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The Role of Patient Engagement in Surgical Site Infection Reduction: A Process Improvement Project
Jill Cox1, Lisa Douglas, Valerie Wemmer
1Jill Cox, PhD, RN, APN-C, CWOCN, FAAN, is Wound/Ostomy/Continence Advanced Practice Nurse, Englewood Health, Englewood, NJ, USA, and Clinical Professor, Rutgers University School of Nursing, New Jersey. Also at Englewood Health, Lisa Douglas, MSN, RN-BC, is Nurse Manager, Surgical Unit; Valerie Wemmer, BSN, RN, is Staff Nurse, Surgical Unit; and Kathleen Kaminsky, MS, RN, NE-BC, is Senior Vice President for Patient Care Services/Chief Nursing Officer. The authors have disclosed no financial relationships related to this article. Submitted November 15, 2022; accepted in revised form December 15, 2022.
Background:
Surgical site infections (SSIs) are the second most common healthcare-associated infection, with prevention being a high-priority goal for all healthcare organizations. Although routine surveillance and standardized prevention protocols have long been used, patient engagement is an additional intervention that should be considered and may be beneficial in SSI prevention.
Objective:
To determine if the development of a standardized patient education discharge plan for management of a surgical site and/or surgical drain would contribute to a reduction in SSI rates in inpatients undergoing colorectal, plastic, or general surgery.
Methods:
A preintervention/postintervention design was used. Before intervention, patients and surgeons were surveyed regarding various discharge practices related to surgical incision/drain care. The intervention consisted of implementing a standardized discharge plan including standardized education and patient discharge kits. After implementation, patients were surveyed regarding discharge practices. Patient survey responses and SSI rates were compared between the preintervention and postintervention time frames.
Results:
Rates of SSIs decreased across all three surgical specialties during the project period: colorectal SSIs decreased from 3.2% to 2.7%, plastics from 1.2% to 0.5%, and general from 0.86% to 0.33%. Improvements were also realized in patient survey responses to various aspects of surgical incision/drain care.
Conclusions:
Patient engagement may be an important strategy to integrate with SSI evidence-based care bundles. Active engagement of surgical patients perioperatively has the potential to improve the patient experience, which ultimately can result in improved healthcare outcomes for this population.
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