Reduction of surgical site infections after implementation of a bundle of care.
BACKGROUND: Surgical Site Infections (SSI) are relatively frequent complications after colorectal surgery and are associated with substantial morbidity and mortality. OBJECTIVE: Implementing a bundle of care and measuring the effects on the SSI rate. DESIGN: Prospective quasi experimental cohort stu...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3433450?pdf=render |
| _version_ | 1818150650976927744 |
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| author | Rogier M P H Crolla Lijckle van der Laan Eelco J Veen Yvonne Hendriks Caroline van Schendel Jan Kluytmans |
| author_facet | Rogier M P H Crolla Lijckle van der Laan Eelco J Veen Yvonne Hendriks Caroline van Schendel Jan Kluytmans |
| author_sort | Rogier M P H Crolla |
| collection | DOAJ |
| description | BACKGROUND: Surgical Site Infections (SSI) are relatively frequent complications after colorectal surgery and are associated with substantial morbidity and mortality. OBJECTIVE: Implementing a bundle of care and measuring the effects on the SSI rate. DESIGN: Prospective quasi experimental cohort study. METHODS: A prospective surveillance for SSI after colorectal surgery was performed in the Amphia Hospital, Breda, from January 1, 2008 until January 1, 2012. As part of a National patient safety initiative, a bundle of care consisting of 4 elements covering the surgical process was introduced in 2009. The elements of the bundle were perioperative antibiotic prophylaxis, hair removal before surgery, perioperative normothermia and discipline in the operating room. Bundle compliance was measured every 3 months in a random sample of surgical procedures. RESULTS: Bundle compliance improved significantly from an average of 10% in 2009 to 60% in 2011. 1537 colorectal procedures were performed during the study period and 300 SSI (19.5%) occurred. SSI were associated with a prolonged length of stay (mean additional length of stay 18 days) and a significantly higher 6 months mortality (Adjusted OR: 2.71, 95% confidence interval 1.76-4.18). Logistic regression showed a significant decrease of the SSI rate that paralleled the introduction of the bundle. The adjusted Odds ratio of the SSI rate was 36% lower in 2011 compared to 2008. CONCLUSION: The implementation of the bundle was associated with improved compliance over time and a 36% reduction of the SSI rate after adjustment for confounders. This makes the bundle an important tool to improve patient safety. |
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| id | doaj.art-e4ad23e69c714542b827b9252634e7b4 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T13:26:19Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-e4ad23e69c714542b827b9252634e7b42022-12-22T01:05:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-0179e4459910.1371/journal.pone.0044599Reduction of surgical site infections after implementation of a bundle of care.Rogier M P H CrollaLijckle van der LaanEelco J VeenYvonne HendriksCaroline van SchendelJan KluytmansBACKGROUND: Surgical Site Infections (SSI) are relatively frequent complications after colorectal surgery and are associated with substantial morbidity and mortality. OBJECTIVE: Implementing a bundle of care and measuring the effects on the SSI rate. DESIGN: Prospective quasi experimental cohort study. METHODS: A prospective surveillance for SSI after colorectal surgery was performed in the Amphia Hospital, Breda, from January 1, 2008 until January 1, 2012. As part of a National patient safety initiative, a bundle of care consisting of 4 elements covering the surgical process was introduced in 2009. The elements of the bundle were perioperative antibiotic prophylaxis, hair removal before surgery, perioperative normothermia and discipline in the operating room. Bundle compliance was measured every 3 months in a random sample of surgical procedures. RESULTS: Bundle compliance improved significantly from an average of 10% in 2009 to 60% in 2011. 1537 colorectal procedures were performed during the study period and 300 SSI (19.5%) occurred. SSI were associated with a prolonged length of stay (mean additional length of stay 18 days) and a significantly higher 6 months mortality (Adjusted OR: 2.71, 95% confidence interval 1.76-4.18). Logistic regression showed a significant decrease of the SSI rate that paralleled the introduction of the bundle. The adjusted Odds ratio of the SSI rate was 36% lower in 2011 compared to 2008. CONCLUSION: The implementation of the bundle was associated with improved compliance over time and a 36% reduction of the SSI rate after adjustment for confounders. This makes the bundle an important tool to improve patient safety.http://europepmc.org/articles/PMC3433450?pdf=render |
| spellingShingle | Rogier M P H Crolla Lijckle van der Laan Eelco J Veen Yvonne Hendriks Caroline van Schendel Jan Kluytmans Reduction of surgical site infections after implementation of a bundle of care. PLoS ONE |
| title | Reduction of surgical site infections after implementation of a bundle of care. |
| title_full | Reduction of surgical site infections after implementation of a bundle of care. |
| title_fullStr | Reduction of surgical site infections after implementation of a bundle of care. |
| title_full_unstemmed | Reduction of surgical site infections after implementation of a bundle of care. |
| title_short | Reduction of surgical site infections after implementation of a bundle of care. |
| title_sort | reduction of surgical site infections after implementation of a bundle of care |
| url | http://europepmc.org/articles/PMC3433450?pdf=render |
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