Reducing surgical site infection following caesarean section
Helen Gregson Infection prevention surveillance nurse, Maidstone and Tunbridge Wells NHS Trust, Maidstone Hospital, Kent
Aim To set up a surgical site infection (SSI) benchmark rate for caesarean sections and improve infection rates by monitoring and implementing compliance with the guidelines produced by the National Institute for Health and Clinical Excellence (NICE).
Method A total of 2,382 patients who had undergone caesarean section at Maidstone and Tunbridge Wells NHS Trust were monitored at two obstetric sites over a two-year period. A proactive infection surveillance system was used during the patients’ hospital stay. Community midwives collected and returned post-discharge data on wound status. Patients were asked to return post-operative questionnaires 30 days after surgery, providing details of any wound problems. Compliance with NICE guidance on reducing SSIs was measured at both sites and changes were implemented accordingly.
Results Infection rates before compliance with NICE guidance from July 2008 to June 2009 ranged from 5.7% to 9.0%. After introducing the guidelines, rates of SSI at site A and site B were reduced by 3.3% and 3.8% respectively. Rates of SSI at site A were reduced further to 1.3% on introduction of the hydrofiber and hydrocolloid dressing.
Conclusion Results suggest that the hydrofiber and hydrocolloid combination dressing assists in the reduction of SSI rates following caesarean section when used in combination with the NICE guidance.
This article has been subject to double blind peer review
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