Unit-Based Safety Program Cuts Surgical Site Infections

(HealthDay News) – Implementation of a comprehensive unit-based safety program (CUSP) can reduce surgical site infections (SSI) rates in a colorectal surgery setting.

Elizabeth C. Wick, MD, from Johns Hopkins University in Baltimore, and colleagues examined the correlation between implementation of a surgery-based CUSP and postoperative SSI rates. SSI rates were collected for one year pre- and post-CUSP intervention using the high-risk pilot module of the American College of Surgeons National Surgical Quality Improvement Program. A multidisciplinary team of front-line providers involved in care of colorectal surgery patients met on a monthly basis.

The researchers found that the mean SSI rate was 27.3% in the 12 months before implementation of the CUSP and interventions. Following implementation of interventions the rate dropped significantly, by 33.3%, to 18.2% for the subsequent 12 months. Interventions included standardization of skin preparation; preoperative chlorhexidine showers; selective elimination of mechanical bowel preparation; patient warming in the preanesthesia area; utilization of improved sterile techniques for skin and fascial closure; and management of previously unrecognized lapses in antibiotic prophylaxis. During the same time period there was no difference in surgical process measure compliance as measured by the Surgical Care Improvement Project.

“Successful SSI reduction efforts require the following facets: accurate outcomes measurement, support of hospital leadership, and engaged front-line personnel in the context of a strong safety culture,” the authors conclude. “The use of CUSP incorporates these key aspects and draws on both local wisdom and evidence-based medicine.”

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