High rate of surgical site infections in maternity and surgical wards of Kigeme District Hospital

Abstract

Surgical site infection is a type of healthcare-associated infection in which a wound infection occurs after an invasive (surgical) procedure. SSIs are associated with increased duration of hospital stay, increased cost of care and increased mortality. The majority of surgical site infections are preventable.. A quality improvement project was established by using strategic problem solving approach to reduce SSI in Maternity and surgical wards of Kigeme district hospital, Rwanda. The aim of this study was to reduce the rate of surgical site infections in Maternity and Surgical wards of Kigeme District Hospital from 6.7% to 3% from January 2017 to March 2017. A pre post intervention study design was utilized in this project to evaluate the effect of the intervention. An intervention was designed and implemented and the collected data were tabulated using Microsoft Excel. Chi Square tests were used to compare the pre- and post-intervention SSI rate. All data analysis was completed using SPSS v.20 statistical software at a significance level of P≤0.05. Results: The intervention (physically separation of five areas in CSSD, Training of CSSD staff) reduced the incidence rate of SSI from 6.7% to 2.3% (<0.001) with a percentage difference of 4.4% (P<0.001). The study was demonstrated elegantly as success due to many factors including the collaboration of the hospital senior management team and concerned departments. In summary, reducing cross contamination in CSSD by separating areas is a crucial intervention and based on the results, it is feasible in a low-resource setting to establish a successful SSI surveillance using strategic problem solving approach. Longer term follow up of the intervention and team approach are needed to understand the sustainability.