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Reducing post-caesarean surgical wound infection rate: an improvement project in a Norwegian maternity clinic
  1. Ole A Dyrkorn1,
  2. Marit Kristoffersen1,
  3. Mette Walberg2
  1. 1Maternity Clinic, Vestre Viken Hospital Trust, Baerum Hospital, Rud, Norway
  2. 2Infection Control Unit, Vestre Viken Hospital Trust, Baerum Hospital, Rud, Norway
  1. Correspondence to Dr Mette Walberg, Vestre Viken Hospital Trust, Baerum Hospital, 1309 Rud, Norway; mette.walberg{at}


Background During 2006 and 2007 the rate of caesarean section surgical wound infection was 17,4 % in Baerum Hospital.

Objective The objective was to reduce the incidence to below the Norwegian national level of 8 %.

Design The intervention (a quality improvement project) was implemented in September 2008. A bundle of measures were introduced. Staff from all aspects of patient flow was recruited. Cochrane literature was used as gold standard. Data registration was based upon CDC criteria. Results were based on data collected through the Norwegian national surveillance system for infections in health care, NOIS.

Study setting This Maternity clinic has about 2500 births annually and a caesarean section rate pushing 15 %.

Patient group The study was conducted on caesarean section patients registered in NOIS (2008–2010). From September 2009 data were harvested continuously.

Assessment Data were monitored as cumulative incidence rate and by statistical process control as g chart (number of surgeries between infections including a delayed moving average). Infection control staff reported results to Head of Maternity Clinic monthly.

Results The overall rate of caesarean section surgical wound infections was significantly reduced to 3,1 % (2008-2010 about 1 % in 2010). This result was demonstrated elegantly as a marked shift in process in g-chart. We found the g-chart was efficient, sensitive and simple to handle.

  • Surgical wound infection
  • caesarean section
  • infection control
  • quality improvement
  • management
  • nosocomial infections

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data available on request from the corresponding author.