A Three-Intervention Evidence-Based Bundle to Reduce Chorioamnionitis Among Patients with Prelabor Rupture of...

Area of Science:

• Obstetrics and Gynecology
• Infectious Disease Prevention
• Quality Improvement in Healthcare

Background:

• Chorioamnionitis poses significant risks to both mothers and newborns.
• Key risk factors include prelabor rupture of membranes (PROM), invasive vaginal procedures, and poor perineal hygiene.
• An infection prevention bundle may reduce chorioamnionitis rates and associated newborn complications, particularly within the Joint Commission Measure of Unexpected Newborn Complications (PC-06).

Purpose of the Study:

• To evaluate the effectiveness of an infection prevention bundle in reducing chorioamnionitis incidence among patients with PROM.
• To assess the impact of the bundle on the rate of newborns affected by chorioamnionitis within the PC-06 measure.

Main Methods:

• A quality improvement project was conducted, implementing a three-intervention bundle for PROM patients.
• Interventions included: minimizing unnecessary vaginal exams, hourly pericare with pad changes, and strict hand hygiene compliance.
• Chorioamnionitis rates were compared pre- and post-bundle implementation (Q1 2023 vs. Q3 2023).

Main Results:

• The chorioamnionitis rate in PROM patients decreased from 8.1% to 3.1% post-implementation.
• The incidence of newborns affected by chorioamnionitis within PC-06 reduced from 9% to 7%.
• PROM cases with chorioamnionitis within PC-06 were eliminated (0% in both periods).

Conclusions:

• Adherence to the infection prevention bundle for PROM is effective in decreasing chorioamnionitis.
• The bundle contributes to a reduction in newborn complications associated with chorioamnionitis.
• This strategy supports improved maternal-newborn outcomes and aligns with infection control best practices.