A Replicable Colectomy Surgical Site Infection Prevention Bundle: Implementation and Electronic Health Record-Enabled...

Area of Science:

• Healthcare quality improvement
• Surgical infection prevention
• Translational science

Background:

• Surgical site infections (SSIs) following colectomy increase patient morbidity, mortality, and healthcare costs.
• Effective implementation of evidence-based SSI prevention bundles remains a significant challenge in clinical practice.
• The Translating Research into Practice (TRIP) model offers a framework for implementing research findings, incorporating electronic health record (EHR)-enabled monitoring.

Purpose of the Study:

• To describe the implementation of a colectomy SSI prevention bundle using the TRIP model.
• To evaluate the impact of an EHR-enabled compliance monitoring system on SSI rates and prevention bundle adherence.

Main Methods:

• A pre/post quasi-experimental design was employed, comparing colectomy cases before and after bundle implementation.
• Compliance was monitored using an EHR dashboard (Epic Systems Corporation).
• The primary outcome measured was the National Healthcare Safety Network (NHSN) Standardized Infection Ratio (SIR).

Main Results:

• SSI rates decreased from 10.6% to 4.9% post-implementation (relative risk 0.46).
• The SIR significantly decreased from 2.04 to 0.895 (relative risk 0.44, p=0.037), indicating fewer infections than expected.
• High compliance rates were observed across most elements of the prevention bundle.

Conclusions:

• The TRIP model provided a structured and replicable approach for implementing the colectomy SSI bundle.
• EHR-enabled monitoring facilitated effective compliance tracking without necessitating additional capital investment.
• The integrated approach resulted in a statistically significant reduction in SIR and a clinically meaningful decrease in colectomy SSIs.