Adherence to Surgical Site Infection Prevention Bundle among Operating Room Staff in a Tertiary Care Hepatology Hospital: An Observational Study

Introduction: Surgical site infections (SSIs) are among the most common healthcare-associated infections. Preventing SSIs requires the consistent adherence to evidence-based guidelines across the preoperative, intraoperative, and postoperative stages. By following these practices, healthcare professionals can significantly reduce the risk of infection and improve patient outcomes. Aim: to observe adherence to Surgical site infection prevention Bundle (SSIPB) Checklist among operating room staff of a selected tertiary care hepatology hospital. Methodology: A total of 43 surgeries were observed to evaluate the adherence of operating room staff including surgeons, anaesthetists, nurses, operating room technicians, general duty assistants (GDAs), and housekeeping staff to the Surgical Site Infection Prevention Bundle (SSIPB). Event sampling was employed, resulting in the observation of 2,967 events across these surgeries. Due to the lack of comprehensiveness in existing checklists, a 61-item SSIPB checklist was developed to address critical aspects before, during, and after surgery. The checklist, designed for observation of operating room staff, included 16 preoperative items, 39 intraoperative items, and 6 postoperative items. Results: Overall adherence to the Surgical Site Infection Prevention Bundle (SSIPB) was 98.11%. Surgeons demonstrated the highest adherence at 99.71%, followed by scrub nurses at 99.45% and circulating nurses at 97.67%. Anaesthetists had a lower adherence rate of 67.15%, while general duty assistants and housekeeping staff achieved adherence rates of 80.24% and 87.44%, respectively. Operating room technicians had the lowest adherence at 78.49%. Notably, a significant association was identified between adherence and surgery duration (p=0.0345). Conclusion: the results of the study shows that 97.67 % of the Operating room staff showed excellent adherence while 2.33 % demonstrated good adherence to surgical site infection Bundle.