Manager Surgical Services Northwestern Medicine West chicago, Illinois, United States
Disclosure(s):
Lisa M. Lehner, RN, MSN, CNOR: No financial relationships to disclose
Description:
Background: In FY22, 6 publicly reported colon surgical site infections were identified at Delnor hospital, which is double the projected/expected amount of 3. Baseline data shows that more of the non-elective cases developed an SSI than the elective cases
Methods: Multidisciplinary team reviewed literature for best practices on non-elective bundles for colon surgeries. The literature review was shared with the hospital's SSI prevention committee with includes senior leadership and surgeons. Following the literature review no best practice was identified. Leading the team to use the previous knowledge and positive outcomes of SSI reduction and the implementation of a bundled protocol approach in the elective colon patient population; could this same bundle approach be implemented in the non-elective population. The elective bundle was reviewed and modified to be a Non-Elective Enhanced Recovery Protocol (NEERP) 13 element bundle for urgent cases and a 11 element bundle for emergent cases. A scorecard was created to be shared amongst the team with the elements and performance data on it. This data was shared monthly with the team.
Results: Since the implementation of NEERP Publicly reported colon surgical site infections went from 6 in FY22 to 0 FYTD23 and went 662 days without a colon SSI
Conclusion: The keys to success included: - Evaluating stakeholders and having a multi-disciplinary team participate in the project - Implementing previous protocols for our elective patients to our urgent emergent patient population - Analyzing and improving outcomes - Implementing robust communication with all involved - Disseminating the data obtained
