Evidence-based preprocessing improvement bundle for surgical instruments: reducing surgical infection risks via quality improvement
- 1Department of Sterile Processing Nursing, West China Second University Hospital, Sichuan University
- 2West China School of Nursing, Sichuan University
- 3Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University
Abstract
Introduction: Inadequate preprocessing of surgical instruments can leave biofilm residue, creating potential risks during instrument reprocessing and increasing the risk of healthcare-associated infections, thereby compromising patient safety and healthcare quality. This study aimed to develop a standardized surgical instrument preprocessing protocol based on evidence-based practice and validate its effectiveness in improving instrument preprocessing quality and central sterile supply department (CSSD) staff’s knowledge of nosocomial infection prevention and control and increasing their compliance with preprocessing criteria.
Methods: Guided by the Joanna Briggs Institute (JBI) model of evidence-based healthcare, this study summarized the best evidence for surgical instrument preprocessing, analyzed implementation barriers in clinical practice, and formulated standardized audit criteria and intervention strategies for surgical instrument preprocessing. A one-group pretest-posttest study was conducted to assess compliance with audit criteria in preprocessing procedures, rate of surgical instruments returned to the decontamination area for initial re-cleaning, and CSSD staff’s knowledge of nosocomial infection prevention and control.
Results: After applying the evidence in practice, 10 of 20 audit criteria achieved a 100% compliance rate. The rate of surgical instruments returned to the decontamination area for initial re-cleaning dropped from 0.67 to 0.085% (χ ² = 3512.527; p < 0.001; absolute risk difference = 0.58%, with 95% confidence interval (CI) of 0.56–0.60%; risk ratio = 7.93, with a 95% CI of 7.31–8.60). CSSD staff’s mean scores for knowledge of nosocomial infection prevention and control increased from 58.06 ± 9.097 to 95.83 ± 3.930 ( t = 22.520, p < 0.001).
Conclusion: The intervention, based on the JBI evidence-based model for improving the quality of surgical instrument preprocessing, could standardize instrument preprocessing procedures, reduce the proportion of surgical instruments returned to the decontamination area for initial re-cleaning, and improve CSSD staff’s theoretical knowledge of instrument preprocessing. This study can provide evidence to support quality control in surgical instrument preprocessing and contribute to the prevention and control of nosocomial infections.
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BibTeX
@article{hu2026evidencebased,
title = {{Evidence-based preprocessing improvement bundle for surgical instruments: reducing surgical infection risks via quality improvement}},
author = {Ruixue Hu and Wei Pan and Liangying Yi and Juan Hu and Hongxia Zhang and Yanhua Chen},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1930642},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1930642/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Evidence-based preprocessing improvement bundle for surgical instruments: reducing surgical infection risks via quality improvement
AU - Ruixue Hu
AU - Wei Pan
AU - Liangying Yi
AU - Juan Hu
AU - Hongxia Zhang
AU - Yanhua Chen
PY - 2026
DA - 2026/10/27
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1930642
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1930642/full
AB - Introduction: Inadequate preprocessing of surgical instruments can leave biofilm residue, creating potential risks during instrument reprocessing and increasing the risk of healthcare-associated infections, thereby compromising patient safety and healthcare quality. This study aimed to develop a standardized surgical instrument preprocessing protocol based on evidence-based practice and validate its effectiveness in improving instrument preprocessing quality and central sterile supply department (CSSD) staff’s knowledge of nosocomial infection prevention and control and increasing their compliance with preprocessing criteria. Methods: Guided by the Joanna Briggs Institute (JBI) model of evidence-based healthcare, this study summarized the best evidence for surgical instrument preprocessing, analyzed implementation barriers in clinical practice, and formulated standardized audit criteria and intervention strategies for surgical instrument preprocessing. A one-group pretest-posttest study was conducted to assess compliance with audit criteria in preprocessing procedures, rate of surgical instruments returned to the decontamination area for initial re-cleaning, and CSSD staff’s knowledge of nosocomial infection prevention and control. Results: After applying the evidence in practice, 10 of 20 audit criteria achieved a 100% compliance rate. The rate of surgical instruments returned to the decontamination area for initial re-cleaning dropped from 0.67 to 0.085% (χ ² = 3512.527; p < 0.001; absolute risk difference = 0.58%, with 95% confidence interval (CI) of 0.56–0.60%; risk ratio = 7.93, with a 95% CI of 7.31–8.60). CSSD staff’s mean scores for knowledge of nosocomial infection prevention and control increased from 58.06 ± 9.097 to 95.83 ± 3.930 ( t = 22.520, p < 0.001). Conclusion: The intervention, based on the JBI evidence-based model for improving the quality of surgical instrument preprocessing, could standardize instrument preprocessing procedures, reduce the proportion of surgical instruments returned to the decontamination area for initial re-cleaning, and improve CSSD staff’s theoretical knowledge of instrument preprocessing. This study can provide evidence to support quality control in surgical instrument preprocessing and contribute to the prevention and control of nosocomial infections.
SN - 2296-2565
ER -