Quality Assurance and Performance Improvement
30/30 Education Session - 30 minutes
Colon SSIs are among the leading preventable infections in the presenter’s state. To reduce colon SSIs, hospitals joined a collaborative and worked to implement a colon bundle. Over an 18-month period, the collaborative realized a 42% reduction in the colon SIR.
During this time, project leaders provided hospitals with toolkits, coaching calls, webinars, one-on-one calls, and evidence-based literature. Interventions operationalized by the hospitals included:
• CHG bathing before surgery;
• CHG bathing in the pre-operative area;
• use of an alcohol-based skin preparation;
• perioperative glucose monitoring of all patients;
• perioperative temperature monitoring; increased oxygenation of patients;
• use of weight-based antibiotics; and,
• change of gloves before closure.
Participating hospitals were asked to submit process measures each month directly into the data portal. Outcome data for hospitals was pulled from the NHSN. Audits showed that some previously adopted evidence-based strategies, such as weight-based dosing, preoperative CHG bathing, and normothermia were not as well established as had been assumed. Major challenges noted during the initiative were two-fold: designating individuals to measure and treat intraoperative glucose levels and the continual need to educate surgical staff about the importance of changing gloves before closure.
The session will discuss the interventions used during the collaborative, describe how the two major challenges in implementing the bundle were overcome by team work, and review the importance of reducing patient harm while improving hospital reimbursement.