Quality Improvement Project in Congenital Cardiothoracic Surgery Patients: Reducing Surgical Site Infections

Area of Science:

• Infection control
• Public health
• Pediatric surgery

Background:

• Healthcare-associated infections (HAIs) are a significant concern in hospitals.
• Surgical site infections (SSIs) in cardiac surgery increase patient morbidity, mortality, and healthcare costs.
• An increase in cardiothoracic surgery site infections (CT-SSIs) prompted an investigation.

Purpose of the Study:

• To explore infection prevention strategies.
• To assess bundle element compliance.
• To identify interventions for reducing the CT-SSI rate.

Main Methods:

• Preoperative screening and decolonization for Staphylococcus aureus (including MRSA) using mupirocin.
• Universal skin preparation with chlorhexidine for all patients.
• Additional antibiotic dosing during cardiopulmonary bypass.

Main Results:

• The CT-SSI rate increased from 1.9 to 3.6 infections per 100 cases between 2014 and 2015.
• Following interventions, the CT-SSI rate decreased to 0.3 infections per 100 cases.
• This reduction was statistically significant compared to the baseline rate.

Conclusions:

• A comprehensive, interdisciplinary approach involving multiple interventions effectively reduced CT-SSIs.
• The strategy proved successful in a tertiary care pediatric hospital setting.
• This highlights the importance of collaborative efforts in combating surgical infections.