A Development of Guidelines for Prevention of Surgical Site Infection after Cardiac Surgery
Keywords:
Surgical site infection, prevention of infection guidelines, cardiac surgeryAbstract
Objective: of the study was to develop guidelines for prevention of surgical site infection after cardiac surgery in a tertiary care center hospital.
Methods: This was a participatory action research study conducted in a tertiary care center hospital. They were 27 staffs in multidisciplinary team, 90 patients with heart surgery and 84 relatives, a total of 201 participants. The study conducted from January to September 2017, divided into 4 phases: Phase 1: studying the situation of risk factors of infection, wound care and postoperative care after heart surgery; Phase 2: presenting the situation and identifying guidelines; Phase 3: implementing of the guidelines at Cardiovascular-Thoracic Surgical Intensive Care Unit and Phase 4: making conclusion and evaluation. The tools used in the study were 1) data recording form of situation, 2) observation form for care practice, 3) satisfaction questionnaire and 4) demographic data form. Data were collected by observation, inquiry, brainstorming and answering a questionnaire. Percentage, mean, standard deviation and content analysis were used to analyze data.
Results of the study displayed a guidelines for prevention of surgical site infection after Cardiac surgery consisted of 8 items; 1) data of wound transferring each shift, 2) wound care and evaluation, 3) wound dressing with 2% chlorhexidine in 70% alcohol, 4) applying chest band, 5) controlling of blood sugar, 6) providing health education, 7) Surgical site infection surveillance, and 8) using registered nurse for evaluation. Percentage of guidelines compliance was 92 percent. Personnel satisfaction at a high level was 100 percent and patient and family satisfaction at a high level was 90 percent. Surgical site infection rate was reduced from 0.75 in 2016 to 0.41 in 2017. Accordingly, guidelines for prevention of surgical site infection could help reduce surgical site infection after cardiac surgery in Cardiovascular and Thoracic Intensive Care Unit.
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