An audit of the implementation of guidelines to reduce wound infection following caesarean section

Area of Science:

• Obstetrics and Gynecology
• Infectious Disease Prevention
• Healthcare Quality Improvement

Background:

• National guidelines recommend antibiotic prophylaxis for Caesarean sections to minimize wound infection rates.
• Auditing infection rates and antibiotic administration is crucial for quality improvement.
• A local protocol was absent, necessitating an audit against a <5% wound infection rate benchmark.

Purpose of the Study:

• To audit wound infection rates following Caesarean sections.
• To assess the impact of implementing a local protocol for antibiotic prophylaxis.
• To evaluate compliance with antibiotic administration guidelines.

Main Methods:

• Retrospective case note review of all Caesarean sections over a six-month period.
• Introduction of specific guidelines to address identified deficiencies.
• Repeat audit one year after guideline implementation.

Main Results:

• Initial wound infection rate was 10% without a local protocol, primarily linked to inadequate antibiotic use.
• Post-protocol implementation, compliance with antibiotic administration reached over 97%.
• The wound infection rate decreased to approximately 3% after protocol introduction.

Conclusions:

• Audit is an effective tool for implementing evidence-based guidelines in clinical practice.
• A standardized protocol for antibiotic prophylaxis demonstrably reduces Caesarean section wound infection rates.
• Local audit findings support adherence to national guidelines for preventing surgical site infections.