Quality Improvement Project in Congenital Cardiothoracic Surgery Patients: Reducing Surgical Site Infections

Ashley B Hodge, Brandis A Thornton, Robert Gajarski, Diane Hersey, Melissa Cannon, Aymen N Naguib, Brian F Joy, Patrick I McConnell

Research output: Contribution to journalArticle

Abstract

Background: Healthcare-associated infections are a major focus for quality improvement in hospitals today. Surgical site infections (SSIs), a postoperative complication in cardiac surgery, are associated with increased morbidity, mortality, hospital length of stay, and financial burden.

Methods: A recent increase in cardiothoracic surgery SSIs (CT-SSIs) at our institution instigated a multidisciplinary team to explore infection prevention, bundle element compliance, and to identify interventions to reduce the CT-SSI rate. Key interventions included preoperative screening and decolonization of methicillin-sensitive Staphylococcus aureus and methicillin-resistant S. aureus with repeated intranasal applications of mupirocin, universal skin prep with chlorhexidine for all patients, and additional antibiotic dosing upon initiating cardiopulmonary bypass.

Results: In 2014, the CT-SSI rate at our institution was 1.9/100 cases, which increased during the "intervention period" to 3.6 infections/100 cases in 2015 (16 total infections). Postinterventions, the CT-SSI rate decreased to 0.3 infections/100 cases (2 total infections), which was significantly lower than our baseline before the spike in infection rate.

Conclusions: A comprehensive interdisciplinary approach with multiple interventions was successful in significantly reducing the CT-SSI rate in cardiothoracic surgery at a tertiary care pediatric hospital.

Original languageEnglish (US)
Pages (from-to)e188
JournalPediatric quality & safety
Volume4
Issue number4
DOIs
StatePublished - Oct 2 2019

Bibliographical note

Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.

PubMed: MeSH publication types

  • Journal Article

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    Hodge, A. B., Thornton, B. A., Gajarski, R., Hersey, D., Cannon, M., Naguib, A. N., Joy, B. F., & McConnell, P. I. (2019). Quality Improvement Project in Congenital Cardiothoracic Surgery Patients: Reducing Surgical Site Infections. Pediatric quality & safety, 4(4), e188. https://doi.org/10.1097/pq9.0000000000000188