Hospital Reduces Hysterectomy SSIs With Prevention Bundle

By on 6:55 AM

A Connecticut hospital significantly decreased surgical site infections associated with hysterectomies through the use of a multi-step prevention bundle, according to a study published in Obstetrics & Gynecology and Medscape report on the research.

The bundle included the following components:
  • chlorhexidine-impregnated preoperative wipes provided to patients;
  • standardized aseptic surgical preparation of the abdomen, vagina, and perineum;
  • standardized antibiotic dosing before and during surgery;
  • maintenance of intraoperative normothermia;
  • surgical dressing maintenance 24 to 48 hours postoperatively; and
  • provision of direct feedback from peers to physicians and other staff when the protocol was breached.
Hospital staff received education about the bundle prior to its implementation.

During the 33-month study period, Yale New Haven Hospital in New Haven, Conn., performed 2,099 hysterectomies. There were 61 SSIs (4.51%) prior to implementation of the full bundle and 14 SSIs (1.87%) following implementation of the full bundle.

According to the Medscape report, the authors concluded the following: "Although additional analyses are needed to further elucidate the relationships among adherence rates, specific bundle components, hysterectomy routes, length of hospital stay and [SSI] reduction and overall surgical costs, we believe that a multidisciplinary, gynecology-specific approach to implementation and maintenance of the SSI prevention bundle serves patients well and will become a mainstay of gynecologic surgical care."

Phenelle Segal, RN, CIC, FAPIC

Phenelle Segal, RN, CIC, FAPIC, is the founder and president of Infection Control Consulting Services LLC (ICCS). Phenelle has more than 30 years' experience providing customized comprehensive infection control and prevention services to healthcare facilities nationwide. Her services focus on assisting hospitals, ambulatory surgery centers, dental office and oral surgery practices, doctor's offices, nursing homes and other organizations with implementing and maintaining an infection control program that: complies with The Joint Commission, AAAHC, Centers for Medicaid and Medicare Services (CMS) and other regulatory agencies; respond to situations of noncompliance; and improve the processes for reducing risk.