Achieving Zero Coronary Artery Bypass Graft Surgical Site Infections for over Four Years: Our Experience Utilizing Bundle Elements, Education, and Audits

Abstract

Background: Surgical site infections (SSI) are expensive and potentially deadly infections; however, with evidence-based infection prevention techniques many can be prevented. The purpose of this quality improvement project is to describe our hospital’s experience achieving zero coronary artery bypass graft (CABG) deep incisional and organ/space SSI incidences from October 2016-July 2021. Methods: To prevent CABG deep incisional and organ/space SSI incidences our Infection Prevention and Epidemiology Department along with the Cardiothoracic and Vascular Surgery Department established SSI prevention bundle elements, continuous education, and monthly audits. Results: From quarter one of 2015 through quarter three of 2016 there were three deep incisional or organ/space SSI cases out of 317 CABG procedures. From quarter four of 2016 through quarter two of 2021 there have been 625 CABG procedures, zero of which developed into deep incisional or organ/space SSI incidences. CABG SSI prevention bundle element compliance ranged from 88.2% to 99.6% and operating room environment of care compliance was 94%. Conclusion: Our results show overall improvements in our quarterly CABG SSI SIR from quarter one of 2015 to quarter two of 2021. This experience demonstrates the importance of complying with SSI prevention bundle elements, education, and auditing in reducing and maintaining zero CABG deep incisional and organ/space incidences for over four years.