Reduction in abdominal hysterectomy surgical site infections: the impact of monitoring and feedback.

Objective: This quality improvement project aims to contribute to the body of knowledge on effective and sustainable surgical site infection (SSI) prevention strategies in a teaching community hospital setting. Design: Retrospective and prospective chart review. Setting: 305-bed acute care urban teaching hospital. Patients: All abdominal hysterectomies were included in the data analysis from January 1, 2018 to June 30, 2025. Methods: The project consisted of two time periods: baseline and monitoring periods. During the baseline period, an SSI prevention bundle was in place, but no individual bundle elements were monitored. At the end of the baseline period, due to rising SSI rates after abdominal hysterectomy, a multi-disciplinary workgroup was formed to evaluate bundle complexity and identify deficiencies in practice. Staff were re-educated and audit tools were created. In the monitoring period, compliance with individual bundle elements was measured and results were disseminated to stakeholders. Results: There were 782 abdominal hysterectomy procedures in the baseline period and 497 in the monitoring period. 13 patients had an SSI in the baseline period versus one patient in the monitoring phase (p = 0.003). Compared with the baseline, the SSI rate decreased significantly during the monitoring period (0.2 SSI versus 1.7 per 100 abdominal hysterectomies, p = 0.002). Conclusion: This project demonstrated significant improvements in outcome (SSI rates) when care processes were regularly monitored, and compliance was shared with key players. Future quality improvement projects will be focused on prioritizing the most important care processes that need to be continuously monitored.