Major articleEducational intervention, revised instrument sterilization methods, and comprehensive preoperative skin preparation protocol reduce cesarean section surgical site infections
Section snippets
Methods
The University of Minnesota Medical Center, Fairview, is a teaching hospital with 1868 licensed beds. At the time of the intervention in this facility, the historical rates of SSI after C-section were from 1% to 8%, which is higher than the benchmarks set by the National Nosocomial Infections Surveillance System index (NNIS index). Of note, at the time of this intervention, the NNIS provided our benchmarks; however, benchmarks are now provided by the National Health Safety Network. In response
Sample size
With data from over 400 procedures in each time period, there was adequate statistical power to detect an absolute difference of more than 4.5% as statistically significant with an α level of 5% and a β level of 20%.
Statistical analysis
The χ2 test was used to assess the change in the SSI rate from 2006 to 2007. Counts per procedures were presented as the SSI rates. In addition, the test statistics and P values were reported. A P value less than or equal to an α level of .05 was considered statistically significant.
Discussion
Interventions, including staff education, use of CHG no-rinse cloths for preoperative skin preparation, CHG with alcohol for intraoperative skin preparation, and appropriate instrument sterilization management, led to a significant reduction in SSI rates in patients undergoing C-section at our institution. Of note, the incisional infection rate fell to 0 immediately after initiating use of the 2% CHG no-rinse cloth skin preparation protocol in August of 2006. We also noted a rapid reduction in
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2016, Nursing for Women's HealthCitation Excerpt :Education for health care staff and for women and their families was a common theme among interventions discussed in the literature. Some studies implemented education for medical personnel on aseptic and scrub techniques in the operative environment (Rauk, 2010; Salim et al., 2011), whereas others emphasized how providing health education to women before the procedure played a role in reducing SSIs (Ng et al., 2013; Riley et al., 2012). Streamlined postpartum education integrated during the hospital stay and reinforcement of individualized discharge education also was found to improve outcomes for women (Buchko, Gutshall, & Jordan, 2012).