Bundled Prevention of Cesarean Surgical Site Infections: The Down and Dirty [20Q]

• DOI: 10.1097/01.aog.0000558940.10104.36
• Publication Date: 2019-05-06T19:42:58Z
• Authors: Stephen Elliott Gee; Robert Orellana; Brian Andrew Kellert; Julie Mangino; Carol Meyers; Kara M. Rood
• Keywords: Surgical Site Infection; Cefazolin

INTRODUCTION: Surgical site infections (SSI) following cesarean delivery (CD) are a major cause of morbidity and economic burden. Our tertiary-care hospital implemented multidisciplinary SSI surveillance system preventative bundles to reduce rate after CD. objective was measure the effect 3 on post-CD SSI. METHODS: A retrospective single-center cohort study all CD July 2012 December 2017 performed. Infections were identified via 30-day active using CDC definitions by one infection preventionist reviewed physician. Patient demographics procedural details stored for submission CDC. Unadjusted adjusted risk factors logistic regression. Bundle 1 (2014) included enhanced surgical instrument sterilization, bandage removal POD2, preoperative sage cloth, grams Cefazolin women >120 kg, recommended patient warming, staples POD7, provided silver dressings. 2 (2015) nurses prepping with prolonged prep time two chlorhexidine applicators. (2016) vaginal 500 mg Azithromycin in unscheduled labor encouraged post-placental glove change. RESULTS: Over 5.5 years, 2.2% (176/8150) developed 79% (138/176) superficial incisional primary The first bundle had no significant odds (odds ratio [OR] 0.48, confidence interval [95% CI] 0.15 - 1.61). We observed decreased odd both (OR 0.63, 95% CI 0.45 0.87) 0.61, 0.42 0.88). CONCLUSION: Evidence-based should be considered at institutions experiencing high rates.