Objective:
To evaluate the impact of a multifaceted safety intervention on the rates of postoperative endophthalmitis (POE) in ophthalmic surgery.
Approach:
- Intervention Description: The intervention included visual safety cues, biweekly training, standardized regulation of surgical instruments, routine microbial sampling, and video-based performance reviews for all staff involved in ophthalmic surgery.
- Study Design: The study compared POE rates among 191,657 patients undergoing inpatient ophthalmic surgery from 2017 to 2023, before and after the intervention.
Key Findings:
- POE incidence decreased from 0.038% before the intervention to 0.013% after, indicating a 64.4% reduction (p < 0.001).
- In cataract and crystalline lens surgery, POE rates fell from 0.132% to 0.021%, a greater than six-fold reduction (p < 0.001).
Interpretation:
The decline in POE rates may be associated with the behavioral and organizational changes implemented rather than changes in antibiotic practices.
Limitations:
- The study was conducted at a single center.
- It included only hospitalized patients.
- Residual confounding over the seven-year observation period cannot be excluded.
Conclusion:
The findings indicate that improving surgical safety culture may be a strategy for reducing POE rates in ophthalmic surgery.
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