Adherence to evidence-based recommendations for surgical site infection prevention: Results among Italian surgical ward nurses

PLoS One. 2019 Sep 26;14(9):e0222825. doi: 10.1371/journal.pone.0222825. eCollection 2019.


Background: The aims of the study were to assess the level of knowledge, the attitudes and the adherence to evidence-based recommendations for surgical site infection (SSI) prevention and to describe any influences that may motivate nurses to adopt evidence-based practices for SSI prevention.

Methods: The present study was a national cross-sectional survey conducted from June to November 2017. For each hospital that agreed to participate, 30 nurses were randomly selected. The questionnaire was aimed at exploring socio-demographic and practice characteristics, knowledge of, attitudes toward, and reported practices regarding evidence-based procedures for SSI prevention.

Results: Out of 55 hospitals that were contacted, 36 agreed to participate (a response rate of 65%). Of the original sample of 1313 nurses, a total of 1305 returned the questionnaire, a response rate of 99.4%. Regarding knowledge, only 53.8% knew that preoperative hair removal, if necessary, should take place shortly before surgery, and 28.9% of the sample did not know the right definition of "bundle". Over three quarters of participants stated that they always perform hand antisepsis before and after biological sample collection while 9.7% considered that wearing gloves during this practice is sufficient to prevent SSI. Furthermore, 91% of nurses reported that they always performed hand antisepsis before and after invasive procedures.

Conclusion: The study findings highlight the areas that were most lacking in nurses' training and for which targeted activities are needed. These data could support healthcare managers to implement interventions focused at enabling adherence to effective prevention practices to reduce risk to all patients.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Clinical Competence / statistics & numerical data*
  • Cross-Sectional Studies
  • Evidence-Based Practice / standards
  • Evidence-Based Practice / statistics & numerical data*
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Hospitals / standards
  • Hospitals / statistics & numerical data
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Nurses / standards
  • Nurses / statistics & numerical data*
  • Practice Guidelines as Topic
  • Preoperative Care / standards
  • Preoperative Care / statistics & numerical data*
  • Surgical Procedures, Operative / adverse effects
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control*

Grant support

The authors received no specific funding for this work.