Applying the quality improvement cycle to prevent cardiac surgical site infections.
Maria Aline Gomes de Oliveira, Ana Elza Oliveira de Mendonça, Rita de Cássia Azevedo Constantino and 3 others
PMID 41919818WHAT IT FOUND
A quality improvement cycle with protocol, bundle, education, adherence strategies, discharge booklet and audits coincided with surgical site infection falling from 13.59% to 6.91% and mediastinitis from 5.34% to 1.38%.
No control group, so components cannot be separated.
Key findings
01The incidence of SSI related to cardiac surgery was 13.59% in the first assessment and 6.91% after the improvement cycle.
02The incidence of postoperative mediastinitis was 5.34% in initial assessment and 1.38% in the final assessment.
03The improvement cycle applied a protocol, a bundle, team education, adherence strategies, a discharge guidance booklet and concurrent audits together.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
There was no control group, so the observed reduction cannot be separated from other changes in the hospital or time period. It was a single private hospital, and the exact number of records analysed is not stated beyond a minimum of 30. Data came from existing records, and some records were incomplete, especially for shaving method and time and antibiotic dosage. Several interventions were delivered together, so no single component can be credited with the infection reduction. Some process measures worsened or remained non-significant, including antibiotic prophylaxis compliance and preoperative stay under 24 hours.
The easy way to misread this
Do not read the fall in SSI rates as proof that one measure worked. The study changed several practices at once and had no control group, so the contribution of any single component cannot be separated.