Aiming for zero: Success of the hysterectomy surgical site infection prevention bundle Journal Article


Authors: Patel, U. J.; Al-Niaimi, A. A.; Parrette, K. M.; Zerbel, S. A.; Barman, S. M.; Gill, T.; Heisler, C. A.
Article Title: Aiming for zero: Success of the hysterectomy surgical site infection prevention bundle
Abstract: Background: The Center for Disease Control’s National Healthcare Safety Network (NHSN) reported increased Standardized Infection Ratios (SIRs) for hysterectomy at a large community hospital. Objective: To promote a surgical site infection (SSI) prevention bundle implemented to reduce hysterectomy-associated SSI. Methods: A multidisciplinary Workgroup implemented the Hysterectomy SSI Prevention Bundle in 2020 to enforce standardization of perioperative techniques. This study included all benign hysterectomies pre-implementation (n = 857) and post-implementation (n = 772). Per NHSN categorization guidelines, “abdominal hysterectomy” includes both open and laparoscopic routes. “Inpatient surgery” is date of discharge different from date of surgery; “outpatient surgery” is same date of discharge. “SSI” includes superficial, deep, and organ/space; “complex SSI” includes deep and organ/space. Patient demographics were categorized and evaluated for statistical significance. Results: After implementation of the SSI bundle, SIRs for hysterectomy were reduced to <1.0, indicating infection prevention. Reductions in SIR were significant for outpatient abdominal hysterectomy (0.868 [p =.007]), inpatient vaginal hysterectomy (0 [p <.001]), inpatient complex abdominal hysterectomy (0 [p =.040]), and inpatient complex vaginal hysterectomy (0 [p <.001]). Differences between groups were significant for increased laparoscopic and decreased vaginal hysterectomies (p <.001), increased outpatient surgeries (p <.001), and longer procedure duration (p <.001). Conclusion: Implementation of an SSI prevention bundle at a large community hospital has significantly reduced SIR for inpatient vaginal hysterectomies, outpatient abdominal hysterectomies, and all inpatient complex hysterectomies. © The Author(s) 2024.
Keywords: hysterectomy; postoperative complications; infection prevention; surgical outcomes; surgical site infection; standardized infection ratio
Journal Title: Journal of Infection Prevention
Volume: 26
Issue: 1
ISSN: 1757-1774
Publisher: Sage Publications  
Date Published: 2025-01-01
Start Page: 4
End Page: 10
Language: English
DOI: 10.1177/17571774241266448
PROVIDER: scopus
PMCID: PMC11562876
PUBMED: 39555002
DOI/URL:
Notes: Article -- Source: Scopus
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