title: A Multidisciplinary Infection Control Bundle to Reduce the Number of Spinal Cord Stimulator Infections.
abstract: OBJECTIVE
  To investigate the effect of a quality improvement project that resulted in an infection control bundle to reduce the number of spinal cord stimulator (SCS) infections.
  
  
  METHODS
  The study was performed in a single center for neuromodulation from January 1, 2014, through May 31, 2016. In response to a high number of surgical site infections (SSIs) after SCS surgery, a multidisciplinary team analyzed the surgical process and developed an infection prevention bundle consisting of five items: 1) showering and decolonization for five days prior to surgery and showering in the hospital on the morning of surgery; 2) performing the SCS implantation as the first in the daily operating room (OR) program; 3) maintaining a minimal number of people in the OR; 4) providing home care nurses with a folder with SCS wound care instructions including pictures; 5) giving oral specific wound care instructions to patients. The number of infections was calculated for the baseline, implementation, and sustainability phases.
  
  
  RESULTS
  A total of 410 SCS surgeries were performed during the study period. In the preintervention phase, 26/249 (10.4%) SCS surgeries were infected. During the implementation and sustainability phase, 2/59 (3.4%) and 1/102 (1.0%) SCS surgeries were infected, respectively. The reduction in the number of infections in pre and postintervention phase was statistically significant (p = 0.003).
  
  
  CONCLUSIONS
  Multidisciplinary measures to reduce SSIs reduced the number of SCS associated infections in our study setting.
authors.affiliation: Department of Medical Microbiology, GZA Hospitals, Wilrijk, Antwerp, Belgium.|Department of Medical Microbiology, Antwerp University Hospital (UZA), University of Antwerp, Edegem, Belgium.
authors.forename: Erlangga
authors.initials: E
authors.lastname: Yusuf
authors.affiliation: Department of Neurosurgery, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Sven
authors.initials: S
authors.lastname: Bamps
authors.affiliation: Department of Infection Control, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Thüer
authors.affiliation: Department of Neurosurgery, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Mattheussen
authors.affiliation: Department of Medical Microbiology, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Ursi
authors.affiliation: Department of Medical Microbiology, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Elke
authors.initials: E
authors.lastname: Del Biondo
authors.affiliation: Department of Neurosurgery, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Kris
authors.initials: K
authors.lastname: de Smedt
authors.affiliation: Department of Neurosurgery, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Raf
authors.initials: R
authors.lastname: Van Paesschen
authors.affiliation: Department of Neurosurgery, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Berghmans
authors.affiliation: Department of Infection Control, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Kaat
authors.initials: K
authors.lastname: Hofkens
authors.affiliation: Department of Medical Microbiology, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Jef
authors.initials: J
authors.lastname: Van Schaeren
authors.affiliation: Department of Neurosurgery, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Tony
authors.initials: T
authors.lastname: van Havenbergh
authors.affiliation: Department of Medical Microbiology, GZA Hospitals, Wilrijk, Antwerp, Belgium.
authors.forename: Bruno
authors.initials: B
authors.lastname: Van Herendael
mesh_terms: D004866:Equipment Contamination / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D010348:Patient Care Team; D011446:Prospective Studies; D012189:Retrospective Studies; D062187:Spinal Cord Stimulation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000517:prevention & control*
keywords: Care bundle; infection; infection control; spinal cord stimulation; surgical site infection