Implementation of a Surgical Site Infection Prevention Bundle in the Cardiac Electrophysiology Laboratory for Management of a Cluster of Cardiac Device Infections

Abstract

Background. Cardiac device infection (CIED-I) rates in our VA facility historically are low (<1%). However, over a 3-month period, we identified a cluster of 4 CIED-Is (2 PPMs and 2 ICDs). There is not a standardized prevention checklist designed for the electrophysiology laboratory, thus we applied a bundle of interventions designed for SSI prevention to CIED procedures. Effective bundled interventions include preoperative chlorhexidine (CHG) baths, intranasal MRSA decolonization with iodine or mupirocin, weight based antibiotic dosing (WBAD), antibiotics given within a peri-operative window, and addition of vancomycin (V) for MRSA colonized patients.