Process Evaluation of a PREVENA™ System Multimodal Quality Improvement Project

AbstractProblem: There is a global initiative to decrease surgical site infection (SSIs) in patient populations and a national initiative to reduce SSIs by the Centers for Disease Control and Prevention (CDC). Extended placement of the PREVENA™ System leaves the patient at risk for SSIs. At a large Midwestern not-for-profit hospital, there is a need to create standardization of care for PREVENA™ Systems among the surgical providers.Aim: This project will aim to conduct audits of the Provider PREVENA™ System initiative, evaluate the outcomes of compliance with nursing worklist tasks, and conduct follow-up patient telephone surveys to assess for outpatient complications. Upon completion, an executive summary will be compiled with recommendations.Methods: The proposed strategy for this project was a process evaluation designed to provide information on the effectiveness of a PREVENA™ System quality improvement initiative to decrease outpatient complications for patients discharged from an adult inpatient medical/surgical floor. The population of interest were the surgical providers, nursing staff, and surgical patients. Quantitative data focused on the number of patients who received a PREVENA™ System, those who received appropriate education, labeling, and removal instructions, staff compliance with the order set, and the patient's outpatient course. A round table discussion was conducted with providers about the order set and with nursing staff about nursing task procedures related to the PREVENA™ System and obtained from patients via follow-up phone calls. Descriptive statistics was used for the analysis of quantitative data and a formative assessment to make a qualitative evaluation.Results: Only 15 of the 98 surgical patients (15%) had the PREVENA™ System order set initiated, indicating low compliance and a need for improved education. Eight of the 98 patients (8%) had PREVENA™ System dressing labels in place. Fifty-seven patients (60%) had education printed on the after visit summary (AVS) regardless of the initiation of the order set. Eighteen of the 62 PREVENA™ Systems (29%) that were removed were documented in the flowsheet. Nineteen of the 35 patients (54%) discharged with a PREVENA™ System had Home Health orders. Two of the 35 patients (6%) discharged with a PREVENA™ System were readmitted within 30 days and one of these patients (3%) had a reinfection within 30 days after discharge. Round table discussions revealed education on the order set was minimal, while most of the patients reported in the follow-up phone call survey positively about the education provided at discharge.Conclusion:This process evaluation identified deficits in the PREVENA™ System protocol, and patient and staff education. The lack of compliance with the protocol and education likely contributed to adverse patient outcomes with readmission within 30 days and post-operative infection.Keywords order set, PREVENA™ System, process evaluation, surgical site infections

Grantor dc:publisher

University of Kansas

Year dc:date.issued

2023

Author dc:creator

• Hall, Melissa

Advisor dc:contributor.advisor

• Paramesh, Colleen

• Nursing
• order set
• PREVENA™ System
• process evaluation
• surgical site infections

Statement dc:rights

• Copyright held by the author.

Language dc:language.iso

en

Dc Identifier Other

http://dissertations.umi.com/ku:18869

OAI identifier oai:identifier

oai:kuscholarworks.ku.edu:1808/37121