will allow us to monitor surgical safety practices throughout the year via our dedicated SSI champions. These SSI champions will disseminate key findings/learning from inspections and action plans for the following year during the annual SSI Prevention SSIPD
3. An SSI champion model that will give us an opportunity to standardise existing SSI surveillance and prevention processes in the UK and all countries around the globe through our dedicated local hospital, regional, country, and continent SSI champions.
4. Proposed SSI champions will span a variety of healthcare professionals and consumers of healthcare. Our ambition is to embrace arts (journalism, music, etc.), science, other IPC branches, human factors experts, implementation science specialists, psychologists, Patient and Public Involvement (PPI) groups and many others to help us raise the profile of this important patient safety initiative.

Figure 2: proposed SSIP champion model and areas of initial focus

Proposed benefits include but are not limited to the following:

1. provision of SSI/infection prevention expertise from ward to board by compassionate local champions, experienced SSI prevention champions, patient safety and infection prevention and control experts.
2. Opportunity for collaboration and learning from each other.
3. Opportunity for Chief Nursing Officers (CNO) and Chief Medical officers (CMO), Politicians and Journalists to champion an important patient safety initiative in the UK and globally.

From humble beginnings

What started as just another tweet in April 2022 has turned out to be perhaps one of the best SSIP campaign I have ever coordinated on social media (SoMe). By October 2022 I was presenting our SSI prevention day initiatives proposals at the largest Infection Prevention conference in the UK. Interestingly, the main reason I submitted an IPS conference abstract was because I just could not imagine myself missing seeing my friend Lisa Butcher being inaugurated as new IPS President. Therefore, I ended up taking the opportunity (aka killing two birds with one stone as some say!) to share our SSIPD aspirations with many conference attendees. Our IPS poster which was produced with input from many of our SSIPD group members was very well received. I left the conference believing that this campaign could become as popular or even surpass successes of the WHO annual Hand Hygiene campaign. Check out the timeline of activities via our Twitter handle here and hashtag #SSIPreventionDay.

Engaging our senior leadership

I presented our proposals to the Head of IPC at NHS England, after being given the go ahead by the Chief Nursing Officer. Engaging senior healthcare leaders and politicians is a critical component of our proposals. This draws from my experiences at Guy’s & St Thomas’ NHS Foundation Trust where with Dame Eileen Sills support, we established a very successful SSI surveillance and prevention service.

Proposed next steps

We held our first ever virtual brainstorm meeting which was kindly chaired by the wonderful, very experienced Infection Prevention Champion and Clinical Director at Gama Healthcare, Karen Wares on the 4^th of January 2023. Everyone came ready to brainstorm! Check some of our highlights via our Twitter handle here. We’re planning our next meeting in February 2023, where we hope to consolidate and firm the future direction of our work. We now have a WhatsApp group where we’re ‘bouncing ideas off each other’, have a Facebook and LinkedIn page which you can join and be part of our exciting patient safety initiatives.

Conclusion

We’re proposing a novel patient safety initiative which we hope will bring enormous surgical patient benefits.  We believe our proposed SSIPD initiatives are feasible, given the level of traction gained over a short period. Thank you to our supporters and advocates who got us to where we’re today… buzzing with excitement! They call me the SSI Queen and I think I have lived up to my title on this occasion, with amazing support of course.

Surgical Site Infection Prevention Day Initiatives Group at the Inaugural Meeting on the 4^th January 2023

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All opinion in this blog are my own