By Sara Bondell - August 27, 2020
With any surgery, there are always risks. One of the main risks a patient has to consider is infection.
At Moffitt Cancer Center, the Infection Prevention and Control Department tracks infection rates in certain surgical procedures and looks for areas for improvement. The department recently set its sights on reducing the amount of surgical site infections after a hysterectomy.
“We did a review of each case of infection in patients to see what was going on,” said Director of Infection Prevention Stacy Martin. “Are we giving correct antibiotics? Are we redosing correctly? Are patients getting too cold in the operating room? Then we identified a few practice issues we could improve upon.”
The team decided to roll out what is called a prevention bundle, a number of new practices at once. The bundle included things like having patients take a preoperative shower with a special soap bath, changing how surgeons disinfect the incision site, standardizing antibiotics and regulating the temperature in the operating room.
“All of these things together resulted in a reduction of surgical site infections,” said gynecologic oncologist Sachin Apte. “Because it is a bundle where multiple changes were made at the same time, we won’t know specifically which item created the biggest impact. What is most important is that we were able to achieve an overall reduction in infection.”
Some of the results were published in the International Journal of Gynecological Cancer, showing the dual antibiotic bundle given to patients before, during and after surgery decreased surgical site infections after a hysterectomy by 58%.
The antibiotic bundle combined with the other practice changes decreased infections even more.
“We went to having no infections for quite some time,” said Martin. “Every now and then we will have one, but it has become abnormal now to have an infection.”
The changes made were at little to no cost to the hospital, yet had a dramatic impact on morbidity and hospital readmission. It was also a great example of teamwork among gynecologic oncologists, Infection Prevention and Control, Nursing and Pharmacy.
“It was a great example of how we could bring a multidisciplinary group in to review the process from a patient first coming to clinic before surgery all the way to the patient being discharged and follow-up,” said Martin. “By bringing the group together we were able to identify several areas to make improvements.”
The team is now looking to see if it can transfer some of these practice changes to other areas, such as colon cancer surgery.