Antisepsis for Cesarean Patients with Body Mass Indices Greater Than 35

Abstract Surgical site infections (SSIs) are one of the risks of cesarean deliveries (CDs) that increase with the severity of obesity. Skin antisepsis protocols are an integral part of preventing SSIs. Due to the lack of definitive evidence in the literature, health care facilities have little guidance about which skin antiseptic agents to select to decrease CD SSIs. The project’s purpose was to use a quantitative methodology to determine whether a skin antiseptic of aqueous povidone iodine followed by 2% chlorhexidine gluconate with 70% isopropyl alcohol was more effective than the standard antiseptic protocol used in the host hospital to minimize CD SSIs among women with body mass indices (BMIs) greater than 35. This quality improvement project, “Antisepsis for Cesarean Patients with Body Mass Index Greater Than 35,” used a practice approach based on Rosswurm and Larrabee’s (1999) model. The project involved an education session, awareness campaign, and retrospective electronic health record reviews of patients undergoing nonemergent CDs four months before and after the implementation of the new intervention skin protocol. The findings of the QI project did not reveal a statistically significant reduction in minimizing CD SSI when comparing the historical protocol versus the interventional protocol. There was a decrease in the CD SSI rate from 12% before the intervention to 8% after the intervention. The host hospital continues to monitor the new skin antiseptic protocol while analyzing and collecting additional data. More research is needed to determine the most effective skin antisepsis for CD patients with BMIs greater than 35. Keywords: cesarean delivery, BMI, skin antisepsis, surgical site infection

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Work Title Antisepsis for Cesarean Patients with Body Mass Indices Greater Than 35
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Penn State
Creators
  1. Cathleen Louise Dillen
Keyword
  1. DNP Project
  2. skin antisepsis
  3. cesarean delivery
  4. BMI
  5. surgical site infection
License Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
Work Type Project
Acknowledgments
  1. Lori Lauver PhD, RN, CPN, CNE
  2. Kelly A. Wolgast DNP, RN, FACHE, FAAN
  3. Lorah Dorn PhD, CPNP
  4. Michael Evans, PhD, RN
Publication Date 04/18/2018
Subject
  1. Cesarean Delivery Surgical Site Infections
Language
  1. English
DOI doi:10.18113/S1H93D
Deposited April 18, 2018

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