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Consensus Bundle on Prevention of Surgical Site Infections After Major Gynecologic Surgery

Pellegrini, Joseph E., PhD, CRNA; Toledo, Paloma, MD, MPH; Soper, David E., MD; Bradford, William C., DO; Cruz, Deborah A., MSN, RNC; Levy, Barbara S., MD; Lemieux, Lauren A., BS

doi: 10.1097/AOG.0000000000001751
Contents: Consensus Statement

Surgical site infections are the most common complication of surgery in the United States. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effort to reduce the incidence of surgical site infection. This bundle was developed by a multidisciplinary team convened by the Council on Patient Safety in Women's Health Care. The bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and Systems Learning. In addition to recommendations for practice, each of the domains stresses communication and teamwork between all members of the surgical team. Although the bundle components are designed to be adaptable to work in a variety of clinical settings, standardization within institutions is encouraged.

The Council on Patient Safety in Women's Health Care developed a consensus driven bundle of action steps to reduce surgical site infection after major gynecologic surgery.

Department of Organizational Systems and Adult Health, University of Maryland School of Nursing, Baltimore, Maryland; the Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; the Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina; the American College of Osteopathic Obstetricians and Gynecologists, Fort Worth, Texas; the Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; and Health Policy and Strategic Health Care Initiatives, American College of Obstetricians and Gynecologists, Washington, DC.

Corresponding author: Joseph E. Pellegrini, PhD, CRNA, Organizational Systems and Adult Health, Nurse Anesthesia Program, University of Maryland School of Nursing, 655 West Lombard Street, Baltimore, MD 21201; email:

Financial Disclosure The authors did not report any potential conflicts of interest.

This article is being published concurrently in the January 2017 issue (Vol. 124, No. 1) of Anesthesia & Analgesia, the January/February 2017 issue (Vol. 46, No. 1) of Journal of Obstetric, Gynecologic, & Neonatal Nursing, and the February 2017 issue (Vol. 85, No. 1) of the online version of the AANA Journal.

Barbara S. Levy, MD, and Lauren A. Lemieux are employees of the American College of Obstetricians and Gynecologists (the College). All opinions expressed in this article are the authors' and do not necessarily reflect the policies and views of the College. Any remuneration that the authors receive from the College is unrelated to the content of this article.

Each author has indicated that he or she has met the journal's requirements for authorship.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.