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Translating Evidence Into Practice: Implementing MRSA Screening and A Surgical Site Infection Bundle in A Level I Pediatric Trauma Center
Susan Weaver, CNS, Roberta Schofield, CNS, Richard W. Kruse, DO, MBA. AI Dupont Hospital for Children, Wilmington, DE, USA.

Background: Methicillin resistant Staphylococcus (MRSA) infections in trauma patients have been associated with increased hospital and intensive care length of stay, and poorer outcomes. Reduction of surgical infection (SSI) is a nationwide patient safety priority. To outline a clinical and research initiative to decrease pediatric surgical site infection through implementation of an SSI prevention bundle.

Methods: An inter-professional taskforce reviewed best practice to develop bundle elements. An educational plan was outlined and implemented led by Clinical Nurse Specialists. Real time compliance with bundle elements was audited. these elements included MRSA screening, identification of planned surgical implants, chlorhexidine pre-surgical scrub, appropriate prophylactic antibiotic delivery. When noncompliance occurred, clinicians were immediately provided with direct feedback.

Results: Within 3 months of implementation 100% compliance was achieved and overall surgical site infection dropped from 2.8% to 1.5%.

Conclusions: Successful implementation of the SSI bundle required meticulous oversight. The Clinical Nurse Specialist is uniquely qualified to provide leadership in such initiatives because of their focus on research utilization, system improvement, education, and outcomes. We outline the pathways used and the lessons learned.


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