A Collaborative Quality Improvement Project to Reduce Surgical Site Infection in Cesarean Delivery

Introduction: Cesarean delivery (CD) facilitates delivery of the baby through an incision and is performed in situations where vaginal delivery poses risks to the mother, baby, or both. Over 1.2 million CDs are performed in the United States annually. Methods: An interdisciplinary council was create...

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Main Authors: Jeanette Harris, Mandy Spitzer
Format: Article
Language:English
Published: Mary Ann Liebert 2024-04-01
Series:Women's Health Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/whr.2024.0009
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author Jeanette Harris
Mandy Spitzer
author_facet Jeanette Harris
Mandy Spitzer
author_sort Jeanette Harris
collection DOAJ
description Introduction: Cesarean delivery (CD) facilitates delivery of the baby through an incision and is performed in situations where vaginal delivery poses risks to the mother, baby, or both. Over 1.2 million CDs are performed in the United States annually. Methods: An interdisciplinary council was created to drive regular data analysis and sharing, interdisciplinary collaboration, and standardized processes to reduce surgical site infections (SSI) following CD. The standardized infection ratio (SIR), a summary measure used to track hospital-acquired infections at a national, state, or local level over time, was used. Bundle components included pre- and postsurgical education and access to follow-up, peri- and intraoperative practice changes, and a risk stratification tool for postoperative dressing selection. Results: The bundle was initiated in April 2022. After use was established for 6 months, the SIR was evaluated in the fourth quarter of 2022. For this one quarter, the expected SIR for the hospital was 2.64, and the calculated SIR measured 0.38. In 2022, which included 3 months prebundle and 9 months postbundle, the expected SIR was 10.57, with a calculated SIR of just 0.66 for the full year. In 2023, the expected SIR was 11.10, with a calculated SIR of 0.27. The SSI rate reflects an observed 75% reduction in SSI between the years 2021 and 2023. Zero SSI have been observed from January to May 2024. For the patients who underwent planned CD, 98% received the full perioperative obstetric bundle. Discussion: The ongoing analysis and sharing of data, the implementation of standardized processes, and interdisciplinary collaboration were imperative to the success of this hospital’s quality improvement project to reduce SSI for patients undergoing CD.
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spelling doaj-art-7d17ef61d8584a8f941aba6ecd4929ca2025-08-20T01:50:53ZengMary Ann LiebertWomen's Health Reports2688-48442024-04-015163264010.1089/whr.2024.0009A Collaborative Quality Improvement Project to Reduce Surgical Site Infection in Cesarean DeliveryJeanette Harris0Mandy Spitzer1Department of Infection Prevention, EvergreenHealth, Kirkland, Washington, USA.Global Clinical and Medical Affairs, Smith and Nephew, Fort Worth, Texas, USA.Introduction: Cesarean delivery (CD) facilitates delivery of the baby through an incision and is performed in situations where vaginal delivery poses risks to the mother, baby, or both. Over 1.2 million CDs are performed in the United States annually. Methods: An interdisciplinary council was created to drive regular data analysis and sharing, interdisciplinary collaboration, and standardized processes to reduce surgical site infections (SSI) following CD. The standardized infection ratio (SIR), a summary measure used to track hospital-acquired infections at a national, state, or local level over time, was used. Bundle components included pre- and postsurgical education and access to follow-up, peri- and intraoperative practice changes, and a risk stratification tool for postoperative dressing selection. Results: The bundle was initiated in April 2022. After use was established for 6 months, the SIR was evaluated in the fourth quarter of 2022. For this one quarter, the expected SIR for the hospital was 2.64, and the calculated SIR measured 0.38. In 2022, which included 3 months prebundle and 9 months postbundle, the expected SIR was 10.57, with a calculated SIR of just 0.66 for the full year. In 2023, the expected SIR was 11.10, with a calculated SIR of 0.27. The SSI rate reflects an observed 75% reduction in SSI between the years 2021 and 2023. Zero SSI have been observed from January to May 2024. For the patients who underwent planned CD, 98% received the full perioperative obstetric bundle. Discussion: The ongoing analysis and sharing of data, the implementation of standardized processes, and interdisciplinary collaboration were imperative to the success of this hospital’s quality improvement project to reduce SSI for patients undergoing CD.https://www.liebertpub.com/doi/10.1089/whr.2024.0009cesarean deliveryincisionNPWTquality improvement projectsingle-use negative pressure wound therapysurgical site infection
spellingShingle Jeanette Harris
Mandy Spitzer
A Collaborative Quality Improvement Project to Reduce Surgical Site Infection in Cesarean Delivery
Women's Health Reports
cesarean delivery
incision
NPWT
quality improvement project
single-use negative pressure wound therapy
surgical site infection
title A Collaborative Quality Improvement Project to Reduce Surgical Site Infection in Cesarean Delivery
title_full A Collaborative Quality Improvement Project to Reduce Surgical Site Infection in Cesarean Delivery
title_fullStr A Collaborative Quality Improvement Project to Reduce Surgical Site Infection in Cesarean Delivery
title_full_unstemmed A Collaborative Quality Improvement Project to Reduce Surgical Site Infection in Cesarean Delivery
title_short A Collaborative Quality Improvement Project to Reduce Surgical Site Infection in Cesarean Delivery
title_sort collaborative quality improvement project to reduce surgical site infection in cesarean delivery
topic cesarean delivery
incision
NPWT
quality improvement project
single-use negative pressure wound therapy
surgical site infection
url https://www.liebertpub.com/doi/10.1089/whr.2024.0009
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