TY - JOUR T1 - Optimising detection and prevention of prosthetic joint infections JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 349 LP - 351 DO - 10.1136/bmjqs-2018-009070 VL - 28 IS - 5 AU - Christopher Kandel AU - Nick Daneman Y1 - 2019/05/01 UR - http://qualitysafety.bmj.com/content/28/5/349.abstract N2 - Translation of best practices to clinical practice can be a considerably lengthy process. Reducing surgical site infections (SSIs) following primary hip and knee arthroplasties is a crucial endeavour in light of the continued rise in the number of these operations being performed and the morbidity associated with prosthetic joint infections (PJIs).1 A number of interventions have been successful in lowering SSI rates following orthopaedic procedures, with those targeting Staphylococcus aureus particularly effective given that it is the most common pathogen.2 Measures to reduce SSIs are evidence-based, relatively straightforward and cheap, yet widespread implementation remains elusive. Perioperative staphylococcal decolonisation represents a substantial cost savings opportunity given the economic burden associated with PJIs, including revision operations, rehospitalisation and prolonged antibiotic courses .3 Calderwood et al 4 report on the impact of disseminating a SSI prevention bundle for hip and knee PJIs using a pre-existing platform designed for quality improvement initiatives. States with hospitals participating in the quality improvement initiative were compared with those who were interested in participating, revealing a reduction in SSI incidence following primary hip and knee arthroplasty. The size and scope of the intervention (193 hospitals in 5 states) were equally as impressive as the reduction in SSI rates observed (PJI reductions in intervention states exceeded the declines in comparator states by 12%–15%). The bundle included a number of simple measures: S. … ER -