An Interproffesional Collaboration to Identify Areas of Potential Risk in Women Having Cesarean Surgery

Purpose:
To improve outcomes and enhance patient safety, through a decrease in cesarean infections occurring within 30 days of the procedure.We hoped to standardize processes in the peri-operative, intra-operative, and post-operative care taken from evidence based medicine of obstetrical surgical patients.

Significance:
Patient safety is paramount in our institution as we are on a journey to become a high reliability organization. C-section infections increase length of stay, increase post operative complication risks, decrease patient satisfaction and leave new moms with a poor perspective on our hospital.

Strategy and Implementation:
A interprofessional collaboration working group was convened that included obstetrical surgeons, peri-operative nurses and managers, anesthesia, central processing, labor and delivery unit personnel, and Infection Prevention. The group performed an in depth literature search, analyzed a variety of current processes, and institutional infection data. As a result, the group identified areas for improvement and began to implemented 4 key initiatives in an effort to decrease c-section infections. These initiatives included: 1) OR staff training on the basics of aseptic technique, maintaining sterility, and standardization of skin site preparation; 2) implementation of a chlorhexidine gluconate (CHG)-based skin antiseptic for skin site preparation; 3) patient education for CHG bathing prior to surgery; and 4) wound care and wound care educational initiatives.

Evaluation:
Since the implementation of the program and processes we have had zero c-section infections! We have identified new staff leaders and have been able to send those leaders to specialized training given by AORN to advance their knowledge in surgical site infection prevention.

Implications for Practice:
An interprofessional collaboration initiative is effective in decreasing c-section infection rates, and as these initiatives become standard practices, low rates of infection may be successfully maintained over longer periods of time and can be easily implemented across other hospitals.