Caesarean section (CS) is one of the most common surgeries in the world. Although the procedure saves lives, it poses important risks such as post-caesarean surgical site infection (PCS-SSI). Basic patient care procedures can prevent PCS-SSI, however, they are not always followed. The purpose of this study is to describe how strategic problem solving (SPS) was used to implement a wound dressing protocol in a district hospital in Rwanda to reduce PCS-SSI rates.
To address variations in wound care practice, a new clinical protocol was developed and implemented by a quality improvement team which included clinicians. Training and supervision was also provided to the maternity team.
The intervention reduced PCS-SSI from 5.1 to 1.8 per cent. It also significantly improved the compliance to recommended wound dressing practices.
By applying SPS and effective leadership skills, the authors secured buy-in and support from stakeholders and introduced a wound management protocol in a district hospital of Rwanda. The intervention significantly improved wound management practice; however, long term follow-up will be necessary to sustain the improvements.
The results will inform hospitals in resource-limited settings of how to improve basic standards of care using SPS and leadership without additional cost to the hospital.
