Surveillance of vascular incisions: outcomes a four-year unit-based quality-improvement program

In a health care climate that emphasizes improving patient outcomes as well as reducing costs of care, the quality improvement process can be an effective tool to identify changes in practice that affect both of these factors in positive directions. Nursing staff members on our vascular surgical ward recognized incisional healing as critical to both cost of care and outcome. Infections and non-healing vascular incisions were problems that resulted in lengthy hospitalizations, the use of expensive antibiotics, and many read missions. Beginning in fiscal year 1992, nurses began monitoring incisional healing in vascular patients as part of the unit-based quality-improvement program. For 3 years nurses collected and analyzed data related to incisional healing in patients with postoperative groin, leg, and amputation incisions. They communicated with interdisciplinary colleagues about ways to improve outcomes and identified and implemented changes in practice that resulted in improvements. A formalized research program is underway to increase knowledge related to incisional healing and factor that affect healing in this specialty population.