Date of Graduation

Winter 12-14-2018

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Family Nurse Practitioner

First Advisor

Dr. Marjorie Barter

Second Advisor

Dr. Mary Bitner


Problem: One of the most preventable health care associated infections (HAI) is surgical site infection (SSI). Approximately sixty percent of SSI’s could be prevented. The devastation of an SSI to the patient can be catastrophic. The cost to the health care system for treating SSI’s can be substantial (Ban et al., 2017).

Context: The rate of surgical site infections has been on the increase over the past three years. The concern for the amount of harm affecting our patients was worrisome. The cost of reputation and the bottom line to the organization was recognized by senior leadership. The support from all key stakeholders was steadfast.

Intervention: An evidenced based change of practice was designed and implemented across 21 medical centers to prevent surgical site infection.

Measures: There were six process measures: The use of chlorhexidine wipes preoperatively, hair clipping outside the operating room, weight based antibiotics, normothermia, antibiotic re-dosing, surgical skin prep. An additional process measure was added half way through the project and that was smoking cessation. There was one outcome measure, surgical site infection rate.

Conclusions: The aim of the project was a 30 percent increase in compliance of the process measures. This aim was realized after the role out of the project. The reduction of SSI across all surgical lines was the proposed outcome measure. The outcome measures are expected to correlate with the increased standardization of the process measures hardwired into the nursing workflows.