MARC details
| 000 -LEADER |
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| fixed length control field |
03612nam a22004217a 4500 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
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| fixed length control field |
190118s20192019 xxu||||| |||| 00| 0 eng d |
| 022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
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| International Standard Serial Number |
0029-7844 |
| 024 ## - OTHER STANDARD IDENTIFIER |
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| Standard number or code |
10.1097/AOG.0000000000003091 [doi] |
| 040 ## - CATALOGING SOURCE |
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| Original cataloging agency |
Ovid MEDLINE(R) |
| 099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
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| PMID |
30633146 |
| 245 ## - TITLE STATEMENT |
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| Title |
Reducing Cesarean Delivery Surgical Site Infections: A Resident-Driven Quality Initiative. |
| 251 ## - Source |
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| Source |
Obstetrics & Gynecology. 2019 Jan 08 |
| 252 ## - Abbreviated Source |
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| Abbreviated source |
Obstet Gynecol. 2019 Jan 08 |
| 253 ## - Journal Name |
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| Journal name |
Obstetrics and gynecology |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Year |
2019 |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Manufacturer |
FY2019 |
| 265 ## - SOURCE FOR ACQUISITION/SUBSCRIPTION ADDRESS [OBSOLETE] |
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| Publication status |
aheadofprint |
| 266 ## - Date added to catalog |
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| Date added to catalog |
2019-01-18 |
| 501 ## - WITH NOTE |
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| Local holdings |
Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006 |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
CONCLUSION: After implementation of a resident-driven quality initiative using a surgical bundle, we observed a significant decrease in cesarean surgical site infections. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
METHODS: This was a quasi-experimental, preintervention and postintervention study of women undergoing cesarean delivery at 23 weeks of gestation or greater between January 2015 and June 2018 at a single tertiary care center. We implemented a resident-driven, evidence-based surgical bundle, excluding women who underwent emergency cesarean or had chorioamnionitis. The bundle included routine prophylactic antibiotics (both cefazolin and azithromycin), chlorhexidine alcohol skin preparation, use of clippers instead of a razor, vaginal cleansing with povidone iodine, placental removal by umbilical cord traction, subcutaneous tissue closure if wound thickness greater than 2 cm, suture skin closure, dressing removal between 24 and 48 hours, and use of postoperative chlorhexidine soap. Our primary outcome was surgical site infections (superficial incisional, deep incisional, and organ or space surgical site infections) occurring up to 6 weeks postpartum. Outcomes were compared between the preimplementation period (January 2015-August 2016) and postimplementation period (December 2016-June 2018). Coarsened Exact Matching with k-to-k solution was performed using age, race-ethnicity, body mass index, rupture of membranes, and labor. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
OBJECTIVE: To examine the association of a resident-driven quality initiative with cesarean delivery surgical site infections. |
| 520 ## - SUMMARY, ETC. |
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| Abstract |
RESULTS: In total, 1,624 underwent cesarean delivery in the preimplementation and 1,523 postimplementation periods, respectively; 1,100 women in the postimplementation period were matched to 1,100 women in the preimplementation period. The rate of surgical site infections in the unmatched cohort was significantly lower in the postimplementation period compared to those in the preimplementation period (2.2% [33/1,523] vs 4.5% [73/1,624]; odds ratio [OR] 0.47 [95% CI 0.31-0.71]; P<.001). This decrease in the rate of surgical site infections remained statistically significant after matching (1.9% [21/1,100] vs 4.1% [45/1,100]; OR 0.46 [0.27-0.77]; P<.001). |
| 546 ## - LANGUAGE NOTE |
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| Language note |
English |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
IN PROCESS -- NOT YET INDEXED |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Institution |
MedStar Health Research Institute |
| 651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
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| Institution |
MedStar Washington Hospital Center |
| 656 ## - INDEX TERM--OCCUPATION |
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| Department |
Obstetrics and Gynecology/Maternal-Fetal Medicine |
| 657 ## - INDEX TERM--FUNCTION |
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| Medline publication type |
Journal Article |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Fries, Melissa H |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Huang, Jim C |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Iqbal, Sara N |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Kawakita, Tetsuya |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Local Authors |
Landy, Helain J |
| 790 ## - Authors |
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| All authors |
Fries M, Huang JC, Iqbal SN, Kawakita T, Landy HJ |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
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| DOI |
<a href="https://dx.doi.org/10.1097/AOG.0000000000003091">https://dx.doi.org/10.1097/AOG.0000000000003091</a> |
| Public note |
https://dx.doi.org/10.1097/AOG.0000000000003091 |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
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| Koha item type |
Journal Article |
| Item type description |
Article |
