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Implementation of Evidence-Based Innovative Bundle Checklist for Reduction of Surgical Site Infection

INTRODUCTION: Surgical site infections are the most common health care-associated infection, accounting for 31% of all health care-associated infections among hospitalized patients. Although advances have been made in infection control practices, surgical site infections remain a substantial cause of morbidity and an associated mortality rate of 3% has been attributed to them. In recent years, many studies have proven that use of checklists has led to improved patient care and decreased morbidity and mortality. The objective of our study is to determine if implementing a surgical site infection checklist for major gynecologic surgeries aimed at increasing compliance with practices known to reduce surgical site infections would reduce the rate of surgical site infections. METHODS: A presurgical checklist of nine different evidence-based practices (ie, chlorhexidine, broad-spectrum systemic antibiotics, etc) was bundled as a checklist and implemented at our teaching institution beginning in July 2012. A retrospective chart review was conducted of total abdominal hysterectomies and supracervical hysterectomies, performed from January 2010 to December 2012, before and after the implementation of our checklist. RESULTS: The surgical site infection rate after abdominal hysterectomies for the institution in 2010 and 2011 was 8.9% and 7.5%, respectively, before implementation of the checklist (Fig. 1). The surgical site infection rate decreased to 4.5% in 2012 after implementation of the checklist (Fig. 1). Surgical site infection rate. CONCLUSIONS: Our evidence-based checklist reduces the rate of surgical site infections after abdominal hysterectomies at our institution. Research geared toward identifying risk factors may be useful in establishing best practices to further decrease surgical site infection in abdominal hysterectomy.