Streltsova-Verma, Svetlana. Identifying risks and prevention strategies for surgical site infections in neonates undergoing cardiac surgery. Retrieved from https://doi.org/doi:10.7282/t3-15ng-aa88
DescriptionPurpose: Surgical site infections (SSIs) contribute to significant morbidity and mortality for neonates undergoing cardiac surgery which prolong length of stay and overall hospital expense. The neonatal patient population is inherently at greater risk for infection. The project developed a bundle and a corresponding surveillance process in the preoperative and postoperative setting for SSI reduction and prevention.
Methodology: This SSI prevention Quality Improvement (QI) pilot project utilized a systematic investigational approach to identify patients with modifiable and non-modifiable risk factors for SSIs and assessed compliance with current standard of care for SSI prevention strategies. It consisted of six weeks of pre-intervention observation, two weeks of data presentation, practice review and evidence-based practice education, followed by six weeks of post-intervention observation.
Results: The Cardiac Neonatal Intensive Care Unit saw the incidence of SSI decrease from two SSIs in the pre-intervention phase to no SSIs in the post-intervention phase. There too was a decrease in non-infectious wound dehiscence from four in the pre to one in the post-intervention phase. Regardless of whether the neonates experienced an SSI or wound dehiscence, demographics such as gestational age, age at surgery, weight in grams, presence of invasive lines, total protein and albumin levels, pre-operative administration of TPN, intraoperative need for by-pass, and intraoperative hypothermia temperature were comparable.
Implication for Practice: SSIs are multifactorial and preventable. It is the responsibility of an interdisciplinary team to take stock in evidence-based practice in the care of surgical wounds and provide for optimal healing environments.