NDLI: Reduction and sustainability of cesarean section surgical site infection: An evidence-based, innovative, and multidisciplinary quality improvement intervention bundle program.

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Reduction and sustainability of cesarean section surgical site infection: An evidence-based, innovative, and multidisciplinary quality improvement intervention bundle program.

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Reduction and sustainability of cesarean section surgical site infection: An evidence-based, innovative, and multidisciplinary quality improvement intervention bundle program.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Hsu, Chaur-Dong Cohn, Inna Caban, Rebeca
Description	Author Affiliation: Hsu CD ( Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY); Cohn I ( Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY.); Caban R ( Department of Obstetrics and Gynecology, Nassau University Medical Center, East Meadow, NY.)
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 4 phases from January 2008-December 2014. The hospital infection control (IC) policies and a presurgical checklist were bundled and implemented. The study was conducted with 3,334 cesarean deliveries: phase A (January 1, 2008-January 31,2010): 1,250 patients without intervention (baseline SSI rate), phase B (February 1, 2010-July 31, 2011): 682 patients were intervened with IC policies, phase C (August 1, 2011-December 31, 2012): 591 patients with an SSI reduction bundle, and phase D (January 1, 2013-December 31, 2014): 811 patients were monitored for C-section SSI sustainability. Patients not following strict protocols because of emergency C-section deliveries were excluded. The χ test, Fisher exact test, and standard Z test were used for statistical analyses. RESULTS: C-section SSI rates were 6.2% (77/1,250) in phase A, 3.7% (25/682) in phase B, 1.7% (10/591) in phase C, and 0.1% (1/811) in phase D, respectively. By implementing the IC policies and bundle, the 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 toward zero. A future prospectively randomized controlled trial is warranted.
File Format	HTM / HTML
ISSN	01966553
Issue Number	11
Journal	American Journal of Infection Control
Volume Number	44
e-ISSN	15273296
Language	English
Publisher	Elsevier
Publisher Date	2016-11-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Communicable Diseases
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Public Health, Environmental and Occupational Health Epidemiology Health Policy

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