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Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery

Tanner, Judith; Kiernan, Martin; Hilliam, R.; Davey, S.; Collins, E.; Wood, T.; Ball, J.; Leaper, David

Authors

Martin Kiernan

R. Hilliam

S. Davey

E. Collins

T. Wood

J. Ball

David Leaper



Abstract

Introduction

In 2010 a care bundle was introduced by the Department of Health (DH) to reduce surgical site infections (SSIs) in England. To date, use of the care bundle has not been evaluated despite incorporating interventions with resource implications. The aim of this study was to evaluate the DH SSI care bundle in open colorectal surgery.

Methods

A prospective cohort design was used at two teaching hospitals in England. The baseline group consisted of 127 consecutive patients having colorectal surgery during a 6-month period while the intervention group comprised 166 patients in the subsequent 6 months. SSI and care bundle compliance data were collected using dedicated surveillance staff.

Results

Just under a quarter (24%) of the patients in the baseline group developed a SSI compared with just over a quarter (28%) in the care bundle group (p>0.05). However, compliance rates with individual interventions, both before and after the implementation of the bundle, were similar. Interestingly, in only 19% of cases was there compliance with the total care bundle. The single intervention that showed an associated reduction in SSI was preoperative warming (p=0.032).

Conclusions

The DH care bundle did not reduce SSIs after open colorectal surgery. Despite this, it is not possible to state that the bundle is ineffective as compliance rates before and after bundle implementation were similar. All studies evaluating the effectiveness of care bundles must include data for compliance with interventions both before and after implementation of the care bundle; poor compliance may be one of the reasons for the lower than expected reduction of SSIs.

Journal Article Type Article
Publication Date Apr 30, 2016
Journal Annals of the Royal College of Surgeons of England
Print ISSN 0035-8843
Electronic ISSN 1478-7083
Publisher Royal College of Surgeons of England
Peer Reviewed Peer Reviewed
Volume 98
Issue 4
APA6 Citation Tanner, J., Kiernan, M., Hilliam, R., Davey, S., Collins, E., Wood, T., …Leaper, D. (2016). Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery. Annals of The Royal College of Surgeons of England, 98(4), https://doi.org/10.1308/rcsann.2016.0072
DOI https://doi.org/10.1308/rcsann.2016.0072
Keywords Colorectal surgery; Surgical site infection; Care bundle; Compliance
Publisher URL https://publishing.rcseng.ac.uk/doi/10.1308/rcsann.2016.0072
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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