Pittsburgh Hospital Reports Over 80% Drop in Neurosurgical Infections

Association for Professionals in Infection Control

Readmissions, patient satisfaction scores improve through infection preventionist-led, multidisciplinary collaboration

Orlando, Fla. June 26, 2023 – When excess surgical site infections (SSIs) were detected among neurosurgery patients at University of Pittsburgh Medical Center (UPMC) Mercy in 2019, infection preventionist Katie Palladino, MPH, CPH, CIC, partnered with a hospital neurosurgeon on a multidisciplinary quality and process improvement initiative that led to a steep drop in infection rates over a two-year period. Their successful initiative is being presented at the Association for Professionals in Infection Control and Epidemiology's (APIC's) Annual Conference in Orlando Florida, June 26-28.

Palladino and the surgeon began the initiative by reviewing the path of a surgical patient -- from the first pre-op meeting to the surgery, to the patient's discharge from the hospital – observing practices and looking for opportunities where infections could arise. They also reviewed pre-surgical instructions for patients and found ways to improve information about chlorhexidine gluconate (CHG) bathing, nasal decolonization, and other important infection prevention practices.

The next step was a literature review of best practices for SSI prevention and the creation of a multidisciplinary team to engage around this initiative and determine the process measures that could be reported on a monthly dashboard.

"SSI prevention extends beyond the surgical suite – it was important for us to bring in the other groups like physical and occupational therapy, environmental services, and facilities management, so they could see their role in preventing infections, and then provide monthly updates on progress," said Palladino. "Getting patients on-board in their own infection prevention also proved to be a critical step in reducing SSIs and readmissions," she added.

Their effort resulted in an 87% drop in the surgeon-specific standardized infection ratio (SIR) from 2019 and 2021. The facility neurosurgery SIR decreased by 82% and neurosurgery-related 90-day and 30-day readmission rates decreased by 46% and 74%, respectively. Correspondingly, the hospital rating score improved from 55.9% to 60.2%. The hospital recommendation score rose from 55.4% to 62.8%.

"Surgical site infections are among the most common healthcare-associated infections," said 2023 APIC President, Patricia Jackson RN, MA, CIC, FAPIC. "UPMC Mercy's success is a testament to the power of multidisciplinary collaboration to achieve the best outcomes for patients."

The oral abstract, "Multidisciplinary Implementation of Published Surgical Site Infection Prevention Recommendations Is Associated with Improved Outcomes in Neurosurgical Patients," is being presented at 2:11 pm ET, June 26 at the APIC Annual Conference in Orlando, Fla.

About APIC

Founded in 1972, the Association for Professionals in Infection Control and Epidemiology (APIC) is the leading association for infection preventionists and epidemiologists. With more than 15,000 members, APIC advances the science and practice of infection prevention and control. APIC carries out its mission through research, advocacy, and patient safety; education, credentialing, and certification; and fostering development of the infection prevention and control workforce of the future. Together with our members and partners, we are working toward a safer world through the prevention of infection. Join us and learn more at apic.org.

APIC's Annual Conference, June 26-28, is one of the most comprehensive infection prevention conferences in the world, with programs led by experts from across the globe and attended by physicians, researchers, epidemiologists, educators, administrators, and medical technologists, with strategies that can be implemented immediately to improve prevention programs and make healthcare safer. Join the conversation on social media with the hashtag #APIC2023.

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