title: A Quality Improvement Approach to Reducing the Caesarean section Surgical Site Infection Rate in a Regional Hospital.
abstract: Surgical site infection (SSI) rates are used extensively by hospitals as a basis for quality improvement. A 30-day post-discharge SSI programme for Caesarean section operations has been implemented in Our Lady of Lourdes Hospital since 2011. It has been shown that skin antisepsis and antibiotic prophylaxis are key factors in the prevention of SSI. Using quality improvement methodology, an infection prevention bundle was introduced to address these two factors. Skin antisepsis was changed from povidone-iodine to chlorhexidine-alcohol. Compliance with choice of antibiotic prophylaxis increased from 89.6% in 2014 to 98.5% in 2015. Compliance with timing also improved. The SSI rate of 7.5% was the lowest recorded to date, with the majority of SSIs (64%) diagnosed after hospital discharge. The level of variation was also reduced. However, the continued presence of variation and possibility of lower infection rates from the literature imply that further improvements are required.
authors.affiliation: Microbiology Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: M
authors.initials: M
authors.lastname: O'Hanlon
authors.affiliation: Pharmacy Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: C
authors.initials: C
authors.lastname: McKenna
authors.affiliation: Quality Improvement Group, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: E
authors.initials: E
authors.lastname: Carton
authors.affiliation: Anaesthesia Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: D
authors.initials: D
authors.lastname: Diviney
authors.affiliation: Theatre Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: M R
authors.initials: MR
authors.lastname: Costello
authors.affiliation: Maternity Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: L
authors.initials: L
authors.lastname: O'Sullivan
authors.affiliation: Quality Improvement Group, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: J
authors.initials: J
authors.lastname: Fitzsimons
authors.affiliation: Quality Improvement Group, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: L
authors.initials: L
authors.lastname: Toland
authors.affiliation: Microbiology Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: G
authors.initials: G
authors.lastname: Dornikova
authors.affiliation: Microbiology Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: R
authors.initials: R
authors.lastname: Curran
authors.affiliation: Maternity Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: C
authors.initials: C
authors.lastname: McCann
authors.affiliation: Maternity Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: L
authors.initials: L
authors.lastname: O'Sullivan
authors.affiliation: Infection Control Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: T
authors.initials: T
authors.lastname: Doherty
authors.affiliation: General Manager Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: C
authors.initials: C
authors.lastname: Crowley
authors.affiliation: Maternity Department, Our Lady of Lourdes Hospital, Drogheda, Co. Louth.
authors.forename: S
authors.initials: S
authors.lastname: O'Coigligh
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D002585:Cesarean Section / Q000009:adverse effects*; D002710:Chlorhexidine / Q000008:administration & dosage; D005260:Female; D006761:Hospitals; D006801:Humans; D011206:Povidone-Iodine / Q000008:administration & dosage; D011247:Pregnancy; D058996:Quality Improvement; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000891:Anti-Infective Agents, Local; D011206:Povidone-Iodine; D002710:Chlorhexidine