Mrs Sandi Gamon1, Jehad Kamal1, Mrs Merissa Rajoo1
1Waitemata, Auckland, Aotearoa / New Zealand
Biography:
Sandi has over 25 years’ experience in Infection Prevention, and she has worked in the UK, Australia and New Zealand over the course of her career. Her career highlights include projects which contribute to improving pt safety.
Abstract:
The Caesarean Section Surgical Site Infection (CS SSI) Surveillance Programme at Waitematā was developed to improve infection monitoring and reporting through the integration of ICNET and Qlik platforms. This initiative tags patients undergoing Caesarean sections (CS) in ICNET, allowing post-operative readmissions to trigger alerts for potential SSIs. Subsequent case reviews and examinations are conducted to verify infections. Initially, discrepancies in SSI rates were noted between ICNET and Qlik due to delayed data export and false alerts stemming from inter-facility transfers and follow-up visits. Corrective investigations aligned the platforms and improved reporting accuracy.
Key findings highlight elevated SSI rates in patients with a BMI >30, with superficial infections being the most common. Notable documentation gaps include perioperative temperature, blood glucose in diabetic patients, and wound care education. Despite strong compliance with existing protocols—such as timely antibiotic administration and sterile theatre conditions, CS SSI rates remain significant, contributing to both physical and emotional patient burdens and costing an estimated $NZD741,162 annually.
To address these challenges, the project recommends adopting a structured CS Delivery Bundle modeled after an evidence-based U.S. approach. This bundle introduces new practices across the surgical timeline: preoperative CHG washes and glucose checks, intraoperative glove changes and dedicated wound trays, and postoperative dressing removal within 48 hours alongside patient education. Establishing a multidisciplinary CS SSI working group is also proposed to oversee implementation, promote standardization, and ensure ongoing surveillance and quality improvement. This structured approach aims to reduce practice variation and ultimately lower CS SSI rates.