Yusuf Erlangga, Bamps Sven, Thüer Bénédicte, Mattheussen Jan, Ursi Jean-Paul, Del Biondo Elke, de Smedt Kris, Van Paesschen Raf, Berghmans Dirk, Hofkens Kaat, Van Schaeren Jef, van Havenbergh Tony, Van Herendael Bruno
Department of Medical Microbiology, GZA Hospitals, Wilrijk, Antwerp, Belgium.
Department of Medical Microbiology, Antwerp University Hospital (UZA), University of Antwerp, Edegem, Belgium.
Neuromodulation. 2017 Aug;20(6):563-566. doi: 10.1111/ner.12555. Epub 2017 Jan 24.
To investigate the effect of a quality improvement project that resulted in an infection control bundle to reduce the number of spinal cord stimulator (SCS) infections.
The study was performed in a single center for neuromodulation from January 1, 2014, through May 31, 2016. In response to a high number of surgical site infections (SSIs) after SCS surgery, a multidisciplinary team analyzed the surgical process and developed an infection prevention bundle consisting of five items: 1) showering and decolonization for five days prior to surgery and showering in the hospital on the morning of surgery; 2) performing the SCS implantation as the first in the daily operating room (OR) program; 3) maintaining a minimal number of people in the OR; 4) providing home care nurses with a folder with SCS wound care instructions including pictures; 5) giving oral specific wound care instructions to patients. The number of infections was calculated for the baseline, implementation, and sustainability phases.
A total of 410 SCS surgeries were performed during the study period. In the preintervention phase, 26/249 (10.4%) SCS surgeries were infected. During the implementation and sustainability phase, 2/59 (3.4%) and 1/102 (1.0%) SCS surgeries were infected, respectively. The reduction in the number of infections in pre and postintervention phase was statistically significant (p = 0.003).
Multidisciplinary measures to reduce SSIs reduced the number of SCS associated infections in our study setting.
探讨一项质量改进项目的效果，该项目产生了一个感染控制综合措施以减少脊髓刺激器（SCS）感染的数量。
本研究于2014年1月1日至2016年5月31日在一个神经调节单中心进行。针对SCS手术后大量手术部位感染（SSI）的情况，一个多学科团队分析了手术过程并制定了一个由五项内容组成的感染预防综合措施：1）术前五天淋浴并进行去定植，手术当天上午在医院淋浴；2）将SCS植入作为每日手术室（OR）程序中的第一台手术；3）保持手术室人员数量最少；4）为家庭护理护士提供一个装有SCS伤口护理说明（包括图片）的文件夹；5）向患者提供口头的特定伤口护理说明。计算了基线期、实施期和可持续性阶段的感染数量。
在研究期间共进行了410例SCS手术。在干预前阶段，26/249（10.4%）例SCS手术发生感染。在实施期和可持续性阶段，分别有2/59（3.4%）和1/102（1.0%）例SCS手术发生感染。干预前后感染数量的减少具有统计学意义（p = 0.003）。
在我们的研究环境中，减少SSI的多学科措施减少了与SCS相关的感染数量。
