As part of our IP2025 Conference highlights series, we will be showcasing innovative work advancing infection prevention and control. This first collection focuses on foundational IPC practices and organism-specific care, from redefining surgical site outcomes and improving mouthcare to reduce infections, to creative education and quality improvement initiatives transforming engagement and everyday practice across healthcare settings.
1. Redefining Surgical Incision Outcomes: A Modified Delphi Study to Establish a Novel Universal Classification System
Surgical site outcomes (SSOs) such as dehiscence, infection, seroma, and haematoma contribute significantly to patient morbidity and healthcare costs, yet current definitions are inconsistent across specialties. To address this, an international panel of experts conducted a modified Delphi study to establish a universal classification system. A targeted literature review informed statement development, followed by four Delphi rounds and an in-person symposium. The study involved a five-member steering committee and 32 pan-specialty panellists worldwide. Consensus (≥75% agreement) was reached on statements defining SSOs and their severity grading, based on both clinical presentation and required interventions. Initial rounds revealed challenges in defining infection and the role of antibiotics, which were refined through iterative feedback. The resulting system, termed the DISH Classification (Dehiscence, Inflammation/Infection, Seroma, Haematoma), provides a graded scale that accounts for clinical management and presentation. It offers a common language to standardise reporting, facilitate surveillance and audit, and improve comparability in research. Importantly, DISH separates classification from actual clinical management to ensure clarity and usability. Next steps include testing the system’s robustness, usability, and applicability across surgical disciplines. By establishing a universal standard, DISH has potential to enhance patient outcomes, research consistency, and healthcare planning.
AUTHORS: Giles Bond-Smith,1 Marja A. Boermeester,2,3 Antonia F. Chen,4 David Leaper,5,6 Philip L Russo.7–9
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; 2.Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; 3.Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands; 4.Department of Orthopedic Surgery, University of Texas Southwestern, Dallas, Texas, USA; 5.University of Newcastle, Newcastle, UK; 6.University of Huddersfield, Huddersfield, UK; 7.Monash Nursing and Midwifery, Monash University, Australia; 8.Cabrini Research, Cabrini Health, Australia; 9.Avondale University, Australia
2. Breaking the Chain of Infection: Using an Escape Room to Enhance IPC Education
To improve engagement in Infection Prevention and Control (IPC) training, an innovative escape room was developed for International Infection Prevention Week. Set in a simulated old hospital lab, the experience focused on blood-borne viruses and challenged healthcare staff to collaboratively solve IPC-related puzzles involving hand hygiene, PPE use, and infection risk management. Seventy-five professionals—including nurses, doctors, and allied health staff—participated. The activity promoted critical thinking, communication, and decision-making under time pressure. Each session concluded with a structured debrief to reinforce learning. Feedback from post-event questionnaires highlighted high engagement and appreciation for the hands-on, team-based format. Participants reported improved understanding of IPC principles, greater awareness of teamwork’s role in preventing transmission, and described the experience as fun, memorable, and practical. This project demonstrates the effectiveness of experiential, game-based learning in IPC education. Unlike traditional methods, the escape room fostered active application of IPC behaviours in a realistic setting, enhancing knowledge retention and promoting behavioural change. It underscores the value of innovative approaches in strengthening infection control culture across healthcare settings.
Takeaway Message: “Engagement leads to understanding — and understanding leads to safer practice.”
Author: Hayley, Head of Infection Prevention and Control Velindre University NHS Trust, Cardiff.
3. Reduction of hospital acquired pneumonia and Clostridioides difficile infections with focused mouth care.
A Quality Improvement Project was initiated to reduce avoidable Clostridioides difficile infections by improving mouthcare to prevent pneumonia in non-ventilated patients. A neurological medical ward was identified as an outlier for such infections, with antimicrobial treatment for hospital-acquired pneumonia felt to be a contributing factor. The project was led by myself with support from the Ward Manager, clinical educator and Matron, involving staff and patient surveys plus audits of mouthcare documentation. Initial training was delivered to ward staff, with resources provided to support ongoing education and embed mouthcare into routine practice.
Results: Significant improvements were observed, including a 46% increase in staff confidence in mouth assessment and referral, and a 56% increase in confidence in providing mouthcare to patients with challenging behaviour. Notably, the ward sustained zero attributed C. difficile infections for ten months following the intervention.
Conclusion: Improved mouthcare led to a reduction in Clostridioides difficile cases. Success was driven by; strong leadership, motivated staff acting as mouthcare champions, staff understanding the importance of completing mouthcare assessment as a patient safety initiative, delivery of an episode of mouth care within 24hrs from admission, and high-quality training delivered by ward-based educators.
Author: Catherine Lemsalu, Infection Prevention & Management Team (University Hospital Plymouth NHS Trust)
4. Clean Smart: QI in action for cleaning efficiency.
Effective decontamination of patient care equipment is vital in preventing healthcare-associated infections (HCAIs). At Doncaster Royal Infirmary, existing practices using Peracetic acid revealed inefficiencies and non-compliance. This quality improvement (QI) study evaluated the impact of introducing ready-to-use disinfectant wipes in dispensers across three clinical areas: a medical ward, surgical ward, and Emergency Department.
Pre- and post-intervention questionnaires assessed staff confidence, product accessibility, and time efficiency. Process mapping compared the original multi-step Peracide protocol with the simplified wipe-based method. Staff training and dispenser installation supported the change.
Post-intervention results showed improved staff confidence in knowing when and how to decontaminate equipment, rising from 63% to 73%. Time efficiency also improved, with 73% completing decontamination in under two minutes using wipes, compared to 26% previously. Training uptake increased from 15% to 73%.
Staff feedback highlighted greater satisfaction, ease of use, and perceived cleanliness. The intervention streamlined workflows, reduced decontamination time, and improved compliance, ultimately freeing nursing time and enhancing infection prevention. This study supports the use of point-of-use disinfectant wipes as an effective and practical QI strategy in clinical settings.
Author: Miriam Boyack (Nurse Consultant – DDIPC) Doncaster & Bassetlaw Teaching Hospitals NHS Foundation Trust
5. QI Programme: To create a sustainable Infection Prevention and Control information/education animation video portfolio for current and future care provision.
The intention to develop a standardised, accessible, and sustainable online portfolio of Infection Prevention and Control (IPC) animation videos. System learning identified the need for shared learning approach to provide information and education to support provider organisations. The resource will provide 24/7 education for health and social care staff, supporting outbreak response, winter pressures, and wider system objectives to reduce infection impact. Quality and Governance processes were put in place.
The Bridgewater – 3 Boroughs Infection Control team successfully led the Quality Improvement programme in collaboration with the communication and education teams to promote digital accessibility to basic IPC resource 24 hrs a day. The first video was launched in May 2025. The team were honoured to receive a highly commended award at the 2025 IPS conference. The sustainable, transferrable resource video portfolio will provide a wide platform through which IPC can continue to empower individuals across all communities, populations, local, regional and national areas.
Enabling providers and individuals to act quickly with IPC measures whilst supporting high quality, safe, effective IPC care across health and social care sectors.
Next steps: To complete the 12-video portfolio whilst ensuring review of feedback and footage across the wider digital footprint against improved IPC measures and strategies.
Author: Dorothy Finnerty (IPC Specialist Nurse), Bridgewater Community Healthcare NHS Foundation Trust
