2.50
Hdl Handle:
http://hdl.handle.net/10755/157194
Category:
Abstract
Type:
Presentation
Title:
Drop a Bundle and Save: Reducing Surgical Site Infections Across Surgical Populations
Author(s):
Adams, Mischa; Hartwig, Jodi; Harrop, Lisa; Line, Scott; Farber, Michelle; Forseth, Katherine; Gilman, Patricia
Author Details:
Mischa Adams, RN,ADN,AS,CCRN, Mercy Hospital, Coon Rapids, Minnesota, USA, email: mischa.adams@allina.com; Jodi Hartwig; Lisa Harrop; Scott Line; Michelle Farber; Katherine Forseth; Patricia Gilman
Abstract:
PURPOSE: Surgical site infection (SSI) rates for cardiac surgeries exceeded national benchmarks at our 271-bed community hospital. A highly engaged multidisciplinary team developed and implemented an evidence-based perioperative surgical bundle (PSB) to support gaps in current practice. A significant decrease in SSI rates in cardiac surgeries were observed and sustained over time. All elements were then applied to the peripheral vascular surgery population (PVBY) with notable success. DESCRIPTION: The team-a cardiothoracic surgeon, cardiologist, anesthesiologist, infection control practitioner, pharmacist, clinical nurse specialist, and staff nurse from the clinical action team (CAT)-developed our PSB (2% chlorohexidine gluconate-impregnated [CHG] clothes, preoperative oral CHG rinse, nasal screening, treatment of Staphylococcus aureus carriers, and tight glycemic control). CAT members served as the frontline link to all roles in the communication and coaching of the interventions. CAT members, involved from the inception of the project, having evidence-based knowledge and leadership supported autonomy, felt empowered to coach and mentor their peers. Staff, with belief in purposeful work and supported by peer coaching, various educational modalities, and timely feedback of results, recognized their valuable role in the successful implementation and subsequent outcomes of the PSB. The PSB was integrated across the continuum of care and supported by automation into the electronic medical record through order-sets, smart links, and "best practice" alerts. Heart-link, an outpatient program for patient prescreening, education, and follow up was also key to our smooth implementation and success. EVALUATION/OUTCOMES:A pre-post study design was used to analyze the effectiveness of the PSB. After implementation of the perioperative surgical interventions, SSI rates decreased significantly in cardiac patients (P =.049; 4.3% in 2006 to 0.71% in 2009) and have been sustained over time. Although not statistically significant, PVBY rates demonstrated a linear downward trend between the second quarter of 2008 (26.7%) and 2009 (0%), and are below national benchmark. Although we recognize several confounding factors, evidence suggests that the PSB is effective in reducing risk of SSIs and may have beneficial effects if extended to other surgical subspecialties.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleDrop a Bundle and Save: Reducing Surgical Site Infections Across Surgical Populationsen_GB
dc.contributor.authorAdams, Mischaen_GB
dc.contributor.authorHartwig, Jodien_GB
dc.contributor.authorHarrop, Lisaen_GB
dc.contributor.authorLine, Scotten_GB
dc.contributor.authorFarber, Michelleen_GB
dc.contributor.authorForseth, Katherineen_GB
dc.contributor.authorGilman, Patriciaen_GB
dc.author.detailsMischa Adams, RN,ADN,AS,CCRN, Mercy Hospital, Coon Rapids, Minnesota, USA, email: mischa.adams@allina.com; Jodi Hartwig; Lisa Harrop; Scott Line; Michelle Farber; Katherine Forseth; Patricia Gilmanen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157194-
dc.description.abstractPURPOSE: Surgical site infection (SSI) rates for cardiac surgeries exceeded national benchmarks at our 271-bed community hospital. A highly engaged multidisciplinary team developed and implemented an evidence-based perioperative surgical bundle (PSB) to support gaps in current practice. A significant decrease in SSI rates in cardiac surgeries were observed and sustained over time. All elements were then applied to the peripheral vascular surgery population (PVBY) with notable success. DESCRIPTION: The team-a cardiothoracic surgeon, cardiologist, anesthesiologist, infection control practitioner, pharmacist, clinical nurse specialist, and staff nurse from the clinical action team (CAT)-developed our PSB (2% chlorohexidine gluconate-impregnated [CHG] clothes, preoperative oral CHG rinse, nasal screening, treatment of Staphylococcus aureus carriers, and tight glycemic control). CAT members served as the frontline link to all roles in the communication and coaching of the interventions. CAT members, involved from the inception of the project, having evidence-based knowledge and leadership supported autonomy, felt empowered to coach and mentor their peers. Staff, with belief in purposeful work and supported by peer coaching, various educational modalities, and timely feedback of results, recognized their valuable role in the successful implementation and subsequent outcomes of the PSB. The PSB was integrated across the continuum of care and supported by automation into the electronic medical record through order-sets, smart links, and "best practice" alerts. Heart-link, an outpatient program for patient prescreening, education, and follow up was also key to our smooth implementation and success. EVALUATION/OUTCOMES:A pre-post study design was used to analyze the effectiveness of the PSB. After implementation of the perioperative surgical interventions, SSI rates decreased significantly in cardiac patients (P =.049; 4.3% in 2006 to 0.71% in 2009) and have been sustained over time. Although not statistically significant, PVBY rates demonstrated a linear downward trend between the second quarter of 2008 (26.7%) and 2009 (0%), and are below national benchmark. Although we recognize several confounding factors, evidence suggests that the PSB is effective in reducing risk of SSIs and may have beneficial effects if extended to other surgical subspecialties.en_GB
dc.date.available2011-10-26T19:30:22Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:30:22Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.