Investigating Lowered Surgical Site Infections
There was some buzz last week on medical news sites like MedPage Today, Fierce Healthcare and Science Codex, about a paper from Johns Hopkins describing how the institution reduced its surgical site infection (SSI) rate for colorectal surgery. A multidisciplinary project called the Comprehensive Unit-Based Safety Program (CUSP), involving 36 people including a “team coach” and a hospital executive, began when the SSI rate was 27.3 percent. After meetings and suggestions for change, they came up with six interventions that they felt would make a difference. They were:
Standardization of skin preparation with chlorhexidine
Administration of preoperative chlorhexidine showers
Selective elimination of mechanical bowel preparation
Warming of patients in the preanesthesia area
Adoption of enhanced sterile techniques for skin and fascial closure
Addressing previously unrecognized lapses in antibiotic prophylaxis
In the year following the implementation of the changes, the SSI rate dropped to 18.2 percent.
Sounds great, doesn’t it? Let’s take a closer look at a few of the interventions.