Fulltext (PDF)
DOI: 10.48087/BJMS.2026.130405
Authors: Farida ILIMI, Amel Leila REBOUH, Hamida GUENDOUZ, Lyès RAHAL
Affiliations: Etablissement Public Hospitalier Djillali Rahmouni, Alger – Algérie.
Abstract
In older healthcare facilities where architectural constraints limit full technical compliance of the operating theater, optimizing organizational processes represents a major lever for improving patient safety. This study aimed to evaluate the impact of implementing standardized procedures on adherence to perioperative practices and the incidence of surgical site infections (SSI). Materials and Methods: This quasi-experimental, longitudinal, prospective study was conducted in the general surgery department of EPH Djillali Rahmouni. It included 334 consecutive patients who underwent elective surgery for digestive cancer — 167 in 2017 (baseline phase) and 167 in 2018 (intervention phase, following protocol standardization). Statistical analysis was performed using SPSS software, applying Pearson’s chi-squared test, Fisher’s exact test, and Student’s t-test. Results: The implementation of standardized procedures led to significant improvements in protocol adherence: compliance with the skin preparation protocol increased from 0% to 89.8% (p < 0.001), and pre-incision antibiotic prophylaxis from 0% to 95.8% (p < 0.001). Surgical safety checklist compliance doubled, rising from 20% to 48% (p < 0.05), and adherence to staffing limits in the operating room improved from 36% to 94% (p < 0.05). The SSI incidence rate decreased from 8.4% to 6.6%, although this difference did not reach statistical significance. Conversely, a significant reduction in bacteremia was observed, from 20% to 8.3% (p = 0.003). Discussion and Conclusion: Despite significant architectural constraints, organizational standardization markedly improved process indicators and perioperative safety. Although the overall reduction in SSI did not reach statistical significance, this approach represents an essential step toward continuous quality improvement. Further studies incorporating multivariate analysis of risk factors will be needed to confirm the long-term clinical impact. The introduction of standardized procedures and protocols for surgical activity at EPH Djillali Rahmouni in 2017, followed by their strict application in 2018, contributed to measurable improvements in operating room performance.
Keywords: digestive surgery; perioperative safety; surgical site infection; quality management.