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Smash Surgical Site Infections

Methodist Hospital Metropolitan (San Antonio, Texas)

CSI Summary

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CSI Presentation

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CSI Toolkit

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Added to Collection

Project Topic:

Decreasing surgical site infections (SSIs)

Hospital Unit(s):

Perioperative Services
Medical Surgical Unit (Med-Surg)

CSI Participants:

  • Rhonda Garcia, BSN, RN
  • Jesus Martinez, BSN, RN, EMT-P
  • Nicole Miljak, MBA, MSN, RN, CNOR
  • Sandra Ortiz, ADN, RN, CST
  • Alicia Wilson, BS, RN, CCM

Project Goals/Objectives:

  1. Revise colorectal bundle to decrease SSIs using established evidence-based guidelines
  2. Create a hysterectomy bundle to reduce SSIs
  3. Reduce SSI occurrences 80%
  4. Achieve a rate of 1.0 or less using the standardized infection ratio (SIR)

Project Outcomes:

  1. Completed revision of the colorectal bundle
  2. Completed creation of a hysterectomy bundle
  3. Decreased the number of SSIs 44%
  4. Reduced the SIR for SSIs to less than 1.0
  5. Implemented strong working relationships with the Infection Prevention team
  6. Presented updated colorectal bundle for SSIs at a wound care convention, generating requests from other hospitals to adopt the bundle at their facility
  7. Submitted a project poster abstract that was accepted for presentation at the Association of periOperative Registered Nurses (AORN) 2024 conference
  8. These outcomes resulted in an estimated annual fiscal impact of $225,752 with a return on investment of 1,048%.

Project Overview:

Surgical site infection rates for colorectal procedures and hysterectomies were higher than average in our hospital’s Perioperative Services and Medical Surgical units. To address this issue, our CSI team first reviewed the existing bundle for colorectal SSI prevention. We decided to revise the bundle to align with current evidence-based best practices documented in nursing literature and with collaborative input from physicians. We then used the same process to develop a bundle for hysterectomy SSI prevention.

We introduced our SSI prevention project to staff in our Perioperative Services and Med-Surg units at educational kickoff events that featured food and a giveaway for a logo badge reel. After the initial kickoff events, the CSI team leveraged unit-level shared governance meetings to educate nurses on the new and updated bundles. We then partnered with the Infection Prevention department to collect data in a joint effort to monitor the progress of our efforts to decrease SSIs.

Once the colorectal and hysterectomy bundles were tested and refined, our CSI team coordinated with our health system’s Education department to create a learning system management (LMS) module on SSI prevention for use with new hires and at annual competency training.

Ultimately, this initiative decreased SSIs in our units 44%, yielding a projected annual fiscal savings of $225,752 and a 1,048% return on investment.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.