Nassau University Medical Center

East Meadow, New York

Citation

Hsu, Chaur-Dong et al. Reduction and sustainability of cesarean section surgical site infection: An evidence-based innovative, and multidisciplinary quality improvement intervention bundle program. American Journal of Infection Control. 2016;44(11)1315-1320.

Results: Open and Endovascular Elective Surgery

Pre-Bundle Post-Bundle
Overall SSI Rate: 6.2%
Superficial Incisional: 5.2%
Deep Incisional: 0.32%
Organ/Space SSI: 0.64%
Overall SSI Rate: 0.1%
Superficial Incisional: 0.1%
Deep Incisional: 0%
Organ/Space SSI: 0%

SSI Prevention Bundle for C-Section Delivery

Hospital Infection Control Policies
Clothing Restrictions

Jewelry restriction among L&D staff and no long sleeves for pediatricians

Alcohol Dispensers

In postpartum unit and L&D patient bathroom

Hand Hygiene and Monitoring

Wash with soap, water and friction for 15-20 seconds or use alcohol-based hand antisepsis agent

Education and Communication

Dissemination of information between patients, families and staff

Preoperative
Team Education

Proper SSI documentation and auditing

Chlorhexidine Gluconate

CHG preparation for surgeries

Hair Removal

Hair removal with electric clippers

Antibiotic Prophylaxis

Cefazolin 1g (2g for obese pregnant women) IV bolus (30-60 min before procedure) and azithromycin 500mg IV infusion (1 hr before surgery)

Intraoperative

Operating room doors closed appropriately during procedures

Traction of Umbilical Cord to Remove Placenta

Closure of Deep Subcutaneous Layer > 2cm
Subcuticular Suture for Skin Closure