"The CUSP program is unique because it focuses on the frontline providersthe nurses and the medical techs taking care of the patients day to dayand it gives them the power to identify and fix defects in the operating room. A key component of the program is a hospital executive is part of the team to help overcome barriers and reiterate the importance of the work," Dr. Wick said.
For the study, the CUSP team identified four defects in their surgical care: antibiotic selection and dosing, skin preparation, maintenance of normal body temperature, and intra-operative sterile technique. All defects surfaced from querying frontline providers.
Further, to evaluate the association between the CUSP intervention and postoperative SSIs, the researchers studied patients undergoing colorectal operations over a two-year period. They used one year of pre- and post-CUSP intervention SSI rates from the ACS Procedure Targeted Module, which collects outcomes data on high-risk procedures such as colectomies (surgical excision of the colon) and proctectomies (surgical excision of the rectum).
The study included 278 colorectal surgery patients in the 12-month preintervention period and 324 patients in the 12-month postintervention period. Patient risk factors were similar in both groups. In one year, researchers found that the overall SSI rate fell from 27.3 percent to 18.2 percent, a notable reduction of 33 percent in this high-risk patient population.
"Changes evolved over one year it was not a bundle, it didn't happen all at once. Therefore, it's hard to figure out what specifically led to our wound infection reduction. But interestingly, as soon as we got this team together and engaged, our wound infection rate dropped," Dr. Wick observed. Based upon the post-CUSP implementation SSI rate, the study authors estimate that 28 infections were prevented during the study period, and that the CUS
|Contact: Sally Garneski|
American College of Surgeons