The DISINFECT Initiative: Decreasing the Incidence of Surgical INFECTions in Gynecologic Oncology

Jolyn S. Taylor, Claire A. Marten, Mark F. Munsell, Charlotte C. Sun, Kimberly A. Potts, Jennifer K. Burzawa, Alpa M. Nick, Larissa A. Meyer, Keith Myers, Diane C. Bodurka, Thomas A. Aloia, Charles F. Levenback, David R. Lairson, Kathleen M. Schmeler

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Surgical site infections (SSIs) lead to increased patient morbidity and healthcare costs. Our objective was to decrease the SSI rate following gynecologic surgery. Methods: Adult patients undergoing abdominal surgery for gynecologic malignancy or benign disease received the following: patient education; preoperative antibacterial soap; appropriate antibiotic prophylaxis; change of gloves and use of clean instruments at surgical closure; surgical dressing for 48 h; and a post-discharge phone call. The baseline SSI rate was determined retrospectively (1 April 2014–30 June 2014), while the post-intervention SSI rate was determined prospectively (16 February 2015–15 October 2015). The main outcome was the overall SSI rate with secondary outcomes, including the rate of superficial, deep, incisional and organ space infection, as well as the cost effectiveness of the bundle. Results: A total of 232 baseline and 555 post-intervention patients were included in the study. No differences were observed between the baseline and post-intervention groups with regard to median body mass index (BMI), surgical approach, receipt of preoperative chemotherapy and/or radiation therapy, and cases including bowel surgery. Overall, the SSI rate decreased significantly from baseline [12.5 %] to post-intervention [7.4 %] (odds ratio [OR] 0.56, 90 % confidence interval [CI] 0.37–0.85; p = 0.01). A 40 % decrease was noted in the rate of superficial and deep infections (9.5 vs. 5.9 %; OR 0.60, 90 % CI 0.38–0.97; p = 0.04) and SSIs after open surgery (21.4 vs. 13.2 %; OR 0.56, 90 % CI 0.34–0.92; p = 0.03). The estimated cost of the intervention was $19.26/case and the net total amount saved during the post-intervention period was $65,625 month. Conclusions: This bundled intervention led to a significant decrease in the overall SSI rate and was cost effective. The largest decreases in SSIs were in incisional infections and following open surgery.

Original languageEnglish (US)
Pages (from-to)362-368
Number of pages7
JournalAnnals of surgical oncology
Volume24
Issue number2
DOIs
StatePublished - Feb 1 2017

Fingerprint

Surgical Wound Infection
Incidence
Gynecologic Surgical Procedures
Odds Ratio
Confidence Intervals
Infection
Costs and Cost Analysis
Soaps
Antibiotic Prophylaxis
Patient Education
Bandages
Surgical Instruments
Health Care Costs
Cost-Benefit Analysis
Body Mass Index
Radiotherapy
Morbidity
Drug Therapy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

The DISINFECT Initiative : Decreasing the Incidence of Surgical INFECTions in Gynecologic Oncology. / Taylor, Jolyn S.; Marten, Claire A.; Munsell, Mark F.; Sun, Charlotte C.; Potts, Kimberly A.; Burzawa, Jennifer K.; Nick, Alpa M.; Meyer, Larissa A.; Myers, Keith; Bodurka, Diane C.; Aloia, Thomas A.; Levenback, Charles F.; Lairson, David R.; Schmeler, Kathleen M.

In: Annals of surgical oncology, Vol. 24, No. 2, 01.02.2017, p. 362-368.

Research output: Contribution to journalArticle

@article{aed06cfcb6134b8193eb9c067d7fcfe9,
title = "The DISINFECT Initiative: Decreasing the Incidence of Surgical INFECTions in Gynecologic Oncology",
abstract = "Background: Surgical site infections (SSIs) lead to increased patient morbidity and healthcare costs. Our objective was to decrease the SSI rate following gynecologic surgery. Methods: Adult patients undergoing abdominal surgery for gynecologic malignancy or benign disease received the following: patient education; preoperative antibacterial soap; appropriate antibiotic prophylaxis; change of gloves and use of clean instruments at surgical closure; surgical dressing for 48 h; and a post-discharge phone call. The baseline SSI rate was determined retrospectively (1 April 2014–30 June 2014), while the post-intervention SSI rate was determined prospectively (16 February 2015–15 October 2015). The main outcome was the overall SSI rate with secondary outcomes, including the rate of superficial, deep, incisional and organ space infection, as well as the cost effectiveness of the bundle. Results: A total of 232 baseline and 555 post-intervention patients were included in the study. No differences were observed between the baseline and post-intervention groups with regard to median body mass index (BMI), surgical approach, receipt of preoperative chemotherapy and/or radiation therapy, and cases including bowel surgery. Overall, the SSI rate decreased significantly from baseline [12.5 {\%}] to post-intervention [7.4 {\%}] (odds ratio [OR] 0.56, 90 {\%} confidence interval [CI] 0.37–0.85; p = 0.01). A 40 {\%} decrease was noted in the rate of superficial and deep infections (9.5 vs. 5.9 {\%}; OR 0.60, 90 {\%} CI 0.38–0.97; p = 0.04) and SSIs after open surgery (21.4 vs. 13.2 {\%}; OR 0.56, 90 {\%} CI 0.34–0.92; p = 0.03). The estimated cost of the intervention was $19.26/case and the net total amount saved during the post-intervention period was $65,625 month. Conclusions: This bundled intervention led to a significant decrease in the overall SSI rate and was cost effective. The largest decreases in SSIs were in incisional infections and following open surgery.",
author = "Taylor, {Jolyn S.} and Marten, {Claire A.} and Munsell, {Mark F.} and Sun, {Charlotte C.} and Potts, {Kimberly A.} and Burzawa, {Jennifer K.} and Nick, {Alpa M.} and Meyer, {Larissa A.} and Keith Myers and Bodurka, {Diane C.} and Aloia, {Thomas A.} and Levenback, {Charles F.} and Lairson, {David R.} and Schmeler, {Kathleen M.}",
year = "2017",
month = "2",
day = "1",
doi = "10.1245/s10434-016-5517-4",
language = "English (US)",
volume = "24",
pages = "362--368",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - The DISINFECT Initiative

T2 - Decreasing the Incidence of Surgical INFECTions in Gynecologic Oncology

AU - Taylor, Jolyn S.

AU - Marten, Claire A.

AU - Munsell, Mark F.

AU - Sun, Charlotte C.

AU - Potts, Kimberly A.

AU - Burzawa, Jennifer K.

AU - Nick, Alpa M.

AU - Meyer, Larissa A.

AU - Myers, Keith

AU - Bodurka, Diane C.

AU - Aloia, Thomas A.

AU - Levenback, Charles F.

AU - Lairson, David R.

AU - Schmeler, Kathleen M.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background: Surgical site infections (SSIs) lead to increased patient morbidity and healthcare costs. Our objective was to decrease the SSI rate following gynecologic surgery. Methods: Adult patients undergoing abdominal surgery for gynecologic malignancy or benign disease received the following: patient education; preoperative antibacterial soap; appropriate antibiotic prophylaxis; change of gloves and use of clean instruments at surgical closure; surgical dressing for 48 h; and a post-discharge phone call. The baseline SSI rate was determined retrospectively (1 April 2014–30 June 2014), while the post-intervention SSI rate was determined prospectively (16 February 2015–15 October 2015). The main outcome was the overall SSI rate with secondary outcomes, including the rate of superficial, deep, incisional and organ space infection, as well as the cost effectiveness of the bundle. Results: A total of 232 baseline and 555 post-intervention patients were included in the study. No differences were observed between the baseline and post-intervention groups with regard to median body mass index (BMI), surgical approach, receipt of preoperative chemotherapy and/or radiation therapy, and cases including bowel surgery. Overall, the SSI rate decreased significantly from baseline [12.5 %] to post-intervention [7.4 %] (odds ratio [OR] 0.56, 90 % confidence interval [CI] 0.37–0.85; p = 0.01). A 40 % decrease was noted in the rate of superficial and deep infections (9.5 vs. 5.9 %; OR 0.60, 90 % CI 0.38–0.97; p = 0.04) and SSIs after open surgery (21.4 vs. 13.2 %; OR 0.56, 90 % CI 0.34–0.92; p = 0.03). The estimated cost of the intervention was $19.26/case and the net total amount saved during the post-intervention period was $65,625 month. Conclusions: This bundled intervention led to a significant decrease in the overall SSI rate and was cost effective. The largest decreases in SSIs were in incisional infections and following open surgery.

AB - Background: Surgical site infections (SSIs) lead to increased patient morbidity and healthcare costs. Our objective was to decrease the SSI rate following gynecologic surgery. Methods: Adult patients undergoing abdominal surgery for gynecologic malignancy or benign disease received the following: patient education; preoperative antibacterial soap; appropriate antibiotic prophylaxis; change of gloves and use of clean instruments at surgical closure; surgical dressing for 48 h; and a post-discharge phone call. The baseline SSI rate was determined retrospectively (1 April 2014–30 June 2014), while the post-intervention SSI rate was determined prospectively (16 February 2015–15 October 2015). The main outcome was the overall SSI rate with secondary outcomes, including the rate of superficial, deep, incisional and organ space infection, as well as the cost effectiveness of the bundle. Results: A total of 232 baseline and 555 post-intervention patients were included in the study. No differences were observed between the baseline and post-intervention groups with regard to median body mass index (BMI), surgical approach, receipt of preoperative chemotherapy and/or radiation therapy, and cases including bowel surgery. Overall, the SSI rate decreased significantly from baseline [12.5 %] to post-intervention [7.4 %] (odds ratio [OR] 0.56, 90 % confidence interval [CI] 0.37–0.85; p = 0.01). A 40 % decrease was noted in the rate of superficial and deep infections (9.5 vs. 5.9 %; OR 0.60, 90 % CI 0.38–0.97; p = 0.04) and SSIs after open surgery (21.4 vs. 13.2 %; OR 0.56, 90 % CI 0.34–0.92; p = 0.03). The estimated cost of the intervention was $19.26/case and the net total amount saved during the post-intervention period was $65,625 month. Conclusions: This bundled intervention led to a significant decrease in the overall SSI rate and was cost effective. The largest decreases in SSIs were in incisional infections and following open surgery.

UR - http://www.scopus.com/inward/record.url?scp=84984612107&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84984612107&partnerID=8YFLogxK

U2 - 10.1245/s10434-016-5517-4

DO - 10.1245/s10434-016-5517-4

M3 - Article

C2 - 27573526

AN - SCOPUS:84984612107

VL - 24

SP - 362

EP - 368

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 2

ER -