• Shalini Ahuja, Nathan Peiffer-Smadja, Kimberly Peven, Michelle White, LeatherAndrew J MAJMKing's Center for Global Health and Health Partnerships, School of Population Health and Environmental Sciences, King's College London, London, UK., Sanjeev Singh, Marc Mendelson, Alison Holmes, Gabriel Birgand, Nick Sevdalis, and ASPIRES study co-investigators.
• Center for Implementation Science, Health Service and Population Research Department, King's College London, UK.
• Ann. Surg. 2022 Feb 1; 275 (2): e345e352e345-e352.

ObjectiveSurgical site infection (SSI) prevention remains significant, particularly in the era of antimicrobial resistance. Feedback on practices and outcomes is known to be key to reduce SSI rates and optimize antibiotic usage. However, the optimal method, format and frequency of feedback for surgical teams remains unclear. The objective of the study is to understand how data from surveillance and audit are fed back in routine surgical practice.MethodsA systematic scoping review was conducted, using well-established implementation science frameworks to code the data. Two electronic health-oriented databases (MEDLINE, EMBASE) were searched to September 2019. We included studies that assessed the use of feedback as a strategy either in the prevention and management of SSI and/or in the use of antibiotics perioperatively.ResultsWe identified 21 studies: 17 focused on SSI rates and outcomes and 10 studies described antimicrobial stewardship for SSI (with some overlap in focus). Several interventions were reported, mostly multimodal with feedback as a component. Feedback was often provided in written format (62%), either individualized (38%) or in group (48%). Only 25% of the studies reported that feedback cascaded down to the frontline perioperative staff. In 65% of the studies, 1 to 5 implementation strategies were used while only 5% of the studies reported to have utilized more than 15 implementation strategies. Among studies reporting antibiotic usage in surgery, most (71%) discussed compliance with surgical antibiotic prophylaxis.ConclusionsOur findings highlight the need to provide feedback to all levels of perioperative care providers involved in patient care. Future research in this area should report implementation parameters in more detail.Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

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