Adherence to a standardized infection reduction bundle decreases surgical site infections after colon surgery: a retrospective cohort study on 526 patients

Abstract

Background Colon surgical site infections (SSI) are detrimental to patient safety and wellbeing. To achieve clinical excellence, our hospital set to improve patient safety for those undergoing colon surgery. Our goal was to implement a perioperative SSI prevention bundle for all colon surgeries to reduce colon surgery SSI rates. Methods This retrospective cohort study evaluated the impact of implementing a perioperative SSI prevention bundle in patients undergoing colon surgery at Banner University Medical Center - Tucson. We compared SSI rates between the Pre- (1/1/2016 to 12/31/2016) and post-bundle (1/1/2017 to 12/31/2017) cohorts using a chi-square test. Results In total, we included 526 consecutive patients undergoing colon surgery in our study cohort; 277 pre-bundle and 249 post-bundle implementation. The unadjusted SSI rates were 8.7 % and 1.2 %, pre- and post-bundle, respectively. Our CMS reportable standard infection rate decreased by 85.4 % from 3.08 to 0.45 after implementing our SSI prevention bundle. Conclusions Implementing a standardized colon SSI prevention bundle reduces the overall 30-day colon SSI rates and national standardized infection rates. We recommend implementing colon SSI reduction bundles to optimize patient safety and minimize colon surgical site infections.

Variation in practice for preoperative antibiotic prophylaxis: a survey from an academic tertiary referral center in the United States

“…Thus, an educational gap could be another contributing factor to our results. Lastly, there is also no antibiotic prophylaxis checklist at our institution to help standardize prophylaxis practices, which is often a key component of successful quality improvement initiatives [ 14 ].…”

Vermeidung postoperativer Wundinfektionen

“…Nach dieser liegt eine SSI vor, wenn folgende Merkmale zutreffen: ▪ Auftreten einer Infektion innerhalb von 30 Tagen nach der Operation (bis 1 Jahr bei Implantat) und ▪ Vorhandensein mindestens eines der 3 in ▶ Tab. 1…”

“…Surgical Site Infections (SSI) belasten den Patienten durch zusätzliche Schmerzen, können zu schwerwiegenden Komplikationen führen und den Operationserfolg infrage stellen. Im Ergebnis einer europäischen Prävalenzstudie stellen SSI mit 22,4 % die zweithäufigste nosokomiale Infektion in deutschen Akutkrankenhäusern dar[1]. Das Auftreten einer SSI erhöht das Risiko für eine Re-Operation, eine intensivmedizinische Behandlung und eine Wiederaufnahme.…”

Are cross-sectional safety climate survey results in operating room staff associated with the surgical site infection rates in Swiss hospitals?

“…For example, the adherence to a standardised bundle of prevention measures reduced SSI after colon surgery in a retrospective cohort study, thus improving patient safety. 2 In order for healthcare workers to perform safety-relevant behaviours, safety climate is thought to play an important role. Specifically, compliance with infection prevention measures is thought to be influenced by the prevailing safety climate, 3 4 however, only with mixed supporting evidence so far.…”

“…SSI rates may be reduced effectively by performing adequate infection prevention measures, such as the use of antibiotic prophylaxis or skin disinfection prior to incision. For example, the adherence to a standardised bundle of prevention measures reduced SSI after colon surgery in a retrospective cohort study, thus improving patient safety 2. In order for healthcare workers to perform safety-relevant behaviours, safety climate is thought to play an important role.…”