Impact of a surgical site infection bundle on cesarean delivery infection rates.

BACKGROUND

This study investigated cesarean delivery surgical site infection (SSI) rates before and after implementation of a SSI care bundle.

METHODS

A SSI bundle for cesareans was introduced in our hospital in April 2014 to reduce the SSI rate. The practices were divided into bundle elements that reflected preoperative, intraoperative, and postoperative care. We conducted a retrospective cohort study to evaluate implementation of the SSI care bundle. Women were included if they had a gestational age of at least 23 0/7 weeks and delivered a liveborn neonate(s) between 2012 and 2015. They were then divided into 2 study groups: pre-bundle and post-bundle. The primary study outcome was SSI rate. Secondary outcomes included comorbidities, perioperative factors, and SSI classification.

RESULTS

The overall incidence of cesarean SSIs during the study time period was 1.89 (76 SSIs in 4014 cesarean deliveries). The pre-bundle mean was 2.44 and decreased to 1.1 following implementation of the SSI bundle (P = .013). This represents a 221% reduction in the SSI rate. Patient demographics and pre-existing medical conditions were similar pre- and post-bundle. Compliance with bundle elements was high.

CONCLUSIONS

A significant reduction in SSI rate in cesarean deliveries was seen following implementation of an infection prevention bundle.