REDUCTION AND SUSTAINABILITY OF CESAREAN SECTION SURGICAL SITE INFECTION: AN EVIDENCE-BASED, INNOVATIVE, AND MULTIDISCIPLINARY QUALITY IMPROVEMENT INVENTION BUNDLE PROGRAM

Global Wound Care Congress

September 12-13, 2016 San Antonio, USA

Chaur-Dong Hsu, Inna Cohn and Rebecca Caban

Nassau University Medical Center, USA
Wayne State University School of Medicine, USA

Posters & Accepted Abstracts: J Nurs Care

Abstract :

Background: We found Cesarean section (C-section) surgical site infection (SSI) at our institution was significantly higher than the national benchmark. Methods: A retrospective cohort study was conducted under four phases from 1/2008 to 12/2014. The hospital infection control (IC) policies and a pre-surgical checklist were bundled and implemented. The study was conducted with 3,334 Cesarean deliveries: Phase A (1/1/2008-1/31/2010):1250 patients without intervention (baseline SSI rate), Phase B (2/1/2010-7/31/2011): 682 patients were intervened with IC policies, Phase C (8/1/2011-12/31/2012):591 patients with a SSI reduction bundle and Phase D (1/1/2013- 12/31/2014):811 patients were monitored C-section SSI sustainability. Patients not following strict protocols due to emergency Cesarean deliveries were excluded. Chi square, Fisher�s Exact test and standard Z test were used for statistical analyses. Results: C-section SSI rates were 6.2% (77/1250; Phase A), 3.7% (25/682; Phase B), 1.7% (10/591; Phase C), and 0.1% (1/811; Phase D) respectively. By implementing the IC policies and bundle, C-section SSI rate was reduced 40.3% (Phase B vs. Phase A), 72.6% (Phase C vs. Phase A), and 98.4% (Phase D vs. Phase A). All statistics were significantly different. Conclusions: We conclude that implementing a C-section SSI reduction bundle was associated with reduced C-section SSI rate down towards zero. A future prospectively randomized clinical trial is warranted.

Biography :

Email: chsu@med.wayne.edu