Implementation of a Prevention Bundle to Decrease Rates of Staphylococcus aureus Surgical Site Infection at 11...

Area of Science:

• Infectious Disease
• Surgical Outcomes
• Quality Improvement

Background:

• Surgical site infections (SSIs) caused by Staphylococcus aureus remain a concern.
• Existing prevention bundles, including screening and decolonization, can reduce SSIs.
• Adaptation of interventions to facility-level factors is crucial for effectiveness.

Purpose of the Study:

• To evaluate the association between a flexible SSI prevention bundle and S. aureus deep incisional or organ space SSI rates.
• To assess the impact of facility discretion in implementing bundle components.

Main Methods:

• Quality improvement study across 11 Veterans Administration hospitals.
• Included patients undergoing coronary artery bypass grafting, cardiac valve replacement, or total joint arthroplasty (TJA).
• Utilized generalized estimating equation (GEE) and interrupted time-series (ITS) models for analysis.

Main Results:

• A total of 95 S. aureus deep incisional or organ space SSIs were identified.
• The GEE model indicated a significant association between the intervention and decreased SSI rates after TJAs (aOR, 0.55).
• No significant associations were found for cardiac operations, and ITS models did not confirm TJA findings.

Conclusions:

• The SSI prevention bundle may be associated with reduced S. aureus SSIs after TJAs.
• The study was underpowered to detect statistically significant long-term effects.
• Further research is needed to confirm the efficacy of adaptable SSI prevention strategies.