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Does a Care Bundle Reduce Racial Disparities in Postcesarean Surgical Site Infections?.

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Citation: American Journal of Perinatology. 36(13):1325-1331, 2019 11.PMID: 31087317Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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 OutcomeYear: 2019 ISSN:

0735-1631

Name of journal: American journal of perinatologyAbstract: 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.All authors: Kawakita T, Umans JGOriginally published: American Journal of Perinatology. 2019 May 14Fiscal year: FY2020Fiscal year of original publication: FY2019Digital Object Identifier:

https://dx.doi.org/10.1055/s-0039-1688822

ORCID:

https://orcid.org/0000-0003-2438-1699

Date added to catalog: 2019-06-21

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	31087317	Available		31087317

CONCLUSION: The care bundle decreased SSI in both black and nonblack women but did not reduce racial disparities.

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.

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