Implementation of colon surgical site infection prevention bundle-The successes and challenges.

Autor: Reese SM; Department of Quality, Swedish Medical Center, Englewood, CO. Electronic address: Sara.reese@healthonecares.com., Knepper B; Department of Quality Management, Denver Health Medical Center, Denver, CO., Amiot M; Department of Surgery, Denver Health Medical Center, Denver, CO., Beard J; Department of Surgery, Denver Health Medical Center, Denver, CO., Campion E; Department of Trauma, Denver Health Medical Center, Denver, CO., Young H; Department of Medicine, Denver Health Medical Center, Denver, CO; School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.
Jazyk: angličtina
Zdroj: American journal of infection control [Am J Infect Control] 2020 Nov; Vol. 48 (11), pp. 1287-1291. Date of Electronic Publication: 2020 May 19.
DOI: 10.1016/j.ajic.2020.05.010
Abstrakt: Background: Surgical site infection (SSI) prevention bundles have proven successful in decreasing infections. Surgeon and nurse engagement and endorsement are essential for success. The objective of this quality improvement project was to develop, implement and sustain a colon SSI prevention bundle and determine which bundle components are most strongly associated with prevention of SSI.
Methods: The bundle was developed and implemented in a 525 bed Level I trauma hospital and included pre-, intra- and postoperative components. Bundle adherence and SSI rate were continually tracked and communicated to surgeons and nursing staff throughout project. Univariate and multivariate analyses were performed to determine the components associated with lowest SSI rates.
Results: There were 280 elective and urgent/emergent colon surgeries between October 2015 and March 2018. Over 60% had preoperative components, 76.5% had intraoperative components and 55.6% had postoperative bundle components with a nonsignificant decreasing trend in SSI rate of -0.5 SSI/100 procedures per quarter. The multivariate analysis suggested that use of 2% chlorhexidine gluconate/70% alcohol skin prep, use of wound protector and change of gloves for fascial closure were associated with fewer SSI.
Discussion: The implementation of a colon SSI prevention bundle in a Level I trauma hospital with pre-, intra- and postoperative components was described. Future directions include focusing implementation efforts on bundle components that significantly prevent SSI to improve adherence.
(Copyright © 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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