The Outcome of the Hospital Protocol for Prevention of Surgical Site Infection After Cesarean Deliveries

ABSTRACT Objective: To describe the profile of women in relation to their living conditions, health status and socio-demographic profile, correlating it with the presence of signs and symptoms suggestive of post-cesarean surgical site infection, identifying information to be considered in the puerperium consultation performed by nurses and proposing a roadmap for the systematization of care. Method: Quantitative, exploratory, descriptive, cross-sectional and retrospective review of medical records of women who had cesarean deliveries in 2014, in the city of São Paulo. Results: 89 medical records were analyzed, 62 of them with incomplete information. In 11, there was at least one of the signs and symptoms suggestive of infection. Conclusion: Given the results of the study, the systematization of puerperal consultation is essential. The roadmap is an instrument that can potentially improve the quality of service and the recording of information.

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Surgical site infection risk following cesarean deliveries covered by Medicaid or private insurance

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.66 ◽

2019 ◽

Vol 40 (6) ◽

pp. 639-648 ◽

Cited By ~ 3

Author(s):

Sarah H. Yi ◽

Kiran M. Perkins ◽

Sophia V. Kazakova ◽

Kelly M. Hatfield ◽

David G. Kleinbaum ◽

...

Keyword(s):

Surgical Site Infection ◽

Cesarean Delivery ◽

Private Insurance ◽

Site Infection ◽

Cesarean Deliveries ◽

Need To Evaluate ◽

Study Population ◽

Facility Level ◽

Primary Payer

AbstractObjective:To compare risk of surgical site infection (SSI) following cesarean delivery between women covered by Medicaid and private health insurance.Study design:Retrospective cohort.Study population:Cesarean deliveries covered by Medicaid or private insurance and reported to the National Healthcare Safety Network (NHSN) and state inpatient discharge databases by hospitals in California (2011–2013).Methods:Deliveries reported to NHSN and state inpatient discharge databases were linked to identify SSIs in the 30 days following cesarean delivery, primary payer, and patient and procedure characteristics. Additional hospital-level characteristics were obtained from public databases. Relative risk of SSI by primary payer primary payer was assessed using multivariable logistic regression adjusting for patient, procedure, and hospital characteristics, accounting for facility-level clustering.Results:Of 291,757 cesarean deliveries included, 48% were covered by Medicaid. SSIs were detected following 1,055 deliveries covered by Medicaid (0.75%) and 955 deliveries covered by private insurance (0.63%) (unadjusted odds ratio, 1.2; 95% confidence interval [CI], 1.1–1.3; P < .0001). The adjusted odds of SSI following cesarean deliveries covered by Medicaid was 1.4 (95% CI, 1.2–1.6; P < .0001) times the odds of those covered by private insurance.Conclusions:In this, the largest and only multicenter study to investigate SSI risk following cesarean delivery by primary payer, Medicaid-insured women had a higher risk of infection than privately insured women. These findings suggest the need to evaluate and better characterize the quality of maternal healthcare for and needs of women covered by Medicaid to inform targeted infection prevention and policy.

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61: Impact of a surgical site infection bundle on surgical site infection rates in cesarean deliveries

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.10.472 ◽

2018 ◽

Vol 218 (1) ◽

pp. S46

Author(s):

Christina Davidson ◽

Jordan Enns ◽

Carrie Dempster ◽

Catherine Eppes

Keyword(s):

Surgical Site Infection ◽

Site Infection ◽

Infection Rates ◽

Cesarean Deliveries

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Incidence of Surgical Site Infection and Factors Associated among Cesarean Deliveries in Selected Government Hospitals in Addis Ababa, Ethiopia, 2019

Obstetrics and Gynecology International ◽

10.1155/2020/9714640 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Hana Lijaemiro ◽

Semarya Berhe Lemlem ◽

Jembere Tesfaye Deressa

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Surgical Site Infection ◽

Cesarean Delivery ◽

Logistic Regression Analysis ◽

Addis Ababa ◽

Site Infection ◽

Cesarean Deliveries ◽

Government Hospitals ◽

Bivariate Logistic Regression

Background. One-third to two-thirds of operated patients in low-income countries acquire surgical site infection, which is nine times higher when compared to high-resource countries. Identifying the incidence and risk factors that contribute to surgical site infection following cesarean delivery is a step ahead for preventing and reducing the problem. Nonetheless, the distribution of the problem in Addis Ababa, where the rate of cesarean delivery is relatively high compared to other parts of the country, is under investigation. Objective. The aim of this study is to assess the incidence of surgical site infection among cesarean deliveries and factors associated with it in selected governmental hospitals found in Addis Ababa, Ethiopia, in 2019. Method. A hospital-based prospective cohort study design was employed to follow 175 women, who gave birth by cesarean delivery in selected government hospitals in Addis Ababa, from March 11 to April 9, 2019. Convenience sampling method was used to select study units from the randomly selected hospitals. Descriptive statistics were run for determining the rate of cesarean delivery surgical site infection. Presence and degree of association between outcome and independent variables were computed through bivariate logistic regression analysis and factors that had p<0.2 significance level in the bivariate logistic regression analysis were considered in the multivariable logistic regression analysis. Result. From 166 participants who completed 30-day follow-up, 25 (15%) of the participants developed surgical site infection. Age, gestational age, duration of operation, and ≥5 vaginal examinations showed a significant association with the outcome variable with AOR (95% CI) of ((AOR = 1.504, 95% CI: (1.170 – 1.933, p=0.001))), ((AOR = 0.019, 95% CI: (0.001 – 0.291, p=0.004))), ((AOR = 1.108, 95% CI: (1.025 – 1.197, p=0.009))), and ((AOR = 13.076, 95% CI: (1.018 – 168.002, p=0.048))), respectively. Conclusion and recommendation. Surgical site infection rate is higher and certain associations lost due to small sample size. Further interventional studies with vast sample size are recommended.

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