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Implementing evidence-based practice findings to decrease postoperative sternal wound infections following open heart

Camille Haycock1, Craig Laser, Jennifer Keuth

  • 1Banner Good Samaritan Medical Center, Phoenix, Arizona 85006, USA. haycock@bannerhealth.com

The Journal of Cardiovascular Nursing
|September 6, 2005
PubMed
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Implementing evidence-based practice changes significantly reduced sternal wound infections after open heart surgery. Nurses led this initiative, improving patient outcomes through collaborative practice improvements.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Disease Prevention
  • Nursing Practice Improvement

Background:

  • Sternal wound infections (SWIs) post-open heart surgery are rare but serious complications.
  • These infections increase patient morbidity, hospital stay, and healthcare costs.
  • Current practices in preoperative and postoperative care require evaluation to reduce SWI incidence.

Purpose of the Study:

  • To decrease the incidence of sternal wound infections following open heart surgery.
  • To examine and modify current preoperative and postoperative patient management protocols.
  • To implement evidence-based practice changes through interdisciplinary collaboration.

Main Methods:

  • Literature review of interdisciplinary best practices.

Related Experiment Videos

  • Formation of process teams to evaluate patient cohorts with documented infections.
  • Focus on five key areas: preoperative skin preparation, antibiotic prophylaxis, blood glucose control, wound care management, and hand hygiene.
  • Retrospective chart review to identify infection-related data, including average postoperative glucose levels (201 mg/dL).
  • Application of a change model to guide project initiatives and ensure sustainability.
  • Peer education and outcome data collection involving staff nurses.

    • Main Results:

    • A retrospective review identified high average postoperative glucose levels in infected patients.
    • Implementation of evidence-based practice changes led to a documented linear decrease in sternal wound infections.
    • Variations in provider practices and causative organisms were noted, highlighting the need for standardized care.

    Conclusions:

    • Evidence-based practice changes, driven by nursing leadership and interdisciplinary collaboration, effectively reduce sternal wound infections.
    • Standardized protocols in preoperative and postoperative care are crucial for preventing SWIs.
    • Nurses are pivotal in initiating, managing, and evaluating clinical practice improvements for enhanced patient outcomes.