Date of Degree
Summer 2026
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Melanie Brewer, DNSc, RN, FNP-BC, NEA-BC, FAANP
Second Advisor
Ebony Parker, DNP, APRN, WHNP-BC
Abstract
Problem: Surgical site infections (SSIs) are a significant concern in the pediatric neurosurgical patient population and are associated with increased morbidity, longer hospital stays, and increased medical expenses. The absence of a standardized preoperative infection prevention process led to variability in perioperative care practices and infections at the practicum site.
Aim of the Project: The aim of the project was to reduce the incidence of SSIs among pediatric patients undergoing neurosurgical procedures who were initially evaluated in an ambulatory setting.
Review of the Evidence: Evidence supports the implementation of bundled infection prevention strategies as a more effective approach to reducing SSIs than single-component interventions. Preoperative chlorhexidine gluconate (CHG) skin antisepsis and structured caregiver wound care education have been identified as evidence-based practices that enhance infection prevention and improve adherence to postoperative wound care protocols.
Project Design: The quality improvement project was guided by the Institute for Healthcare Improvement's Plan-Do-Study-Act framework and the OhioHealth Change Management Model to support implementation, stakeholder engagement, and sustainability. Stakeholder assessments, Change Readiness Surveys, staff education, workflow mapping, micro-educational sessions, and workflow simulations facilitated successful implementation through interdisciplinary collaboration among the pediatric neurosurgeon, nursing staff, and administrative personnel.
Intervention: A standardized infection prevention protocol consisting of preoperative CHG wipes, structured caregiver wound care education using the teach-back method, and preoperative reminder calls to enhance protocol adherence was implemented.
Significant Findings/Outcomes: The project exceeded the goal of reducing SSIs to zero during the 10-week implementation period. Compliance with staff training, CHG wipes provision and education, caregiver wound care education, documentation compliance, and CHG wipes utilization verification was 100%. Minimal impact on workflow, CHG education on average was 3.8 minutes per patient, and caregiver wound care education on average was 9 minutes per patient. The intervention cost was $8.53 per patient and demonstrated substantial cost avoidance potential compared to the estimated $20,000 hospitalization cost of treating an SSI.
Implications for Nursing: The standardized, evidence-based infection prevention protocol was effective in improving patient safety, supporting workflow efficiency, and promoting consistent clinical practice aligning with the Institute of Medicine's principles of safe, effective, and patient-centered care while supporting the Institute for Healthcare Improvement's Triple Aim by improving the population health, enhancing the patient experience, and reducing healthcare costs.
Recommended Citation
Kareth, Pisey, "Standardized Infection Prevention Protocol to Reduce Surgical Site Infections in Pediatric Neurosurgery" (2026). Doctor of Nursing Practice (DNP) Scholarly Project. 53.
https://fuse.franklin.edu/dnp-project/53
Rights
Copyright, all rights reserved
Included in
Bacterial Infections and Mycoses Commons, Pediatric Nursing Commons, Perioperative, Operating Room and Surgical Nursing Commons, Quality Improvement Commons, Wounds and Injuries Commons
