The Impact of Surgical Care Improvement Project Compliance on Surgical Site Infection in a Trauma Population

Author(s):
Adel Elkbuli; Alyssa Eily; Brianna Dowd; Shaikh Hai; Mark Mckenney; Dessy Boneva

Background:

Surgical site infections (SSIs) are a critical, possibly preventable, threat to patient safety and are one of the most common healthcare-associated infections. The Surgical Care Improvement Project (SCIP) was established to increase standardization, improve patient safety, and reduce SSIs. National benchmark metrics are established by the Trauma Quality Improvement Program (TQIP). We sought to assess the rate of SSIs in our trauma population, associated with SCIP compliance against a national benchmark.

Hypothesis:

Adherence to SCIP guidlines is associated with reduced SSI rates.

Methods:

A four-year review between February 2014 and December 2017 of operative trauma procedures, which complied with the SCIP guidelines using our level I Trauma Center’s registry. Patients were categorized based on total SSI and also into superficial SSI (SSSI), deep SSI (DSSI), and Organ/Space SSI. Chi-squared analysis was utilized to compare our rate of SSIs to the TQIP benchmark.

Results:

Overall, 13,052 SCIP compliant trauma operations were reviewed. Patients ranged from under 1 to 105 years-old with a mean age of 49.7 years. There were 34 SSIs out of 13,052 operations for a rate 0.26%. This rate is significantly lower than TQIP benchmark for 2016-2017 (0.26% vs. 0.75% vs. 0.70%, 95%CI=1.47-1.70, p<0.0001).

Conclusions:

SCIP adherence was associated with an 65% reduction rate of SSIs compared to the TQIP benchmarks for trauma patients. The SCIP guidelines are effective in decreasing the rate of surgical site infections in trauma patients.