Background: Surgical site infections (SSI) are an undesirable surgical complication that leads to negative patient and system outcomes. SSI risk correlates with various intrinsic (patient) and extrinsic (system) factors. Colorectal surgeries are especially susceptible. In 2013, the incidence of postoperative colorectal SSI rates was noted to be elevated at our institution with respect to national benchmarks. We developed and implemented an evidence based Colorectal Bundle (CRB) as our targeted intervention to reduce SSI. Methods: A multidisciplinary team was formed to develop and implement a CRB. The bundle was created using interventions established in the literature while also accounting for institutional biases. After a period of implementation, data was then analyzed using baseline and post implementation statistics. Additionally, infection rates were compared to national expected incidences using two national programs, the NSQIP and NHSN. Bundle compliance was encouraged over time to achieve sustained results. Results: We performed a total of 519 colorectal surgeries over a span of two and a half years and limited our infection rate to only 12 cases (2.3%). This was a significant reduction in SSI rates (RR 0.28, p < 0.001) and according to NSQIP, placed our system in the top decile with respect to SSI incidence. Conclusions: Implementation of our CRB resulted in a sustained decrease in SSI rates with respect to colorectal surgeries. We hope this manuscript can serve as a recipe for change. We highlight steps that were crucial to the success of our CRB from inception onward. We believe these key elements include the presence of a surgical champion, multi departmental buy-in, and continued compliance leading to a culture of excellence.
| Published in | Science Journal of Clinical Medicine (Volume 10, Issue 4) |
| DOI | 10.11648/j.sjcm.20211004.19 |
| Page(s) | 131-137 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2021. Published by Science Publishing Group |
Surgical Site Infection, Colorectal Surgery, Bundled Care, Culture, Surgical Champion, Compliance
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APA Style
Christopher Wolff, Stephen Brandstetter, Wanda Mullins, Mark Horattas. (2021). Preventing Surgical Site Infections and Colorectal Surgery: Creating an Interdisciplinary Culture of Safety and Excellence. Science Journal of Clinical Medicine, 10(4), 131-137. https://doi.org/10.11648/j.sjcm.20211004.19
ACS Style
Christopher Wolff; Stephen Brandstetter; Wanda Mullins; Mark Horattas. Preventing Surgical Site Infections and Colorectal Surgery: Creating an Interdisciplinary Culture of Safety and Excellence. Sci. J. Clin. Med. 2021, 10(4), 131-137. doi: 10.11648/j.sjcm.20211004.19
AMA Style
Christopher Wolff, Stephen Brandstetter, Wanda Mullins, Mark Horattas. Preventing Surgical Site Infections and Colorectal Surgery: Creating an Interdisciplinary Culture of Safety and Excellence. Sci J Clin Med. 2021;10(4):131-137. doi: 10.11648/j.sjcm.20211004.19
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Download@article{10.11648/j.sjcm.20211004.19,
author = {Christopher Wolff and Stephen Brandstetter and Wanda Mullins and Mark Horattas},
title = {Preventing Surgical Site Infections and Colorectal Surgery: Creating an Interdisciplinary Culture of Safety and Excellence},
journal = {Science Journal of Clinical Medicine},
volume = {10},
number = {4},
pages = {131-137},
doi = {10.11648/j.sjcm.20211004.19},
url = {https://doi.org/10.11648/j.sjcm.20211004.19},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20211004.19},
abstract = {Background: Surgical site infections (SSI) are an undesirable surgical complication that leads to negative patient and system outcomes. SSI risk correlates with various intrinsic (patient) and extrinsic (system) factors. Colorectal surgeries are especially susceptible. In 2013, the incidence of postoperative colorectal SSI rates was noted to be elevated at our institution with respect to national benchmarks. We developed and implemented an evidence based Colorectal Bundle (CRB) as our targeted intervention to reduce SSI. Methods: A multidisciplinary team was formed to develop and implement a CRB. The bundle was created using interventions established in the literature while also accounting for institutional biases. After a period of implementation, data was then analyzed using baseline and post implementation statistics. Additionally, infection rates were compared to national expected incidences using two national programs, the NSQIP and NHSN. Bundle compliance was encouraged over time to achieve sustained results. Results: We performed a total of 519 colorectal surgeries over a span of two and a half years and limited our infection rate to only 12 cases (2.3%). This was a significant reduction in SSI rates (RR 0.28, p Conclusions: Implementation of our CRB resulted in a sustained decrease in SSI rates with respect to colorectal surgeries. We hope this manuscript can serve as a recipe for change. We highlight steps that were crucial to the success of our CRB from inception onward. We believe these key elements include the presence of a surgical champion, multi departmental buy-in, and continued compliance leading to a culture of excellence.},
year = {2021}
}
TY - JOUR T1 - Preventing Surgical Site Infections and Colorectal Surgery: Creating an Interdisciplinary Culture of Safety and Excellence AU - Christopher Wolff AU - Stephen Brandstetter AU - Wanda Mullins AU - Mark Horattas Y1 - 2021/12/07 PY - 2021 N1 - https://doi.org/10.11648/j.sjcm.20211004.19 DO - 10.11648/j.sjcm.20211004.19 T2 - Science Journal of Clinical Medicine JF - Science Journal of Clinical Medicine JO - Science Journal of Clinical Medicine SP - 131 EP - 137 PB - Science Publishing Group SN - 2327-2732 UR - https://doi.org/10.11648/j.sjcm.20211004.19 AB - Background: Surgical site infections (SSI) are an undesirable surgical complication that leads to negative patient and system outcomes. SSI risk correlates with various intrinsic (patient) and extrinsic (system) factors. Colorectal surgeries are especially susceptible. In 2013, the incidence of postoperative colorectal SSI rates was noted to be elevated at our institution with respect to national benchmarks. We developed and implemented an evidence based Colorectal Bundle (CRB) as our targeted intervention to reduce SSI. Methods: A multidisciplinary team was formed to develop and implement a CRB. The bundle was created using interventions established in the literature while also accounting for institutional biases. After a period of implementation, data was then analyzed using baseline and post implementation statistics. Additionally, infection rates were compared to national expected incidences using two national programs, the NSQIP and NHSN. Bundle compliance was encouraged over time to achieve sustained results. Results: We performed a total of 519 colorectal surgeries over a span of two and a half years and limited our infection rate to only 12 cases (2.3%). This was a significant reduction in SSI rates (RR 0.28, p Conclusions: Implementation of our CRB resulted in a sustained decrease in SSI rates with respect to colorectal surgeries. We hope this manuscript can serve as a recipe for change. We highlight steps that were crucial to the success of our CRB from inception onward. We believe these key elements include the presence of a surgical champion, multi departmental buy-in, and continued compliance leading to a culture of excellence. VL - 10 IS - 4 ER -
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