Implementing wound dressing protocol to reduce post cesarean section surgical site infections in Mibilizi District Hospital, Rwanda

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.