Wound Classification Score Discordance in Pediatric Operations - A Quality Improvement Study.

Area of Science:

• Surgical Quality Improvement
• Patient Safety
• Healthcare Informatics

Background:

• Inaccurate wound classification recording in electronic health records (EHRs) poses a risk for postoperative infections.
• A quality improvement initiative was implemented to address this charting inaccuracy at an academic institution.

Purpose of the Study:

• To evaluate the effectiveness of a quality improvement program in enhancing the accuracy of wound classification charting.
• To compare the impact of nursing-focused interventions versus physician-focused changes on charting accuracy.

Main Methods:

• A retrospective chart review compared pre- and post-intervention wound classification accuracy in pediatric operations.
• Data from an academic institution were compared with a nearby community hospital where the same surgeons practice.
• Pearson's Chi-squared test and Clopper-Pearson confidence intervals were used for statistical analysis.

Main Results:

• No significant improvement in charting accuracy was observed at the academic institution post-intervention.
• A significant improvement in appendectomy charting accuracy was noted at the community institution (3.33% to 44.83%).

Conclusions:

• The implemented quality improvement program did not significantly enhance wound classification accuracy at the academic institution.
• The observed improvement at the community hospital suggests potential deficiencies in nursing-focused interventions.
• Future efforts will concentrate on intensive and sustained operating room nurse training to improve accuracy.