Patel Ushma J, Al-Niaimi Ahmed A, Parrette Kelly M, Zerbel Sara A, Barman Stephanie M, Gill Tressa, Heisler Christine A
Department of Obstetrics & Gynecology, University of Wisconsin, Madison, WI, USA.
Department of Obstetrics & Gynecology, Memorial Sloan Kettering Cancer Center, NY, NY, USA.
J Infect Prev. 2024 Jul 21:17571774241266448. doi: 10.1177/17571774241266448.
The Center for Disease Control's National Healthcare Safety Network (NHSN) reported increased Standardized Infection Ratios (SIRs) for hysterectomy at a large community hospital.
To promote a surgical site infection (SSI) prevention bundle implemented to reduce hysterectomy-associated SSI.
A multidisciplinary Workgroup implemented the Hysterectomy SSI Prevention Bundle in 2020 to enforce standardization of perioperative techniques. This study included all benign hysterectomies pre-implementation ( = 857) and post-implementation ( = 772). Per NHSN categorization guidelines, "abdominal hysterectomy" includes both open and laparoscopic routes. "Inpatient surgery" is date of discharge different from date of surgery; "outpatient surgery" is same date of discharge. "SSI" includes superficial, deep, and organ/space; "complex SSI" includes deep and organ/space. Patient demographics were categorized and evaluated for statistical significance.
After implementation of the SSI bundle, SIRs for hysterectomy were reduced to <1.0, indicating infection prevention. Reductions in SIR were significant for outpatient abdominal hysterectomy (0.868 [ = .007]), inpatient vaginal hysterectomy (0 [ < .001]), inpatient complex abdominal hysterectomy (0 [ = .040]), and inpatient complex vaginal hysterectomy (0 [ < .001]). Differences between groups were significant for increased laparoscopic and decreased vaginal hysterectomies ( < .001), increased outpatient surgeries ( < .001), and longer procedure duration ( < .001).
Implementation of an SSI prevention bundle at a large community hospital has significantly reduced SIR for inpatient vaginal hysterectomies, outpatient abdominal hysterectomies, and all inpatient complex hysterectomies.
疾病控制中心的国家医疗安全网络（NHSN）报告称，一家大型社区医院子宫切除术的标准化感染率（SIR）有所上升。
推广为降低子宫切除术相关手术部位感染（SSI）而实施的预防措施。
一个多学科工作组于2020年实施了子宫切除术SSI预防措施，以加强围手术期技术的标准化。本研究纳入了所有实施该措施前（n = 857）和实施后（n = 772）的良性子宫切除术。根据NHSN分类指南，“腹部子宫切除术”包括开放和腹腔镜手术途径。“住院手术”是出院日期与手术日期不同；“门诊手术”是出院日期与手术日期相同。“SSI”包括浅表、深部和器官/腔隙感染；“复杂SSI”包括深部和器官/腔隙感染。对患者人口统计学进行分类并评估其统计学意义。
实施SSI预防措施后，子宫切除术的SIR降至<1.0，表明预防了感染。门诊腹部子宫切除术（0.868 [P = .007]）、住院阴道子宫切除术（0 [P < .001]）、住院复杂腹部子宫切除术（0 [P = .040]）和住院复杂阴道子宫切除术（0 [P < .001]）的SIR降低具有统计学意义。腹腔镜子宫切除术增加和阴道子宫切除术减少（P < .001）、门诊手术增加（P < .001）以及手术时间延长（P < .001），组间差异具有统计学意义。
一家大型社区医院实施SSI预防措施后，住院阴道子宫切除术、门诊腹部子宫切除术以及所有住院复杂子宫切除术的SIR显著降低。
