COMMITTEE CHAIR: Dr. Abida Solomon
TITLE: ENHANCING PROTOCOL COMPLIANCE: AN EDUCATIONAL APPROACH TO INCREASE STAFF KNOWLEDGE AND COMPLIANCE WITH CHLORHEXIDINE GLUCONATE TO REDUCE SURGICAL SITE INFECTIONS IN OBSTETRIC CARE
ABSTRACT: Introduction: Surgical site infections (SSIs) after cesarean deliveries remain a significant challenge in obstetric care, contributing to increased maternal morbidity, longer hospital stays, and higher healthcare costs. Although chlorhexidine gluconate (CHG) has been proven effective for preoperative skin preparation, inconsistent staff education and adherence to protocols continue to lead to suboptimal outcomes. Purpose: This quality improvement project seeks to implement and evaluate a structured preoperative skin care education protocol for obstetric (OB) nursing staff at a hospital-affiliated outpatient clinic in Texas, comprised of registered nurses (RNs) and Licensed Vocational Nurses (LVNs). The project is guided by the PICO framework, which is structured as follows: The population of interest is OB nursing staff (RNs and LVNs) working in the clinic. The intervention involves implementing a standardized educational protocol focused on the use of chlorhexidine gluconate (CHG) for preoperative skin cleansing, comprehensive documentation, and effective patient education. The comparison group consists of baseline staff knowledge and practices before the implementation of the new protocol. Outcomes will be measured as improvements in nurse knowledge scores and compliance with preoperative CHG skin preparation protocols, as documented through electronic health record (EHR) audits. The overall aim is to determine whether this structured education protocol can significantly enhance both knowledge and adherence to best practices among nursing staff in this setting, as compared to existing non-standardized practices. Intervention: Implementation of a structured education protocol on CHG use for preoperative skin cleansing, documentation, and patient education. Method: The project is guided by the Plan-Do-Study-Act (PDSA) framework. A single-group, pre-post intervention design will be employed with 20 registered and 11 licensed vocational nurses. The sample size was determined based on a priori power analysis targeting a moderate effect size (Cohen’s d = 0.5), alpha = .05, and power (1-ß) = 0.80 for paired comparisons. The intervention consists of hybrid (in-person and electronic) educational sessions focused on evidence-based preoperative CHG use, standardized EHR documentation, and effective patient instruction. The primary measure will be the Surgical Site Infection Prevention Knowledge Assessment (SSI-PKA). The SSI-PKA is a customized, validated survey instrument collaboratively developed by the Nurse Manager, Director of Quality, and DNP student, directly aligned with the CDC/AORN guidelines. The compliance will consist of HER audits to evaluate adherence to CHG documentation protocols before and after the intervention. Descriptive statistics will be used to analyze the demographic variables, and compliance rates will be analyzed using the Pearson Chi-square test to compare pre- and post-intervention compliance rates. Changes in knowledge scores will be assessed with paired t-tests.
Location Online:
Zoom Link:
https://pvpanther.zoom.us/j/99925943496?pwd=g9IERfiGYB83zbxdJYsHwgMkfhuTJh.1