Using a Data-Driven Improvement Methodology to Decrease Surgical Site Infections in a Community Neurosurgery...

Area of Science:

• Neurosurgery
• Infectious Disease Control
• Quality Improvement

Background:

• Surgical site infections (SSIs) pose a significant risk to neurosurgical patients.
• Existing protocols for preoperative antibiotic use and infection prevention had limitations.

Purpose of the Study:

• To implement and evaluate a data-driven methodology to decrease the departmental surgical site infection rate in neurosurgery.
• To achieve a target SSI rate of 1%.

Main Methods:

• A prospective interventional study with historical controls was conducted.
• Interventions included optimized preoperative chlorhexidine showers, methicillin-sensitive Staphylococcus aureus (MSSA)/methicillin-resistant Staphylococcus aureus (MRSA) screening and decolonization, and an optimized preoperative antibiotic order set.
• The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) was used for surveillance.

Main Results:

• Analysis of 317 NSQIP neurosurgical cases (163 pre-implementation, 154 post-implementation) showed no significant demographic differences, except for inpatient and functional status.
• The SSI rate decreased from 6.7% to 0.96% post-implementation.
• The implementation cost was $27,179, averaging $58 per patient.

Conclusions:

• Systematic investigation of clinical practice gaps is crucial for enhancing patient safety in neurosurgery.
• Quality improvement projects can effectively increase patient safety and the value of care.
• The implemented protocol demonstrated significant success in reducing SSIs.