Reducing surgical site infections (SSI) in women who have had Lower Segment Caesarean Sections (LSCS)

Mr Brendon Heley1, Ms Amanda Bath1

1Fiona Stanley Hospital, Murdoch, Australia

Background:

On a global scale, Caesarean section (C-sections) rates have increased due to the complexities of women. The risk of surgical site infections (SSI) increases with high Body Mass Index (BMI) and gestational diabetes. Since January 2018 to March 2019, Fiona Stanley Hospital (FSH) has completed 1487 C-sections with ten (10) of these resulting in SSI.

Method/Actions:

A partnership of expertise between Infection Prevention and Maternity was used to lead clinical change through education to reduce the risk of SSI. A multidimensional C-section Bundle was subsequently implemented following a critical review of the ward environment and staff across all disciplines. A ‘back to basics’ program was integral to the Bundle highlighting the importance of:

  • bare below the elbow (BBE);
  • wound dressing integrity;
  • dressing selection for patients with a BMI >35;
  • compliance with aseptic technique;
  • resources at the point-of-care;
  • hand hygiene auditing;
  • surgical skin preparation; and
  • reducing cross contamination in fully dilated women

Results:

The Bundle was implemented following the clinical review of all incidents and resulted in a reduction of C-section infections at FSH. Since March 2019, there has been one (1) infection of 204 procedures. Hand hygiene compliance has improved (from 48.8% to 72.2%).

Conclusions:

The implementation of the Bundle has helped to significantly reduce the number of SSI and readmissions. Through a quality initiative cycle, the Bundle has been used to improve clinical practice; positively influence staff behaviours; and better health outcomes for the patient and their family.


Biography:

Brendon Heley is a passionate Infection Prevention nursing with a keen interest in patient safety. He is currently the Clinical Nurse Specialist for Infection Prevention and Staff Health at Fiona Stanley Hospital. He is a member of the ACIPC Education and Professional Development Committee.

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