Evidence-Based Prevention of SSI Following Total Abdominal Hysterectomy Using a Multi-Factorial Intervention [13Q]

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Abstract

INTRODUCTION:

In the U.S., there are approximately 500,000 Surgical Site Infections (SSI) each year in patients following an in-patient surgery. Our institution set a goal of a 25% reduction in SSI following total abdominal hysterectomy (TAH). The objective of this study was to determine if implementation of a literature-based, multi-factorial intervention would reduce the rate of surgical site infections following TAH.

METHODS:

Surgical Site Infections (SSI) were measured using Standard Infection Ratios (SIR). A Quality Committee was formed and an extensive literature review of current, evidence-based methods for SSI prevention was conducted. Based on the literature review, key components were extracted from the medical records of the 16 patients with reported SSI following TAH in the pre-intervention period. An intervention that addressed preoperative, perioperative, postoperative and patient factors was implemented. The post-intervention SIR was compared to the pre-intervention period.

RESULTS:

In the pre-intervention period, January 2013 to June 2014, the overall SIR was 1.5. In the post-intervention period, SIR decreased to 0.44, 0.42, and 1.36 for the 3rd quarter 2014, 4th quarter 2014, and 1st quarter 2015, respectively. In the 2nd quarter of 2015, no SIR was given because the value was less than 1.0.

CONCLUSION:

Our evidence-based, multi-factorial intervention contributed to the significant reduction of SSI following TAH and our goal of 25% reduction in SIR of the post-intervention period was met. Our institution will continue to identify opportunities for improvement and monitor the implementation of evidence-based methods aiming to decrease SSI after TAH.

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