Quality Standard Details
Surgical Site Infections: Care in All Settings
- Publication Date
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2023-March-01
- Status
- Published
- Topic Area
- Surgical
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Surgical site infections are the most common type of health care–associated infection among surgical patients, and they are the third leading cause of hospital-acquired infections in Canada, accounting for 77% of infection-related patient deaths. In Canada, health care–associated infections (including surgical site infections) result in 3.7 million excess hospital days, and surgical site infections on their own cost the health care system $350,000 to $1 million each year. Data from the Ontario Surgical Quality Improvement Network suggest that the rate of surgical site infections for all procedures was decreasing from 2019 to 2021, but increased to 3.48% in 2022.
Populations at a greater risk of complications from surgery (such as surgical site infections) include those with chronic, complex, or comorbid medical conditions; children; the frail and the elderly; those experiencing poor housing conditions or homelessness; and those who are discharged to correctional facilities. There are many opportunities to improve the quality of surgical wound care in Ontario, enabling the optimal prevention and treatment of surgical site infections in all care settings.
This quality standard addresses care for people of all ages who have a surgical procedure that requires an incision (a cut through the skin). The standard identifies what can be done to prevent a surgical site infection when a surgery is planned; however, many of the statements also apply to unplanned or emergency surgeries when decisions are made quickly. The standard outlines the best methods for communication among patients, family members, caregivers, and the health care team; it does not address specific treatment modalities. It applies to care for people in all settings where surgical care is provided and surgical wounds are managed, including acute care, primary care, emergency departments, hospital outpatient care, home and community care, rehabilitation, and long-term care.
Quality Standard in Brief
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Quality Statement 1: Risk Assessment
People having surgery receive a routine preoperative health assessment that includes general health evaluations and an assessment of their risk for developing a surgical site infection. These assessments are documented using a standardized approach.
Quality Statement 2: Preoperative Patient Care
People having surgery are advised to have (or are helped to have) a shower, bath, or bed bath on the day before or the day of surgery. If hair removal is required, it is performed immediately before surgery. Nasal decolonization may be performed if indicated.
Quality Statement 3: Antibiotic Prophylaxis
If antibiotic prophylaxis is indicated prior to surgery, people receive appropriate medication based on the type of surgery – at the appropriate time, dose, and postoperative duration. This includes repeat intraoperative doses when indicated.
Quality Statement 4: Perioperative Monitoring
People having surgery have their body temperature and oxygen levels optimized during the perioperative period.
Quality Statement 5: Operating Room Procedures
People having surgery receive care from an operating room team that minimizes the transfer of microorganisms during the procedure. Specific safety measures are required for operating room personnel, equipment, and patients, as well as for the management of traffic in and out of the operating room.
Quality Statement 6: Patient, Family, and Caregiver Education
People having surgery, as well as their family members and caregivers, receive information, education, and support for all stages of their care. This includes the results of the risk assessment, how to prevent and recognize an infection, and who to contact if they have concerns about wound healing.
Quality Statement 7: Coordination of Postoperative Care
People who have had surgery are given an appropriate referral for follow-up care and treatment, if required. All members of the care team use regular written, verbal, or electronic communications to share information about the patient’s status and treatment regimen.
Supporting Documents
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Patient guide for this quality standard
Know what to ask for in your care
Placemat for this quality standard
A quick-reference resource for clinicians that summarizes the quality standard and includes links to helpful resources and tools
Quality improvement tools and resources for health care professionals, including an action plan template
Supplementary information to support the data collection and measurement process
Additional Resources
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- Case for improvement (slide deck)
Share why this standard was created and the data behind it, to get the support you need to put it into practice - Technical specifications
See the technical specifications for the indicators within the quality standard - Summary of the public feedback we received
- Case for improvement (slide deck)
Last Updated: February 24, 2026
