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Implementation of Bundled Interventions to Reduce Surgical Site Infections in Pediatric Patients Undergoing

Melissa M Campbell, Jennifer Turi, Sharah Collier

    AORN Journal
    |January 29, 2025
    PubMed

    Insights

    A new infection prevention bundle for pediatric cardiothoracic surgery did not significantly reduce surgical site infections (SSIs). However, compliance remained high, indicating the bundle

    Area of Science:

    • Pediatric Surgery
    • Infectious Disease Prevention
    • Healthcare Epidemiology

    Background:

    • Pediatric cardiothoracic surgery patients face high risks of healthcare-associated infections, particularly surgical site infections (SSIs).
    • Delayed sternal closures increase hospital stay and infection risks.
    • SSIs are a significant source of morbidity in pediatric surgical patients.

    Purpose of the Study:

    • To evaluate the effectiveness of a comprehensive SSI prevention bundle in pediatric cardiothoracic surgery.
    • To assess SSI rates before and after the implementation of a multi-period (preoperative, intraoperative, postoperative) SSI prevention strategy.
    • To determine the sustainability of SSI prevention bundle compliance during and after the COVID-19 pandemic.

    Main Methods:

    • Implementation of a standardized SSI prevention bundle across preoperative, intraoperative, and postoperative care.
    • Epidemiological analysis of SSIs in pediatric cardiothoracic surgery patients from 2017-2023.
    • Measurement and comparison of SSI rates per 100 procedures pre- and post-bundle implementation.

    Main Results:

    • No statistically significant difference in overall SSI rates per 100 procedures was observed between the pre- and post-implementation periods.
    • An initial decrease in SSI rates was noted for routine procedures and those with delayed sternal closures.
    • Compliance with the SSI prevention bundle elements remained high throughout the study period, including during the COVID-19 pandemic.

    Conclusions:

    • The implemented SSI prevention bundle, while not significantly reducing overall SSI rates, demonstrated sustainability in compliance.
    • The findings suggest that adherence to infection control protocols is achievable even during challenging periods like a pandemic.
    • Further research may be needed to refine the bundle for greater efficacy in reducing SSIs in this vulnerable pediatric population.

    Keywords:
    bundle implementationdelayed sternal closureinfection preventionpediatric cardiothoracic (CT) surgerysurgical site infections (SSIs)

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