American journal of infection control · 2025
Reduction in immediate use steam sterilization associated with reduction in surgical site infections.
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Jaffe Jennifer, Merz Linda, McMullen Kathleen
Аннотация
BACKGROUND: Immediate use steam sterilization (IUSS) is a potential risk factor for surgical site infection (SSI). A quality improvement project to reduce IUSS was implemented at a single hospital after a regulatory survey noted excessive use.
METHODS: Components of the project included 3 signatures for every cycle of IUSS; Ordering of additional trays; removal of ability of surgery personnel to perform IUSS; reduction in number of IUSS sterilizers from 8 to 1. The project was fully implemented in December 2019. No other changes were made that were anticipated to impact orthopedic SSI rates.
RESULTS: There was no IUSS use after November 2019. Prior to the project, there were 9 hip SSI (rate = 0.54 per 100 procedures) and 14 knee SSI (rate = 0.49). After the project, hip SSI decreased by 76% (2 SSI, rate = 0.13, P = <.05) and knee SSI decreased by 18% (7 SSI, rate = 0.41, P = .67).
CONCLUSIONS: A multidisciplinary quality improvement project was successful at drastically reducing the use of IUSS, and a correlating statistically significant decrease in hip SSI and clinically significant decrease in knee SSI was seen for 3 years after the project was completed.
METHODS: Components of the project included 3 signatures for every cycle of IUSS; Ordering of additional trays; removal of ability of surgery personnel to perform IUSS; reduction in number of IUSS sterilizers from 8 to 1. The project was fully implemented in December 2019. No other changes were made that were anticipated to impact orthopedic SSI rates.
RESULTS: There was no IUSS use after November 2019. Prior to the project, there were 9 hip SSI (rate = 0.54 per 100 procedures) and 14 knee SSI (rate = 0.49). After the project, hip SSI decreased by 76% (2 SSI, rate = 0.13, P = <.05) and knee SSI decreased by 18% (7 SSI, rate = 0.41, P = .67).
CONCLUSIONS: A multidisciplinary quality improvement project was successful at drastically reducing the use of IUSS, and a correlating statistically significant decrease in hip SSI and clinically significant decrease in knee SSI was seen for 3 years after the project was completed.