The BASIC Trial: Improving implementation of evidence-based approaches and surveillance to prevent bacterial transmission and infection.
Perioperative ESKAPE (Enterococcus, S. aureus, Klebsiella, Acinetobacter, Pseudomonas, Enterobacter) transmission contributes to the development of surgical site infections (SSIs) which affect 3-5% of patients undergoing surgery. SSIs increase patient morbidity, prolong hospitalization, increase the risk of intensive care unit admission, and increase the risk of death 2-fold. The BASIC trial aims to establish a best practice for implementation of a multifaceted approach designed to reduce perioperative ESKAPE transmission and associated surgical site infection (SSI) development. An evidence-based approach for attenuation of the perioperative bacterial inoculum must integrate improvements in provider hand hygiene, intravascular catheter design/handling, environmental cleaning/organization, and patient decolonization. The Brown Lab will examine the relative effectiveness of increased site awareness and commitment to generating improvements via technical assistance (TA), team coaching implementation of an evidence-based set of interventions (EBIP), and TA or EBIP with ESKAPE transmission surveillance feedback. The BASIC trail will advance scientific knowledge and inform future dissemination and implementation by investigating how best to scale-up an already successful multifaceted approach to national dissemination through either TA or EBIP with or without surveillance.
Study status: Ongoing
To learn more about this project, please see major publications below:
- Epidemiology of enterococcus, staphylococcus aureus, klebsiella, acinetobacter, pseudomonas, and enterobacter species transmission in the pediatric anesthesia work area environment with and without practitioner use of a personalized body-worn alcohol dispenser
- The efficacy of multifaceted versus single anesthesia work area infection control measures and the importance of surgical site infection follow-up duration
- Staphylococcus aureus transmission in the anaesthesia work area has greater risk of association with development of surgical site infection when resistant to the prophylactic antibiotic administered for surgery
- The importance of targeting intraoperative transmission of bacteria with antibiotic resistance and strain characteristics
- Effectiveness and feasibility of an evidence-based intraoperative infection control program targeting improved basic measures: a post-implementation prospective case-cohort study