Implementation of surgical site infection care bundle in patients undergoing gastrointestinal surgeries

Surgical site infection (SSI) is one of the frequent healthcare associated infections linked with significant morbidity, prolonged hospitalization, and death. SSI can be reduced by implementation of customized care bundle components as per standard guidelines. Hence this study was undertaken with the objective to implement care bundle in patients undergoing elective gastrointestinal surgeries and assess their impact on SSI rate.

The study was an interventional study conducted in the department of surgical gastroenterology for 8 months. Sample size was calculated to be 196 and only elective surgeries are included. CDC NHSN 2023 guidelines are used for surveillance of SSI and global guidelines for prevention of SSI was used for preparation of list of pre-operative, intraoperative and post-operative care bundle components and were implemented before the start of the study.

Overall SSI rate and compliance to SSI care bundle in this study are 13.8% and 28.6%, respectively. When compared with the baseline SSI rate of 19.4%, there is reduction of 28.9% in SSI rate after the implementation of care bundle. Escherichia coli (54.2%) is the most commonly isolated organism. Care bundle non-compliant surgeries are associated with 2.3 times (relative risk-2.3) increased risk of SSI. There is fluctuating trend in compliance of care bundle and SSI rates across months.

This study shows the importance of implementation of set of care bundle for prevention of SSI which can be customized and adapted for reducing SSI.