Enhancing Preoperative Bathing Adherence: A Cost-Effective Strategy to Reduce Surgical Site Infections
Joshua D Smith1, Kenneth J Romito, Mihye Sol
1Department of Operative and Anesthesia Services (Smith, Perioperative Clinical Nurse Specialist & Chief of Sterile Processing), Womack Army Medical Center, Fort Bragg, NC, Graduate School of Nursing (Romito, Associate Professor, Mitchell, Assistant Professor, Sheets, Assistant Professor), Uniform Services University of the Health Sciences, Bethesda, MD, Center for Nursing Science and Clinical Inquiry (Sol, Perioperative Clinical Nurse Specialist), Tripler Army Medical Center, Honolulu, HI, Center for Nursing Science and Clinical Inquiry (Atwood, Perioperative Clinical Nurse Specialist), Landstuhl Regional Medical Center, Landstuhl, Germany, Center for Nursing Science and Clinical Inquiry (Eberhardt, Perioperative Clinical Nurse Specialist), Madigan Army Medical Center, Joint Base Lewis McChord, WA.
Purpose/Objectives:
This project evaluated preoperative bathing workflows using evidence-based methods, comparing them to suggested practices. This data was used to determine whether implementing evidence-based preoperative bathing protocols could lower costs and surgical site infection (SSI) rates after 12 months.
Description Of The Project/Program:
An interdisciplinary team was established to develop and implement process improvement protocols for preoperative bathing. This team employed Lean Six Sigma methods to identify the problem, define project objectives, analyze the root cause, implement new processes, monitor the plan, and eliminate defects. An audit tool, developed based on evidence from the Association for the Advancement of Medical Instrumentation, was then used to determine the risk of SSI.
Outcome:
Based on the data collected, a preoperative bathing skin aseptic care bundle was developed, resulting in a SSI rate decline from 2.16% to 1.26%, patient adherence increase from 16% to 91%, and cost savings of 73% per patient, with an estimated $200,000 savings per year.
Conclusion:
This project demonstrated the effective use of preoperative skin antiseptics in reducing bacteria near the surgical incision site. Through the implementation of an evidence-based PBB bundle, the risk of postoperative SSI can be significantly decreased.
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