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Published on: June 7, 2017
The Crani Bundle: Chlorhexidine Gluconate Bathing, Patient Hand Hygiene, and Surgical Site Dressing Care in
Lauren M Franker1, Molly Pretet, Kristin Simmons
1Author Affiliations: Neurosurgery, Rush Medical Group, Aurora, Illinois (Dr Franker); Stroke and Spine Coordinator, Neuroscience Institute, Rush Copley Medical Center, Aurora, Illinois (Mrs Pretet); Infection and Quality Surveillance, Nursing Professional Practice, Rush Copley Medical Center, Aurora, Illinois (Mrs Simmons); Heart and Vascular Service Line, Critical Care, and Respiratory Services, Critical Care Department, Rush Copley Medical Center, Aurora, Illinois (Mrs Douglas); and Nursing Professional Practice, Rush University System for Health, Chicago, Illinois (Dr Young).
Background:
Surgical site infections (SSIs) are preventable complications. The Joint Commission (TJC) National Patient Safety Goal® (NPSG) 7 focuses on decreasing health care-associated infections (HAIs), such as SSIs.
Local Problem:
The neurosurgery service line encountered 4 SSIs from craniotomy procedures over a 27-month period with 2 occurring in 1 month requiring immediate attention.
Methods:
A pre- (January 2018 to March 2020)/post-implementation (April 2020 to July 2022) design, using rapid Plan-Do-Study-Act cycles, guided this evidenced-based practice quality improvement project.
Interventions:
The Crani Bundle, a nurse-led SSI prevention initiative focusing on patient hand hygiene and postoperative chlorhexidine gluconate bathing, was developed and implemented to reduce SSI after craniotomy (SSI-CRAN).
Results:
Implementation of the Crani Bundle decreased SSI-CRAN from 3.38% ( n = 4/118) to 0.0% ( n = 0/87).
Conclusions:
The Crani Bundle was effective in reducing SSI-CRAN, meeting TJC NPSG® of preventing HAIs and improving patient safety.
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