Drivers and barriers of surgical wound management in a large health care organisation: Results of an environmental scan

Over 234 million surgeries are performed around the world every year. Yet, surgical site infections (SSIs) occur in up to 30% of all surgical procedures, and are the third most commonly reported nosocomial infection. The growing cost and complexity of wound care means that decisions around surgical wound management require a concerted approach from all stakeholders. The purpose of this environmental scan was to inform a program of clinical research in surgical wounds in a large health care organisation. A related purpose was to report findings in relation to drivers and barriers that impact on decision making back to key stakeholders within the organisation. This outside-in scan included five health care facilities and data sources included stakeholders such as clinical and specialist nurses, surgeons, inventory managers and wound product representatives. Other data sources included government and speciality documents, published research and websites. A content analysis approach was used to uncover emergent concepts and triangulation across data sources permitted confirmation of findings. Drivers included a plethora of product choice, infection surveillance, interdisciplinary collaboration, and regulatory mechanisms. The barriers identified were traditional and historical pretexts, economic constraints, clinical knowledge and expertise, and patient factors. Based on these findings, recommendations include working with health care partners to develop an incremental research program focusing on clinical research and knowledge transfer in surgical wound management.