NHS Joins Forces To Reduce Infections For Patients Having Hip And Knee Replacement Surgery


Leeds Teaching Hospitals NHS Trust (LTHT) has joined forces with 30 organisations across the NHS to reduce infections from MSSA for patients having hip and knee replacement surgery.

This unique collaborative, called QIST (Quality Improvement for Surgical Teams) Infection, will drive forward improvements for patients by ‘scaling up’ interventions such as screening and the use of body wash and nasal gel treatments for patients carrying the bug, to reduce infections and save lives.

MSSA is a common cause of infection in joint replacement surgery.  Research has shown that interventions – such as decolonisation using nasal gel and body washes – can reduce the risk of infection from MSSA by 60% in some cases.

In Leeds the multi-disciplinary study team leading locally on QIST is based at Chapel Allerton Hospital and led by Professor Hemant Pandit.

Around 1200 joint replacements are carried out at Chapel Allerton Hospital annually. All patients are assessed for infections before surgery and receive follow-up appointments at regular intervals. Every patient undergoing an elective joint replacement completes a course of decolonisation to ensure that they do not carry any bugs when undergoing their surgery.

Professor Hemant Pandit said: “With this policy and careful vigilance, there has not been a single MRSA infection recorded in patients attending Chapel Allerton Hospital for nearly nine years and no MSSA bacteremia for the past two years (since we started recording MSSA). These results are one of the best in the whole country and something everyone in the organisation should be proud of.”

He commented: “Colleagues from pre-operative assessment, outcome assessment, ward and theatre staff, coding and IT support teams have been instrumental in ensuring this study is delivered to the highest standards and our data is exemplary.”

The QIST Infection study was formally launched at Chapel Allerton Hospital on 1 November by Dr Yvette Oade, Chief Medical Officer, and Dr Ali Cracknell, Associate Medical Director for Quality Improvement.

Dr Ali Cracknell said: “We are delighted to be part of this unique surgical improvement programme which will help us to continually improve care for our patients undergoing joint replacements. It gives us opportunities to share our learning and support further adoption across the NHS so many more patients can benefit in the future.”

The project is part of the QIST collaborative which was established by Northumbria Healthcare NHS Foundation Trust in 2013. QIST infection is a partnership between Northumbria Healthcare, British Orthopaedic Association, University of York trials unit and NHS Improvement.

Interventions have already been tested by Northumbria Healthcare which has adapted a MSSA ‘care bundle’ or ‘checklist’ to meet the needs of patients having joint replacement surgery. Before and after data for the 9,000 patients cared for at the Trust shows they are making a real difference.

Clinical Director for Trauma and Orthopaedics at Northumbria Healthcare and Chief Investigator for the QIST infection collaborative, Professor Mike Reed said: “The overall ambition of this collaborative is to prove the case we can successfully introduce these interventions and improve care for patients having joint replacement surgery so that they become routine clinical practice across the NHS. By joining forces and sharing best practice, I strongly believe we can make a real difference to patients across the NHS.”

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