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Reducing surgical site infections by bundling multiple risk reduction strategies and active surveillance

Virginia Leigh Lipke1, Anthony S Hyott

  • 1Division of Global HIV/AIDS, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.

AORN Journal
|September 7, 2010
PubMed

Insights

A quality improvement intervention significantly reduced surgical site infections (SSIs) by implementing Methicillin-resistant Staphylococcus aureus (MRSA) screening and nasal decolonization with mupirocin. This initiative also involved a new preoperative skin antisepsis protocol, leading to substantial cost savings.

Area of Science:

  • Healthcare epidemiology
  • Infectious disease control
  • Surgical quality improvement

Background:

  • Postoperative surgical site infections (SSIs) represent a significant burden in healthcare, associated with increased mortality.
  • Methicillin-resistant Staphylococcus aureus (MRSA) is a growing concern as a causative agent of SSIs.

Purpose of the Study:

  • To evaluate the effectiveness of a quality improvement intervention aimed at reducing SSIs.
  • To decrease the incidence of MRSA-related SSIs through targeted screening and treatment.

Main Methods:

  • Implementation of a protocol for identifying nasal MRSA colonization in surgical patients.
  • Treatment of colonized patients with mupirocin and introduction of 2% chlorhexidine gluconate preoperative skin antisepsis.
  • Integration of screening and antisepsis protocols into routine hospital workflow.

Main Results:

  • A 63% reduction in the total number of SSIs was observed.
  • A significant 78% decrease in MRSA-specific SSIs was achieved.
  • The intervention was successfully integrated and well-received by patients.

Conclusions:

  • Preoperative MRSA screening, mupirocin treatment, and chlorhexidine antisepsis are effective in reducing SSIs.
  • This multifaceted approach offers a cost-effective strategy for infection control.
  • The intervention demonstrates a successful model for improving surgical patient safety and reducing healthcare costs.

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