Creating a Surgical Site Infection Prevention Bundle for Patients Undergoing Cesarean Delivery

We formed an interdisciplinary team to create a standardized, evidence-based protocol that would reduce cesarean delivery surgical site infection rates at our tertiary teaching facility. The Joint Commission's current implementation guide for surgical site infections, although comprehensive, does not specifically address strategies associated with the obstetric patient population. The team's approach included developing and providing patient education and preparation, standardizing prophylactic antibiotic administration, developing consistent evidence-based abdominal and vaginal preparation processes, standardizing postoperative incision care, and engaging clinical team members in process improvement. This collaboration resulted in a decrease in surgical site infection rates from 4.1% in 2014 and 5.9% in 2015 to 0.8% by the end of 2016 and 0.6% in the first two quarters of 2017. Systemizing processes initiated by the interdisciplinary team improved patient outcomes, limited readmissions, and reduced costs to the institution.