1. Reducing Pediatric Sternal Wound Infections: A Quality Improvement Project.
- Author
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Delgado-Corcoran C, Van Dorn CS, Pribble C, Thorell EA, Pavia AT, Ward C, Smout R, Bratton SL, and Burch PT
- Subjects
- Child, Preschool, Female, Gram-Negative Bacterial Infections epidemiology, Gram-Negative Bacterial Infections etiology, Gram-Positive Bacterial Infections epidemiology, Gram-Positive Bacterial Infections etiology, Humans, Infant, Infant, Newborn, Male, Patient Care Bundles, Perioperative Care methods, Prospective Studies, Retrospective Studies, Surgical Wound Infection epidemiology, Treatment Outcome, Cardiac Surgical Procedures, Gram-Negative Bacterial Infections prevention & control, Gram-Positive Bacterial Infections prevention & control, Perioperative Care standards, Quality Improvement statistics & numerical data, Sternotomy, Surgical Wound Infection prevention & control
- Abstract
Objectives: To evaluate whether a quality improvement intervention reduces sternal wound infection rates in children after cardiac surgery., Design: This is a pre- and postintervention quality improvement study., Setting: A 16-bed cardiac ICU in a university-affiliated pediatric tertiary care children's hospital., Patients: All patients undergoing cardiac surgery via median sternotomy from January 2010 to December 2014 are included. The sternal wound infection rates for primary closure and delayed sternal closure are reported per 100 sternotomies. The hospital-acquired infection records were used to identify preintervention cases, while postintervention cases were collected prospectively., Intervention: Implementation of a sternal wound prevention bundle during the preoperative, intraoperative, and postoperative periods for cardiac surgical cases., Measurements and Main Results: During the preintervention period, 32 patients (3.8%) developed sternal wound infection, whereas only 19 (2.1%) developed sternal wound infection during the postintervention period (p = 0.04). The rates of sternal wound infection following primary closure were not significantly different pre- and postintervention (2.4% vs 1.6%; p = 0.35). However, patients with delayed sternal closure had significantly lower postintervention infection rates (10.6% vs 3.9%; p = 0.02)., Conclusions: Implementation of a sternal wound prevention bundle during the perioperative period was associated with lower sternal wound infection rates in surgeries with delayed sternal closure.
- Published
- 2017
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