Surgical care bundles can significantly reduce the incidence of surgical site infections, according to a meta-analysis published in the July 2015 Surgery. The 13 studies in the analysis, which included a total of 8,515 patients, generally involved a series of core interventions such as antibiotic administration, appropriate hair removal, glycemic control, and normothermia. Patients who received the studied bundles had a surgical site infection rate of 7%, compared with an infection rate of 15% in patients who did not receive bundles. The authors note that the four core interventions mentioned above are likely so frequently included because they are mandated by the Centers for Medicare and Medicaid Services in patients undergoing colorectal surgery and are required statewide in Michigan by the Michigan Surgical Quality Collaborative. Four of the 13 studies addressed costs associated with the bundles, with conclusions ranging from a 36% increase in variable costs per patient to annual savings of more than $230,000. Given not only direct costs of care but also ancillary costs to both providers and patients, the authors state that "while it is difficult to arrive at a consensus of the economic benefit of embracing a strategy of surgical care bundles, enhanced compliance, especially of the core processes, will likely be cost effective for the majority of patients undergoing colorectal surgery."

HRC Recommends: Surgical site infections are costly, lead to longer hospital stays, and are detrimental to patient recovery postsurgery. This analysis supporting the effectiveness of care bundles, collections of several controls that are each known to achieve a certain goal, is promising. Facilities may wish to incorporate the bundled interventions detailed in the studies into their practices.