The West of England AHSN is working collaboratively with the region’s six acute maternity hospital trusts on a new project to reduce surgical site infections (SSI) following caesarean births. In March 2023 the first wave of four trusts launched their use of the locally developed PreCiSSIon (Preventing Caesarean Birth Surgical Site Infection) care bundle. The remaining two trusts will launch shortly.
With over 10,000 caesarean births carried out across the region’s maternity units each year, caesarean birth is one of the most common surgical procedures carried out, and yet reporting the infection rate is not nationally mandated, so it is not reliably recorded. Based on the data currently available it is thought that SSIs occur in approximately 15% of cases nationally. Whilst this is a relatively common complication, SSI can have a significant impact on a new mother and their ability to care for their baby. SSIs can cause increased maternal mortality and morbidity, longer hospital stays, readmissions, requirement of extra antibiotics, dressing and healthcare visits for mothers resulting in higher treatment costs and negatively impacting how a new mother feels about their birthing experience. Many mothers will also require a caesarean birth for any future pregnancies and an infection can potentially make the future surgery more difficult, resulting in more complications.
‘I developed a wound infection about a week after my caesarean. Fortunately, I didn’t feel unwell, but I did need to take antibiotics. However, my baby reacted badly to the antibiotics, not feeding and diarrhoea. In the end I felt he was losing more than he was drinking so we had to give him formula milk. I pumped for the week I was on antibiotics and gave him formula, but in the end found it too difficult to go back to exclusively breastfeeding which was a real shame.’
– Patient story
To establish the baseline of SSIs after caesarean births across the region, the PreCiSSIon project has implemented an electronic patient reported outcome measure system (ePROMS). Establishing the current rate of SSI will allow project teams to closely monitor changes and improvements whilst the cost effective and evidence based PreCiSSIon bundle is adopted. The PreCiSSIon collaborative, which uses quality improvement (QI) methodology and coaching to underpin its approach, ultimately aims to reduce SSI rates by at least 30% – preventing circa 450 mothers each year from having a wound infection.
PreCiSSIon has been developed in conjunction with the AHSN’s key stakeholders to address local healthcare priorities. It is based on the award-winning care bundle implemented regionally to reduce SSI rates after elective colorectal surgery.
Posted on February 21, 2023