Using Evidence-Based Practice to Prevent Surgical Site Infections

Surgical site infection (SSI) can arise following surgery in the area of the body where a surgical procedure occurs. This direct practice improvement (DPI) project applies evidence-based practice (EBP) interventions from recommendations promulgated by the Association of periOperative Registered Nurses (AORN) through education and surveillance of environmental cleaning at an acute care hospital in California to address the increasing rate of SSIs among hip and knee arthroplasty patients. The project consists of retrospective existing/pre-intervention SSI data rates, EBP interventions and post-intervention SSI data rates to determine if a relationship exists. The purpose of this descriptive and correlational project is to replace the current cleaning practice with EBP cleaning practices for hip and knee arthroplasty patients to improve patient outcomes. Total knee and hip arthroplasties are highly susceptible to SSIs due to prosthetic implantation. Bioburden can be left behind when the surgical team demonstrates poor cleaning practices. Adequate cleaning entails appropriate elimination of these pathogens to reduce the risk of infection. Iowa model framework helps to promote quality patient care through collaboration in relation to environmental cleaning. Analysis through t-Test and ANOVA correlation tests compare retrospective existing infection rates to post-intervention SSI rates to test statistical significance. Total number of knee arthroplasties (N = 52) yielded a statistically significant difference between pretest and post-intervention test ( F = 5.95; p = .059). The mean for post-intervention test is lower (M = 52.00) than the pretest (M = 100.17). The analysis indicates that the cleaning intervention was successful in reducing the total number of SSIs for knee arthroplasties.