title: Improving Surveillance and Prevention of Surgical Site Infection in Pediatric Cardiac Surgery.
abstract: BACKGROUND
  Postoperative cardiovascular surgical site infections are preventable events that may lead to increased morbidity, mortality, and health care costs.
  
  
  OBJECTIVE
  To improve surgical wound surveillance and reduce the incidence of surgical site infections.
  
  
  METHODS
  An institutional review of surgical site infections led to implementation of 8 surveillance and process measures: appropriate preparation the night before surgery and the day of surgery, use of appropriate preparation solution in the operating room, appropriate timing of preoperative antibiotic administration, placement of a photograph of the surgical site in the patient's chart at discharge, sending a photograph of the surgical site to the patient's primary care physician, 30-day follow-up of the surgical site by an advanced nurse practitioner, and placing a photograph of the surgical site obtained on postoperative day 30 in the patient's chart.
  
  
  RESULTS
  Mean overall compliance with the 8 measures from March 2013 through February 2014 was 88%. Infections occurred in 10 of 417 total operative cases (2%) in 2012, in 8 of 437 total operative cases (2%) in 2013, and in 7 of 452 total operative cases (1.5%) in 2014.
  
  
  CONCLUSIONS
  Institution of the surveillance process has resulted in improved identification of suspected surgical site infections via direct rather than indirect measures, accurate identification of all surgical site infections based on definitions of the National Healthcare Safety Network, collaboration with all persons involved, and enhanced communication with patients' family members and referring physicians.
authors.affiliation: Melissa Cannon is an advanced nurse practitioner, Diane Hersey is a nurse clinician, Sheilah Harrison is a quality coordinator, Brian Joy is a cardiologist, Aymen Naguib is a cardiac anesthesiologist, Mark Galantowicz is a cardiac surgeon, and Janet Simsic is a cardiologist, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Melissa
authors.initials: M
authors.lastname: Cannon
authors.affiliation: Melissa Cannon is an advanced nurse practitioner, Diane Hersey is a nurse clinician, Sheilah Harrison is a quality coordinator, Brian Joy is a cardiologist, Aymen Naguib is a cardiac anesthesiologist, Mark Galantowicz is a cardiac surgeon, and Janet Simsic is a cardiologist, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Diane
authors.initials: D
authors.lastname: Hersey
authors.affiliation: Melissa Cannon is an advanced nurse practitioner, Diane Hersey is a nurse clinician, Sheilah Harrison is a quality coordinator, Brian Joy is a cardiologist, Aymen Naguib is a cardiac anesthesiologist, Mark Galantowicz is a cardiac surgeon, and Janet Simsic is a cardiologist, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Sheilah
authors.initials: S
authors.lastname: Harrison
authors.affiliation: Melissa Cannon is an advanced nurse practitioner, Diane Hersey is a nurse clinician, Sheilah Harrison is a quality coordinator, Brian Joy is a cardiologist, Aymen Naguib is a cardiac anesthesiologist, Mark Galantowicz is a cardiac surgeon, and Janet Simsic is a cardiologist, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Brian
authors.initials: B
authors.lastname: Joy
authors.affiliation: Melissa Cannon is an advanced nurse practitioner, Diane Hersey is a nurse clinician, Sheilah Harrison is a quality coordinator, Brian Joy is a cardiologist, Aymen Naguib is a cardiac anesthesiologist, Mark Galantowicz is a cardiac surgeon, and Janet Simsic is a cardiologist, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Aymen
authors.initials: A
authors.lastname: Naguib
authors.affiliation: Melissa Cannon is an advanced nurse practitioner, Diane Hersey is a nurse clinician, Sheilah Harrison is a quality coordinator, Brian Joy is a cardiologist, Aymen Naguib is a cardiac anesthesiologist, Mark Galantowicz is a cardiac surgeon, and Janet Simsic is a cardiologist, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Mark
authors.initials: M
authors.lastname: Galantowicz
authors.affiliation: Melissa Cannon is an advanced nurse practitioner, Diane Hersey is a nurse clinician, Sheilah Harrison is a quality coordinator, Brian Joy is a cardiologist, Aymen Naguib is a cardiac anesthesiologist, Mark Galantowicz is a cardiac surgeon, and Janet Simsic is a cardiologist, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio. Janet.simsic@nationwidechildrens.org.
authors.forename: Janet
authors.initials: J
authors.lastname: Simsic
mesh_terms: D006348:Cardiac Surgical Procedures; D002648:Child; D006801:Humans; D017410:Practice Guidelines as Topic; D011300:Preoperative Care / Q000379:methods*; D013530:Surgical Wound Infection / Q000517:prevention & control*