Abstract

Background: An increase in deep sternal wound infections (DSWI) within the cardiovascular surgery (CVS) department at a large midwestern teaching hospital among adult patients with an open sternotomy approach. Objective: To reduce the DSWI rate within the hospital’s CVS department. Methods: After gathering stakeholder input and observing the perioperative process, an extensive review of current literature was conducted to address the problem. Interventions that had literature support were then reanalyzed with stakeholder input for implementation selection, along with a cost-benefit analysis. A pilot was designed applying the Posthorax™ Pro Sternal Support Vest for adult cardiac surgery patients with a sternotomy approach meeting high-risk inclusion criteria, after the patient was stabilized in the ICU until six weeks postoperatively. Results: Rounding on patients and staff to collect real-time feedback revealed overall positive remarks. A five-point Likert survey was given to patients on day-of-discharge and a similar six-week survey sent via mail and electronic message. A low return rate occurred (13.2% and 42.1%, respectively) but, of those returned, 100% and 85.7% recommended continued use of the vest. A staff survey showed 65.4% recommending continued use of the vest. Conclusions: Though the patient surveys had a low return, they were all positive in nature; staff surveys noted slight concerns, but the majority were positive as well. The real-time staff and patient feedback also showed overall positive remarks with a few negative comments. Through further discussions with department stakeholders, a full roll-out was adopted within the department. Key Words: Cardiovascular Infections; Cardiovascular Surgical Procedures; Primary Prevention

Date of Project Completion

Spring 1-10-2023

Document Type

Project Paper

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Marci Newcome, DNP, APRN, CNP

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