1460. A Reduction in Craniotomy Surgical Site Infections at an Academic Teaching Facility
Session: Poster Abstract Session: HAI: Surgical Site Infections
Friday, October 28, 2016
Room: Poster Hall
Posters
  • CRAN poster.pdf (234.1 kB)
  • Background:

    Surgical site infections (SSI) account for 31% of all hospital acquired infections (HAI). Surgical site infections due to craniotomies are associated with significant patient morbidity, as they often require surgical intervention and prolonged antibiotics. The unadjusted observed number of Craniotomy (CRAN) infections for our facility in calendar year (CY) 2011 was almost twice the expected number according to National Healthcare Safety Network (NHSN) benchmarks.

    Methods:

    SSI surveillance was conducted for 100% of CRAN procedures according to NHSN definitions. Denominators were identified via a monthly report distributed by the Operating Room (OR) and were subjected to surveillance by a certified Infection Preventionist. Identified events were validated by the Hospital Epidemiologist. All events and associated microbiology were reviewed for trends in infection criteria which prompted focused attention on pre-operative disinfection and post-operative wound care. The Infection Prevention team partnered with the Neurosurgery (NUS) department to assess current standards of care and conduct OR observations. Interventions included the addition of Chlorhexidine Gluconate shampoo pre-operatively, increased area of pre-operative hair removal, coverage of incision with post-operative dressing beyond 24 hours, patient education on hand hygiene before dressing removal, and improved post-operative wound hygiene.

    Results:

    The standardized infection ratio (SIR) for CRAN SSI in CY11 was 1.99. The bacteriology of these infections were primarily skin flora, specifically

    Conclusion:

    After clinical and epidemiologic review of CRAN SSI events we determined the most likely cause of our infections to be related to the surgical wound preparation and post-operative care. After implementation of a customized set of wound management interventions, a decrease was observed and sustained for two years. The success of these interventions highlights the importance of hair removal and wound care, as well as the need for a multidisciplinary assessment and multi-factorial approach to reduce CRAN SSI’s.

    Kerri Huber, RN, MSN, CIC1, Alfredo Quinones-Hinojosa, MD2, Judy Huang, MD2 and Geeta Sood, MD2, (1)Infection Prevention, Johns Hopkins Bayview Medical Center, Baltimore, MD, (2)Johns Hopkins University School of Medicine, Baltimore, MD

    Disclosures:

    K. Huber, None

    A. Quinones-Hinojosa, None

    J. Huang, None

    G. Sood, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.