Abstract
The COVID-19 pandemic has forced neurosurgeons to adapt in the face of an unforeseen crisis, including reevaluating an important aspect of neurosurgical practice: surgical infection control and prevention. Before COVID-19, surgical site infections (SSI) remained a costly and burdensome issue within neurosurgery and the medical field at-large. Furthermore, as options for linking payment to quality of care and mandatory reporting of SSI expands, cranial and spine surgery can expect to face increased oversight and pressure in efforts to reduce SSI. The risk of COVID-19 transmission to both patients and healthcare workers has inspired rigorous attention to inspection control practices. Therefore, at our institution we have applied the momentum gained introducing new infection control practices and procedures to prevent of COVID-19 transmission to the adoption of a surgical infection control bundle. We describe our implementation spanning screening and selection of patients for surgery, intraoperative precautions, postoperative care, and systems for monitoring and feedback.
Highlights
The COVID-19 pandemic has forced neurosurgeons to adapt in the face of an unforeseen crisis
At our institution, located in New York City, the United States COVID-19 epicenter, we have applied the momentum gained introducing new infection control practices and procedures to prevent of COVID-19 transmission to the adoption of a surgical infection control bundle (Table 1)
We describe our implementation spanning screening and selection of patients for surgery, intraoperative precautions, postoperative care, and systems for monitoring and feedback
Summary
The COVID-19 pandemic has forced neurosurgeons to adapt in the face of an unforeseen crisis. SSI are associated with significant cost and morbidity, and this burden is increasing in the United States [13] This is increasingly untenable in a pandemic era amidst increased scarcity of resources and elevated risk to patients associated with every healthcare encounter. At our institution, located in New York City, the United States COVID-19 epicenter, we have applied the momentum gained introducing new infection control practices and procedures to prevent of COVID-19 transmission to the adoption of a surgical infection control bundle (Table 1). Implementation of a SSI control bundle has been previously shown to potentially reduce neurosurgery and spine SSI [16,17,18,19,20,21,22,23,24] This effort requires a multi-disciplinary approach involving OR nurses and staff, anesthesia, infection control, and neurosurgeons. Mitigation of controllable risk factors Patients are advised and encouraged on steps to (e.g., DM control, smoking cessation) control modifiable risk factors
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