Nursing Recognized at 2018 Sterling Conference

Quality improvement project leads to significant reduction in C-section infections.

By: Natalie Spindle

A strategic team formed to address cesarean section infection rates at UF Health Jacksonville was recently recognized for best customer impact at the 2018 Florida Sterling Annual Conference in Orlando.

In 2016, Labor and Delivery nurses noted an increase in readmissions due to surgical site infections following C-section deliveries. The unit formed the Bug Busters team to answer the question, “Why are postoperative C-section patients getting infections and how can we prevent them?”

To align with the hospital’s strategic plan, the team sought to improve core measure performance by reducing readmission rates and preventable complications, as evidenced by decreased hospitalacquired infection rates.

The team includes Amanda Ratliff, MSN, RN; Stefanie Buchanan, BSN, RN; Danielle Jones, MSN, RN; Paula Malone, MSN, RN; Shannon Little, MSN, RN; and Johanna Thompson, MSN, RN.

Labor and Delivery has seen the infection rate decrease from an average of 8.7 out of 100 C-sections to a range of 0 to 1.4 out of 100 C-sections within seven months of implementing the updated procedures.

“Our team used multiple methods to trace and determine the potential root causes of the infections,” said Ratliff, a clinical quality nurse leader. “After creating a process control system flowchart for C-sections, we performed thorough chart reviews, unit assessments and conducted patient and staff surveys.”

Nurses from various units put the plan into action by revising the labor and delivery protocols for the application of chlorhexidine, or CHG, on C-section patients. CHG is used for infection prevention due to its antimicrobial properties. A standardized practice has since been established to include two or more applications of CHG, patient education, surgical site dressing removal on the second postoperative day, evaluation of the surgical site prior to discharge and staff-assisted showers.

The Bug Busters presented their findings in the team showcase event at the Florida Sterling Conference in June. The team event allows groups from across the state to highlight problem-solving process improvement strategies.

Recognized as the nation’s premier conference for practical learning in all areas of leadership and management systems, the Florida Sterling Conference is held annually. The event is hosted by the Florida Sterling Council, a public-private partnership serving Florida through assessment, training and recognition for performance excellence.

“We are honored by this opportunity to represent the tremendous work of nursing at UF Health Jacksonville and play a role in improving outcomes for our patients,” Ratliff said.