Surgical Site Infection Quality Improvement

Surgical site infections among perioperative patients remain a problem in the United States. These infections are one of the most common in the hospitalized patient population and cost the country billions of dollars each year. This infection and the increased cost on the healthcare system compromises the delivery of high-quality care from healthcare systems across the nation. In a Philadelphia university teaching hospital, the surgical site infection rate remained low however, upon assessment of the Perioperative Department there was a noted lack of evidence support the reason for various surgical scrubbing solutions being utilized. This quality improvement project is a randomized retrospective chart review to compare closed records of patients in the operating room to patients in the electrophysiology lab as they used different surgical skin preparation products. Patients identified in the operating room used 3M Duraprep Surgical Scrubbing Solution while patients identified in the electrophysiology lab used DB Chloraprep Surgical Scrubbing Solution. An analysis of the results demonstrated that zero patients acquired surgical site infection. Additionally, 80% of operating room procedures spend one minute on surgical scrub and in the electrophysiology lab 45% of procedures spend more than three minutes on surgical scrub. In addition to increased time surgically scrubbing, the electrophysiology lab spends more money on BD Chloraprep per applicator, when compared to the 3M Duraprep applicator in the operating room. Therefore, electrophysiology technologist resources can be used in various ways when less time is spent for sterile preparation and the department can save money on product purchases. The cost savings of these findings are equal to more than $14,000 per year. Keywords: surgical site infection, Chloraprep, Duraprep, perioperative, operating room, electrophysiology lab, patient