scholarly journals Reduction of deep surgical site infections in cardiac surgery by introducing a multimodal infection control program

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P79
Author(s):  
A Rutten ◽  
JP Ory ◽  
L Jamaer ◽  
A Van Assche ◽  
J Dubois
2020 ◽  
Author(s):  
Yeon Su Jeong ◽  
Jin Hwa Kim ◽  
Seungju Lee ◽  
So Young Lee ◽  
Sun Mi Oh ◽  
...  

Abstract Activities of infection control and prevention are diverse and complicated. Regular and well-organized inspection of infection control is essential element of infection control program. The aim of study was to identify strong points and limitations of weekly infection control rounding (ICTR) in an acute care hospital. We conducted infection control rounding weekly to improve the compliance of infection control in the real field at a 734-bed academic hospital in Republic of Korea between January, 18, 2018 to December, 26, 2018. We investigated the functional coverage of a weekly ICTR. The result of the rounding are categorized well maintained, improvement is needed, long-term support such as space or manpower is needed, not applicable and could not observed. ICTR visited median 7 times [interquartile range (IQR) 6–7 times] per department. When visiting a department, ICTR observed median 16 practices (IQR 12–22). There were 7452 results of practices. Of those results, 75% were monitored properly, 22% were not applicable, and 4% were difficult-to-observe. Among applicable practice results, the most common practices that were difficult to observe were strategies to prevent catheter-related surgical site infections and pneumonia, injection safety practices, and strategies to prevent occupationally-acquired infections. The ICTR was able to maintain regular visits to each department; however, additional observation is necessary to eliminate blind spots.* These authors contributed equally


2014 ◽  
Vol 35 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Renato Finkelstein ◽  
Galit Rabino ◽  
Tania Mashiach ◽  
Yaron Bar-El ◽  
Zvi Adler ◽  
...  

Objective.To evaluate the effect of an optimized policy for antibiotic prophylaxis on surgical site infection (SSI) rates in cardiac surgery.Design.Prospective cohort study.Setting.Tertiary medical center in Israel.Methods.SSIs were recorded during a 10-year study period and ascertained through routine surveillance using the National Healthcare Safety Network (NHSN) methodology. Multivariable analyses were conducted to determine which significant covariates, including the administration of preoperative prophylaxis, affected these outcomes.Results.A total of 2,637 of 3,170 evaluated patients were included, and the overall SSI rate was 8.4%. A greater than 50% reduction in SSI rates was observed in the last 4 years of the study. Overall and site-specific infection rates were similar for patients receiving cefazolin or vancomycin. SSIs developed in 206 (8.1%) of the 2,536 patients who received preoperative prophylaxis (within 2 hours of the first incision) compared with 14 (13.9%) of 101 patients who received antibiotic prophylaxis at a different time (P= .04; odds ratio [OR], 1.8; 95% confidence interval [CI], 1.0–3.3). After accounting for covariates, preoperative hospital stay (5 days or more), an NHSN risk category (2 or 3), age (60 years or more), surgeon's role, and the period of measurement were significantly associated with SSIs. Emergency surgery, age, surgeon's role, and nonpreoperative prophylaxis were found to be independent predictors of superficial SSI.Conclusions.We observed a progressive and significant decrease in SSI rates after the implementation of an infection control program that included an optimized policy of preoperative prophylaxis in cardiac surgery.


1999 ◽  
Vol 20 (8) ◽  
pp. 533-538 ◽  
Author(s):  
Samuel J. McConkey ◽  
Paul B. L'Ecuyer ◽  
Denise M. Murphy ◽  
Terry L. Leet ◽  
Thoralf M. Sundt ◽  
...  

AbstractObjective:To evaluate the efficacy of a comprehensive infection control program on the reduction of surgical-site infections (SSIs) following coronary artery bypass graft (CABG) surgery.Design:Prospective cohort study.Setting:1,000-bed tertiary-care hospital.Patients:Persons undergoing CABG with or without concomitant valve surgery from April 1991 through December 1994.Interventions:Prospective surveillance, quarterly reporting of SSI rates, chlorhexidene showers, discontinuation of shaving, administration of antibiotic prophylaxis in the holding area, elimination of ice baths for cooling of cardioplegia solution, limitation of operating room traffic, minimization of flash sterilization, and elimination of postoperative tap-water wound bathing for 96 hours. Logistic regression models were fitted to assess infection rates over time, adjusting for severity of illness, surgeon, patient characteristics, and type of surgery.Results:2,231 procedures were performed. A reduction in infection rates was noted at all sites. The rate of deep chest infections decreased from 2.6% in 1991 to 1.6% in 1994. Over the same period, the rate of leg infections decreased from 6.8% to 2.7%, and of all SSI from 12.4% to 8.9%. The adjusted odds ratio (OR) for all SSIs for the end of 1994 compared to December 31,1991, was 0.37 (95% confidence interval [CI95], 0.22-0.63). For deep chest and mediastinal infections, the adjusted OR comparing the same period was 0.69 (CI95, 0.28-1.71).Conclusions:We observed significant reductions in SSI rates of deep and superficial sites in CABG surgery following implementation of a comprehensive infection control program. These differences remained significant when adjusted for potential confounding covariables


2005 ◽  
Vol 33 (8) ◽  
pp. 450-454 ◽  
Author(s):  
Renato Finkelstein ◽  
Galit Rabino ◽  
Tania Mashiah ◽  
Yaron Bar-El ◽  
Zvi Adler ◽  
...  

2008 ◽  
Vol 21 (02) ◽  
pp. 99-105 ◽  
Author(s):  
J. S. Weese

SummarySurgical site infections are an inherent risk in orthopaedic surgery and many of the infections that develop are likely to be non-preventable. However, a variety of measures can be undertaken to reduce the risk and impact of surgical site infections. The development and implementation of an infection control program, including surgical site infection surveillance, can be an important tool for patient management. All veterinary practices should have some form of infection control program in order to address surgical site infections, among other issues, and to provide the optimal and expected level of care.


1987 ◽  
Vol 8 (12) ◽  
pp. 495-500 ◽  
Author(s):  
José A. Marinero Càceres ◽  
Yolanda de Sotello

AbstractWe describe circumstances at the Hospital Rosales, located in San Salvador, El Salvador, and some salient observations from an infection control program begun in 1978. Findings include overuse of antibiotics, especially of penicillin and chloramphenicol; a predominance of gram-negative rod infections, especially Pseudomonas aeruginosa; a relative infrequency of Staphylococcus aureus infections; an apparent doubling of the mean duration of hospitalization for patients with nosocomial infections compared with other patients (22.1 days versus 11.0 days); documentation and partial correction of deficiencies in aseptic and antiseptic practices; an outbreak of Pseudomonas aeruginosa endophthalmitis traced to the hospital's factory for the manufacturing of intravenous fluids; and attitudinal problems such as the care of patients with rabies on open wards. Prevalence surveys conducted during 1981 and 1986 suggest a dramatic increase in the recent incidence of surgical wound infection (44% v 28%, P < 0.001). This latter observation suggests a direct relationship between infection rates and the hardships imposed by poverty and civil war.


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