Date of Graduation
Project/Capstone - Global access
Master of Science in Nursing (MSN)
School of Nursing and Health Professions
Problem: Colorectal surgery is a procedure with one of the highest surgical site infection (SSI) rates; therefore, necessary efforts were implemented to reduce harm (Harris, 2018). Approximately 60% of these surgical infections are preventable (Ban et al., 2017). SSIs can have severe consequences, including extended length of stay, high morbidity and mortality rates, delayed recovery, and high healthcare costs (Harris, 2018). The financial burden of SSI is substantial.
Context: This project aimed to explore opportunities for enhancing patient engagement and awareness of SSI preventive measures. After an extensive microsystem analysis, a knowledge gap in patient education on preoperative colorectal SSI prevention strategies was identified. Patients and their families need to take an active role in reducing SSI risk to improve their surgical outcomes (Park & Giap, 2019).
Interventions: Preventive education will drive patients to seek greater understanding or awareness of their surgical journey and their willingness to take steps on their own to prevent harmful events. Educational tools and preoperative phone calls were developed to improve patient engagement in their surgical care. These tools target patient education on 2% chlorhexidine gluconate (CHG) bathing, umbilicus hygiene, and SSI prevention to promote patient engagement in SSI prevention.
Measures: The outcome measure for this project is to reduce the National Surgical Quality Improvement (NSQIP) risk-adjusted ratio of colorectal SSI from 1.23 to 1.0 by October 2020. The first process measure is to improve CHG skin preparation compliance to 95% or higher. The secondary process measure is qualitative interviews with colorectal surgical patients using pre- and post-intervention questionnaires. The balancing measure is patient satisfaction scores collected from the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems.
Results: From May 2020 to October 2020, the NSQIP risk-adjusted ratio of colorectal SSIs decreased from 1.23 to 0.9. The overall colorectal SSI rates were reduced by 2.2%. In total, 100 colorectal surgical patients completed the questionnaires from August 2020 to October 2020. The pre-intervention questionnaires demonstrated an immediate need to improve SSI education in colorectal surgical patients. The results from Post-intervention data on the implementation of patient engagement and education on SSI prevention can influence positive change. After implementing staff education, CHG skin preparation compliance rates increased to 98%. Patient overall satisfaction scores increased from 75% to 85% from May 2020 to October 2020.
Conclusions: As the role of patient engagement in the context of surgical care continues to evolve, the importance of patient education and sustainable engagement will become increasingly important. Patient engagement and education on SSI prevention is the first step towards impacting outcomes. Integrating patient participation within prevention measures for SSI is imperative. Ultimately, patient engagement aims to improve patient outcomes and reduce the risk of SSIs following colorectal surgery.
Strieff, Vanessa, "Patient Engagement: A Key Concept to Surgical Site Infection Reduction in Colorectal Patients" (2020). Master's Projects and Capstones. 1445.