Surgical site infection prevention bundle for children submitted to cardiac surgery

de Andrade, Giselle Viana; de Souza, Nayana Maria Gomes; Rocha, Ana Caroline Felisola; Ribeiro, Silvania Braga; da Silva, Viviane Martins; Oliveira, Luis Adriano Freitas

doi:10.1590/1980-220X-REEUSP-2020-0470

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Revista da Escola de Enfermagem da USP

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Sumário

ORIGINAL ARTICLE • Rev. esc. enferm. USP 55 • 2021 • https://doi.org/10.1590/1980-220X-REEUSP-2020-0470 copy

Surgical site infection prevention bundle for children submitted to cardiac surgery

Bundle para la prevención de la infección de sitio quirúrgico en los niños sometidos a cirugía cardíaca

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To build and validate the content and appearance of a surgical site infection prevention bundle for children submitted to cardiac surgery.

Method:

Methodological study in two phases: 1) Bundle construction from an integrative literature review from which interventions have been extracted to compose the instrument; 2) Bundle content and appearance validation by 24 judges.

Results:

The 24 found articles presented 17 interventions for surgical site infection prevention in this population. Out of them, seven intervention proposals have been chosen to compose the bundle and sent for assessment by judges. The final proposal includes all the seven items chosen in the construction phase and has achieved a content validity index over 0.8 in all items referring to content and appearance.

Conclusion:

The content and appearance of the developed bundle proposes care for the prevention of surgical site infection throughout the perioperative period.

Keywords
Thoracic Surgery; Child; Sugery Wound Infection; Perioperative Nursing; Validation Study

Variables	p-value*	CVI	IQI	95% CI
1. Bath with chlorhexidine the night before the surgical procedure and bath one hour before referring the patient to the surgical center
Relevance	–	1.00	–	–	–
Objectivity	–	1.00	–	–	–
Simplicity	<0.001	1.00	0	0.75	1.00
Clarity	<0.001	1.00	0	0.75	1.00
Accuracy	<0.001	1.00	0	0.75	1.00
2. Use of antibiotics one hour before surgical incision
Relevance	–	1.00	–	–	–
Objectivity	<0.001	1.00	0	0.75	1.00
Simplicity	<0.001	1.00	0	0.75	1.00
Clarity	<0.001	1.00	0	0.75	1.00
Accuracy	<0.001	1.00	0	0.75	1.00
3. Skin preparation with chlorhexidine antiseptic
Relevance	–	1.00	–	–	–
Objectivity	<0.001	1.00	0	0.75	1.00
Simplicity	<0.001	1.00	0	0.75	1.00
Clarity	<0.001	1.00	0	0.75	1.00
Accuracy	<0.001	1.00	0	0.75	1.00
4. The surgeons must change surgical gloves after sternotomy and before sternum suture
Relevance	<0.001	1.00	0	0.75	1.00
Objectivity	<0.001	1.00	0	0.75	1.00
Simplicity	<0.001	1.00	0	0.75	1.00
Clarity	<0.001	1.00	0	0.75	1.00
Accuracy	<0.001	1.00	0	0.75	1.00
5. Hyperglycemic control
Relevance	<0.001	1.00	0	0.75	1.00
Objectivity	<0.001	1.00	0	0.75	1.00
Simplicity	<0.001	1.00	0	0.75	1.00
Clarity	<0.001	1.00	0	0.75	1.00
Accuracy	<0.001	1.00	0	0.75	1.00
6. Use of prophylactic antibiotic
Relevance	–	1.00		–	–
Objectivity	<0.001	1.00	0	0.75	1.00
Simplicity	<0.001	1.00	0	0.75	1.00
Clarity	<0.001	1.00	0	0.75	1.00
Accuracy	–	1.00		–	–
7. Keep the bandage applied in the surgical center for 48 hours after the surgical procedure
Relevance	<0.001	1.00	0	0.75	1.00
Objectivity	<0.001	1.00	0	0.75	1.00
Simplicity	<0.001	1.00	0	0.75	1.00
Clarity	<0.001	1.00	0	0.75	1.00
Accuracy	<0.001	1.00	0	0.75	1.00

Variables	p-value*	CVI	IQI	95% CI
Structure and presentation
1. Presents the logical sequence of the proposed content.	<0.001	1.00	0	0.75	1.00
2. The information is well-structured concerning agreement and orthography.	<0.001	1.00	0	0.75	1.00
3. Font size and type are appropriate to reading.	<0.001	1.00	0	0.75	1.00
4. The colors applied to the text and the chart are appropriate.	<0.001	1.00	0	0.75	1.00
5. The visual composition is attractive and well-organized.	<0.001	1.00	0	0.75	1.00
Usability
6. The bundle items portray key aspects which should be reinforced.	<0.001	1.00	0	0.75	1.00
7. It is appropriate for use by health professionals when providing care to children submitted to cardiac surgery.	<0.001	1.00	0	0.75	1.00

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Nayana Maria Gomes de Souza, Rua Alexandre Baraúna, 1115, Rodolfo Teófilo, 60020-181 – Fortaleza, CE, Brazil, nayanamgs@hotmail.com