Does a Care Bundle Reduce Racial Disparities in Postcesarean Surgical Site Infections?.
Does a Care Bundle Reduce Racial Disparities in Postcesarean Surgical Site Infections?.
- 2019
CONCLUSION: The care bundle decreased SSI in both black and nonblack women but did not reduce racial disparities. Copyright Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. OBJECTIVE: To examine the effect of a care bundle on racial disparities in surgical site infections (SSIs). RESULTS: Of 2,696 women, 1,947 were black (1,014 in the preimplementation period and 933 in the postimplementation period) and 749 were nonblack (370 in the preimplementation period and 379 in the postimplementation period). Regardless of race, women in the postimplementation period had lower rates of SSI compared with those in the preimplementation period (black: 2.9 vs. 5.2%, aOR: 0.53 [95% CI: 0.33-0.85]; nonblack: 1.1 vs. 3.5%, aOR: 0.28 [95% CI: 0.09-0.89]). There was no interaction by race (p for interaction = 0.94). STUDY DESIGN: This was a retrospective cohort study of women undergoing cesarean delivery at >=23 weeks' gestation. The care bundle included routine antibiotics (both cefazolin and azithromycin), chlorhexidine skin preparation, clippers, vaginal cleansing, placental removal by cord traction, subcutaneous tissue closure, suture skin closure, dressing removal in 24 to 48 hours, and postoperative chlorhexidine soap. Our primary outcome was SSI (superficial incisional, deep incisional, and organ/space) occurring up to 6 weeks. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were calculated, adjusting for predefined covariates.
English
0735-1631
*Anti-Bacterial Agents/tu [Therapeutic Use]
*Cesarean Section/ae [Adverse Effects]
*Health Status Disparities
*Patient Care Bundles
*Surgical Wound Infection/eh [Ethnology]
Adult
Azithromycin/tu [Therapeutic Use]
Cefazolin/tu [Therapeutic Use]
Female
Humans
Retrospective Studies
Surgical Wound Infection/pc [Prevention & Control]
Suture Techniques
Treatment Outcome
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Maternal-Fetal Medicine
Journal Article
CONCLUSION: The care bundle decreased SSI in both black and nonblack women but did not reduce racial disparities. Copyright Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. OBJECTIVE: To examine the effect of a care bundle on racial disparities in surgical site infections (SSIs). RESULTS: Of 2,696 women, 1,947 were black (1,014 in the preimplementation period and 933 in the postimplementation period) and 749 were nonblack (370 in the preimplementation period and 379 in the postimplementation period). Regardless of race, women in the postimplementation period had lower rates of SSI compared with those in the preimplementation period (black: 2.9 vs. 5.2%, aOR: 0.53 [95% CI: 0.33-0.85]; nonblack: 1.1 vs. 3.5%, aOR: 0.28 [95% CI: 0.09-0.89]). There was no interaction by race (p for interaction = 0.94). STUDY DESIGN: This was a retrospective cohort study of women undergoing cesarean delivery at >=23 weeks' gestation. The care bundle included routine antibiotics (both cefazolin and azithromycin), chlorhexidine skin preparation, clippers, vaginal cleansing, placental removal by cord traction, subcutaneous tissue closure, suture skin closure, dressing removal in 24 to 48 hours, and postoperative chlorhexidine soap. Our primary outcome was SSI (superficial incisional, deep incisional, and organ/space) occurring up to 6 weeks. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were calculated, adjusting for predefined covariates.
English
0735-1631
*Anti-Bacterial Agents/tu [Therapeutic Use]
*Cesarean Section/ae [Adverse Effects]
*Health Status Disparities
*Patient Care Bundles
*Surgical Wound Infection/eh [Ethnology]
Adult
Azithromycin/tu [Therapeutic Use]
Cefazolin/tu [Therapeutic Use]
Female
Humans
Retrospective Studies
Surgical Wound Infection/pc [Prevention & Control]
Suture Techniques
Treatment Outcome
MedStar Health Research Institute
MedStar Washington Hospital Center
Obstetrics and Gynecology/Maternal-Fetal Medicine
Journal Article