Reduction of Surgical Site Infections Following Spinal Fusion Procedures Through Implementation of Bundled Interventions

The neurosurgery service at this Level I trauma center had experienced high rates of surgical site infections (SSIs) for several years. From January 2013 to December 2014, the SSI rate associated with spinal fusion surgery was 11.40 infections per 100 procedures, while the national average was about 1.54 infections per 100 procedures. The goal of this project was to lower the hospital's rate of SSI following spinal fusion procedures by using a bundled approach that incorporated several intervention strategies known to help prevent and lower the risk of SSIs.

The bundle consisted of 19 interventions, which included specific processes during the preoperative clinic visit, the procedure in the operating room (OR) and the patient's postoperative inpatient stay. The bundle was reviewed with clinic, OR and inpatient nursing staff. Infection control staff collected bundle sheets on a weekly basis to monitor compliance.

Through the first three months of bundle implementation, the neurosurgery service did not record a single SSI, resulting in a rate of 0.00 infections per 100 procedures.

This case study is part of the Illinois Health and Hospital Association's annual Quality Excellence Achievement Awards. Each year, IHA recognizes and celebrates the achievements of Illinois hospitals and health systems in continually improving and transforming health care in the state. These organizations are improving health by striving to achieve the Triple Aim—improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of health care—and the Institute of Medicine's six aims for improvement—safe, effective, patient centered, timely, efficient, and equitable. To learn more, visit https://www.ihaqualityawards.org/javascript-ui/IHAQualityAward/