原创力文档reduction of surgical site infections after implementation of a bundle of care减少手术部位感染后一束护理的实施.pdfVIP
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reduction of surgical site infections after implementation of a bundle of care减少手术部位感染后一束护理的实施
Reduction of Surgical Site Infections after
Implementation of a Bundle of Care
1 1 1 2 3
Rogier M. P. H. Crolla , Lijckle van der Laan , Eelco J. Veen , Yvonne Hendriks , Caroline van Schendel ,
Jan Kluytmans2,4*
1 Department of surgery, Amphia Hospital, Breda, The Netherlands, 2 Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, The Netherlands,
3 Operating Theatre, Amphia Hospital, Breda, The Netherlands, 4 Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam,
The Netherlands
Abstract
Background: Surgical Site Infections (SSI) are relatively frequent complications after colorectal surgery and are associated
with substantial morbidity and mortality.
Objective: Implementing a bundle of care and measuring the effects on the SSI rate.
Design: Prospective quasi experimental cohort study.
Methods: A prospective surveillance for SSI after colorectal surgery was performed in the Amphia Hospital, Breda, from
January 1, 2008 until January 1, 2012. As part of a National patient safety initiative, a bundle of care consisting of 4 elements
covering the surgical process was introduced in 2009. The elements of the bundle were perioperative antibiotic prophylaxis,
hair removal before surgery, perioperative normothermia and discipline in the operating room. Bundle compliance was
measured every 3 months in a random sample of surgical procedures.
Results: Bundle compliance improved significantly from an average of 10% in 2009 to 60% in 2011. 1537 colorectal
procedures were performed during the study period and 300 SSI (19.5%) occurred. SSI were associated with a prolonged
length of stay (mean additional length of sta
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