scholarly journals Effectiveness of a multidisciplinary patient care bundle for reducing surgical-site infections

2018 ◽  
Vol 105 (12) ◽  
pp. 1680-1687 ◽  
Author(s):  
M. R. Weiser ◽  
M. Gonen ◽  
S. Usiak ◽  
T. Pottinger ◽  
P. Samedy ◽  
...  
Keyword(s):  
Patient Care ◽  
Surgical Site Infections ◽  
Care Bundle ◽  
Multidisciplinary Patient Care

scholarly journals Manejo da dor em punção venosa pediátrica: um pacote de medidas

2021 ◽  
Vol 11 (33) ◽  
pp. 157-168
Author(s):  
Larissa Grispan e Silva Guimarães ◽  
Natália Shinkai Binotto ◽  
Stela Faccioli Ederli ◽  
Mauren Teresa Grubisich Mendes Tacla
Keyword(s):  
Pain Management ◽  
Patient Care ◽  
Nursing Staff ◽  
Professional Growth ◽  
Management Strategies ◽  
Care Bundle ◽  
Evidence Based ◽  
Topical Anesthetic ◽  
Care Research ◽  
Before And After

Apresentar o processo de elaboração de um pacote de medidas para manejo da dor de crianças submetidas à punção venosa pela equipe de enfermagem. Pesquisa Convergente Assistencial, do tipo antes e após intervenção, realizada com a equipe de enfermagem de uma unidade pediátrica do sul do Brasil. Elaboração de pacote de medidas com seis estratégias selecionadas pela equipe de enfermagem a serem utilizadas antes e durante a punção venosa: preparo da criança e/ou acompanhante, posicionamento da criança, distração, amamentação, solução adocicada associada ou não à sucção não nutritiva e anestésico tópico. Os participantes manifestaram satisfação quanto ao modo de elaboração do mesmo, destacando a contribuição deste para seu crescimento profissional. O pacote de medidas otimizou a adoção das estratégias para manejo da dor. A Pesquisa Convergente Assistencial alicerçada na prática baseada em evidências mostrou-se adequada, visto que propiciou a aplicação de achados científicos no cenário assistencial considerando suas particularidades.Descritores: Manejo da Dor, Criança, Cateterismo Periférico, Enfermagem Baseada em Evidências. Management of pediatric venipuncture pain: a package of measuresAbstract: To present the process of elaboration of a patient care package for pain management in children undergoing venipuncture by the nursing staff. Convergent Care Research, before and after intervention, conducted with the nursing staff of a southern pediatric unit in Brazil. Patient care packege with six strategies, selected by the nursing staff, to be used before and during venipuncture: preparation of the child and/or companion, child positioning, distraction, breastfeeding, sweet-tasting solution with or without non-nutritive suction and topical anesthetic usage. The package of measures optimized the adoption of pain management strategies, highlighting its contribution to their professional growth. The patient care bundle optimized the adoption of strategies for pain management. The Convergent Care Research grounded in evidence-based practice showed appropriate, since it allowed the application of scientific findings in the care setting, considering its peculiarities.Descriptors: Pain Management, Child, Catheterization, Peripheral, Evidence-Based Nursing. Manejo del dolor de la venopunción pediátrica: un paquete de medidasResumen: Presentar el proceso de elaboración de un paquete de medidas para manejo del dolor de niños sometidos a la venopunción por el equipo de enfermería. Investigación Convergente Asistencial, del tipo antes y después de la intervención, realizada con el equipo de enfermería de una unidad pediátrica en el sur de Brasil. Paquete de medidas con seis estrategias seleccionadas por el equipo de enfermería que deben ser utilizadas antes y durante la venopunción: preparación del niño y/o acompañante, posicionamiento del niño, distracción, amamantamiento, solución dulce asociada o no a succión no nutritiva y anestésica tópica. Los participantes manifestaron satisfacción en cuanto al modo de elaboración del mismo, destacando la contribución de este para su crecimiento profesional. El paquete de medidas optimizó la adopción de estrategias para manejo del dolor. La Investigación Convergente Asistencial cimentada en la práctica basada en evidencias se mostró adecuada, visto que propició la aplicación de hallazgos científicos en el escenario asistencial considerando sus particularidades.Descriptores: Manejo del Dolor, Niño, Cateterismo Periférico, Enfermería Basada en la Evidencia.

Does preventive care bundle have an impact on surgical site infections following spine surgery? An analysis of 9607 patients

2020 ◽  
Vol 8 (4) ◽  
pp. 677-684 ◽  
Author(s):  
Rajdeep S. Bagga ◽  
Ajoy P. Shetty ◽  
Vyom Sharma ◽  
K. S. Sri Vijayanand ◽  
Rishi M. Kanna ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Preventive Care ◽  
Surgical Site Infections ◽  
Care Bundle

scholarly journals The Implementation of a Complication Avoidance Care Bundle Significantly Reduces Adverse Surgical Outcomes in Orthopedic Trauma Patients

2020 ◽  
Vol 9 (12) ◽  
pp. 4006
Author(s):  
Thomas Lustenberger ◽  
Simon Lars Meier ◽  
René Danilo Verboket ◽  
Philipp Störmann ◽  
Maren Janko ◽  
...  
Keyword(s):  
Complication Rate ◽  
Surgical Outcomes ◽  
Surgical Complications ◽  
Situational Awareness ◽  
Surgical Complication ◽  
Surgical Site Infections ◽  
Care Bundle ◽  
Trauma Patients ◽  
Complication Rates ◽  
Time Period

Background: Surgical complications are associated with a significant burden to patients and hospitals and are increasingly discussed in recent literature. This cohort study reviewed surgery-related complications in a Level I trauma center. The effect of a complication avoidance care bundle on the rate of surgical complications was analyzed. Methods: All complications (surgical and nonsurgical) that occur in our trauma department are prospectively captured using a standardized documentation form and are discussed and analyzed in a weekly trauma Morbidity and Mortality (M&M) conference. Surgical complication rates are calculated using the annual surgical procedure numbers. Based on discussions in the M&M conference, a complication avoidance care bundle consisting of five measures was established: (1) Improving team situational awareness; (2) reducing operating room traffic by staff members and limiting door-opening events; (3) preoperative screening for infectious foci; (4) adapted preoperative antibiotic prophylaxis in anatomic regions with a high risk of infectious complications; and (5) use of iodine-impregnated adhesive drape. Results: The number of surgical procedures steadily increased over the study years, from 3587 in 2015 to 3962 in 2019 (an increase of 10.5%). Within this 5-year study period, the overall rate of surgical complications was 0.8%. Surgical site infections were the most frequently found complications (n = 40, 24.8% of all surgical complications), followed by screw malposition (n = 20, 12.4%), postoperative dislocations of arthroplasties (n = 18, 11.2%), and suboptimal fracture reduction (n = 18, 11.2%). Following implementation of the complication avoidance care bundle, the overall rate of surgical complications significantly decreased, from 1.14% in the year 2016 to 0.56% in the study year 2019, which represents a reduction of 51% within a 3-year time period. Conclusions: A multimodal strategy targeted at reducing the surgical complication rate can be successfully established based on a transparent discussion of adverse surgical outcomes. The combination of the different preventive measures was associated with reducing the overall complication rate by half within a 3-year time period.

A Postoperative Care Bundle Reduces Surgical Site Infections in Pediatric Patients Undergoing Cardiac Surgeries

2019 ◽  
Vol 45 (3) ◽  
pp. 156-163 ◽  
Author(s):  
Thomas J. Caruso ◽  
Ellen Y. Wang ◽  
Hayden Schwenk ◽  
Juan Luis S Marquez ◽  
Julie Cahn ◽  
...  
Keyword(s):  
Postoperative Care ◽  
Pediatric Patients ◽  
Surgical Site Infections ◽  
Care Bundle

A Care Bundle Intervention to Prevent Surgical Site Infections After a Craniotomy

2020 ◽  
Author(s):  
Emilio Jiménez-Martínez ◽  
Guillermo Cuervo ◽  
Jordi Carratalà ◽  
Ana Hornero ◽  
Pilar Ciercoles ◽  
...  
Keyword(s):  
Propensity Score ◽  
Cox Regression ◽  
Surgical Site Infections ◽  
Care Bundle ◽  
Primary Study ◽  
Preventive Strategy ◽  
Propensity Score Model ◽  
Vancomycin Powder ◽  
Score Model ◽  
Control Study

Abstract Background Although surgical site infections after a craniotomy (SSI-CRANs) are a serious problem that involves significant morbidity and costs, information on their prevention is scarce. We aimed to determine whether the implementation of a care bundle was effective in preventing SSI-CRANs. Methods A historical control study was used to evaluate the care bundle, which included a preoperative shower with 4% chlorhexidine soap, appropriate hair removal, adequate preoperative systemic antibiotic prophylaxis, the administration of 1 g of vancomycin powder into the subgaleal space before closing, and a postoperative dressing of the incisional surgical wound with a sterile absorbent cover. Patients were divided into 2 groups: preintervention (January 2013 to December 2015) and intervention (January 2016 to December 2017). The primary study end point was the incidence of SSI-CRANs within 1 year postsurgery. Propensity score matching was performed, and differences between the 2 study periods were assessed using Cox regression models. Results A total of 595 and 422 patients were included in the preintervention and intervention periods, respectively. The incidence of SSI-CRANs was lower in the intervention period (15.3% vs 3.5%; P < .001). Using a propensity score model, 421 pairs of patients were matched. The care bundle intervention was independently associated with a reduced incidence of SSI-CRANs (adjusted odds ratio, 0.23; 95% confidence interval, .13–.40; P < .001). Conclusions The care bundle intervention was effective in reducing SSI-CRAN rates. The implementation of this multimodal preventive strategy should be considered in centers with high SSI-CRAN incidences.

The Impact of a Colorectal Care Bundle for Surgical Site Infections at an Academic Disproportionate Share Hospital With a Level I Trauma Center

2020 ◽  
Vol 86 (7) ◽  
pp. 848-855
Author(s):  
Luv N. Hajirawala ◽  
Timothy B. Legare ◽  
Simon Peter T. Tiu ◽  
Amy M. DeKerlegand ◽  
Jeffrey S. Barton ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Surgical Site Infections ◽  
Care Bundle ◽  
Limited Data ◽  
Elective Colorectal Surgery ◽  
Care Bundles ◽  
Risk Patients ◽  
Multivariable Analyses ◽  
Level I ◽  
The Impact

Objectives Colorectal care bundles for surgical site infections (CRCB-SSIs) have been shown to reduce SSIs following elective colorectal surgery (CRS). There are limited data evaluating the effect of CRCB-SSI at Academic Disproportionate Share Hospitals (ADSH) with significant rates of urgent and emergent cases. Methods A CRCB-SSI was implemented in April 2016. We reviewed medical records of all patients undergoing colon resections between August 2015 and December 2017. Patients were divided into preimplementation and postimplementation groups. The primary endpoint was the SSI rate, and the secondary endpoint included types of SSI (superficial, deep, organ space). Univariable and multivariable analyses were performed. A subset analysis was performed in elective cases. Results We analyzed a total of 417 patients. Of these, 116 (28%) and 301 (72%) patients were in the preimplementation and postimplementation groups, respectively. The rate of SSI decreased from 30.1% to 15.9% in the postimplementation group ( P = .0012); however, it was not statistically significant after adjusting for baseline differences (relative risk [RR] 0.65; 95% CI 0.41-1.02). The elective subset included 219 patients. The rate of SSI in this cohort decreased from 25% to 10.5% in the postimplementation group ( P = .0012) and remained significant following multivariable analysis (RR 0.41, 95% CI 0.19- 0.88). There were no differences in the subtypes of SSI. Discussion While the CRCB-SSI was effective in decreasing the postoperative SSI rate for elective cases, its effect on the overall patient population was limited. CRCB-SSIs are not enough to bring SSI rates to accepted rates in high-risk patients such as those seen at ADSH.

scholarly journals 702: Reduction of cesarean delivery surgical site infections using an evidence-based care bundle

2017 ◽  
Vol 216 (1) ◽  
pp. S410-S411 ◽  
Author(s):  
Margaret S. Villers ◽  
Cami H. Thomas ◽  
Chad A. Grotegut ◽  
R. Phillips Heine ◽  
Geeta K. Swamy
Keyword(s):  
Cesarean Delivery ◽  
Surgical Site Infections ◽  
Care Bundle ◽  
Evidence Based ◽  
Evidence Based Care

scholarly journals Economic impact of a care bundle to prevent surgical site infection after craniotomy: a cost-analysis study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Emilio Jiménez-Martínez ◽  
Guillermo Cuervo ◽  
Jordi Carratalà ◽  
Ana Hornero ◽  
Pilar Ciercoles ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Cost Analysis ◽  
Economic Impact ◽  
Hospital Costs ◽  
Surgical Care ◽  
Length Of Hospital Stay ◽  
Surgical Site Infections ◽  
Care Bundle ◽  
Preventive Strategy ◽  
Mean Cost

Abstract Background Surgical site infections after craniotomy (SSI-CRAN) significantly impact patient outcomes and healthcare costs by increasing length of stay and readmission and reoperation rates. However, to our knowledge, no study has yet analysed the economic impact of a surgical care bundle for preventing SSI-CRAN. The aim is to analyse the hospital cost saving after implementation of a care bundle for the prevention of SSI-CRAN. Methods A retrospective cost-analysis was performed, considering two periods: pre-care bundle (2013–2015) and care bundle (2016–2017). A bottom-up approach was used to calculate the costs associated with infection in patients who developed a SSI-CRAN in comparison to those who did not, in both periods and on a patient-by-patient basis. The derived cost of SSI-CRAN was calculated considering: (1) cost of the antibiotic treatment, (2) cost of length of stay in the neurosurgery ward within the 1-year follow up period, (3) cost of the re-intervention, and (4) cost of the implant for cranial reconstruction, when necessary. Results A total of 595 patients were included in the pre-care bundle period and 422 in the care bundle period. Mean cost of a craniotomy procedure was approximately €8000, rising to €24,000 in the case of SSI-CRAN. Mean yearly hospital costs fell by €502,857 in the care bundle period (€714,886 vs. €212,029). Extra costs between periods were mainly due to increased length of hospital stay (€573,555.3 vs. €183,958.9; difference: €389,596.4), followed by the cost of implant for cranial reconstruction (€69,803.4 vs. €9,936; difference: €59,867.4). Overall, implementation of the care bundle saved the hospital €500,844.3/year. Conclusion The implementation of a care bundle for SSI-CRAN had a significant economic impact. Hospitals should consider the deployment of this multimodal preventive strategy to reduce their SSI-CRAN rates, and also their costs.

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