221 - Reducing Infections In Pediatric Neurosurgical Patients
Clinical Problem/Significance: Post- operative shunt infections are costly and can cause further developmental delay. The purpose of this study is to assess the efficacy of a neurosurgical shunt protocol that was implemented in 2016.
Background: There was an increase in neurosurgical shunt infections from 6.2 % in 2015 to 19.5 % in 2016. Clinical Question: How to reduce pediatric neurosurgical shunt infections. Description of Evidenced-Based Protocol: An evidence based protocol was developed involving various interventions which include preoperative bathing, pre operative antibiotics, traffic control intraoperatively, a specific regiment for patient surgical skin prep performed by nurses and specific surgical hand scrub regimen surgical techs and all surgical team members which includes mechanical hand scrub, the use of green gown and double gloving, draping and changing the outer gloves after draping is complete. Implementation of Evidenced-Based Protocol: The checklist is used preoperatively and follows the patient into the operating room where the checklist is used in every step that leads to patient readiness which includes positioning, hair removal using clippers, skin prep and is integrated into surgeon lead time out.
Results: The infection rate went from 19.5 % in the first half of 2016 to 3.1% in the second half of 2016. Conclusions/
Discussion: Although our infection rate has fluctuated some since the implementation of the protocol, we have remained below the initial infection rate which triggered the implementation of this protocol. Perioperative Nursing Implications: The financial and emotional cost from a hospitalization due to a shunt infection negatively impacts our patients and families. The implementation of a standardized protocol for the care of a shunt patient contributes to positive outcomes.