Quality improvement initiative: Preventative Surgical Site Infection Protocol in Vascular Surgery

Autor: Michael Amaturo, Enrico Ascher, Anil Hingorani, Eric Johnson, Syed Ali Rizvi, David Parizh
Rok vydání: 2017
Předmět:
Lower extremity revascularization
Male
medicine.medical_specialty
Quality management
Time Factors
New York
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Risk Factors
Medicine
Humans
Surgical Wound Infection
Radiology
Nuclear Medicine and imaging
030212 general & internal medicine
Single institution
Aged
Quality Indicators
Health Care
Retrospective Studies
Protocol (science)
Aged
80 and over
Infection Control
business.industry
Wound Closure Techniques
Background data
General Medicine
Vascular surgery
Antibiotic Prophylaxis
Middle Aged
Quality Improvement
Surgery
Treatment Outcome
Surgical Care Improvement Project
Lower Extremity
Female
Cardiology and Cardiovascular Medicine
business
Surgical site infection
Vascular Surgical Procedures
Program Evaluation
Zdroj: Vascular. 26(1)
ISSN: 1708-539X
Popis: Objective A quality improvement initiative was employed to decrease single institution surgical site infection rate in open lower extremity revascularization procedures. Summary background data: In an attempt to lower patient morbidity, we developed and implemented the Preventative Surgical Site Infection Protocol in Vascular Surgery. Surgical site infections lead to prolonged hospital stays, adjunctive procedure, and additive costs. We employed targeted interventions to address the common risk factors that predispose patients to post-operative complications. Methods Retrospective review was performed between 2012 and 2016 for all surgical site infections after revascularization procedures of the lower extremity. A quality improvement protocol was initiated in January 2015. Primary outcome was the assessment of surgical site infection rate reduction in the pre-protocol vs. post-protocol era. Secondary outcomes evaluated patient demographics, closure method, perioperative antibiotic coverage, and management outcomes. Results Implementation of the protocol decreased the surgical site infection rate from 6.4% to 1.6% p = 0.0137). Patient demographics and comorbidities were assessed and failed to demonstrate a statistically significant difference among the infection and no-infection groups. Wound closure with monocryl suture vs. staple proved to be associated with decreased surgical site infection rate ( p Conclusions Preventative measures, in the form of a standardized protocol, to decrease surgical site infections in the vascular surgery population are effective and necessary. Our data suggest that there may be benefit in the incorporation of MRSA and Gram-negative coverage as part of the Surgical Care Improvement Project perioperative guidelines.
Databáze: OpenAIRE
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