The Impact of Structured Anti Infective Nursing Care on Outcomes in Emergency Surgical Trauma Patients: A Quasi Experimental Study

Xiangcheng Zhang

Department of Critical Care Medicine, Huai'an First People's Hospital, Huai'an, China

Yonggang Peng

The University of Florida, Gainesville, USA

Leng Fei

lengf@bch.edu.cn

Beijing Children's Hospital, Capital Medical University, Beijing, China

Address correspondence to

Leng Fei, Beijing Children's Hospital, Capital Medical University, Beijing, China. Email: lengf@bch.edu.cn

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The Impact of Structured Anti Infective Nursing Care on Outcomes in Emergency Surgical Trauma Patients: A Quasi Experimental Study

Xiangcheng Zhang

Department of Critical Care Medicine, Huai'an First People's Hospital, Huai'an, China

Yonggang Peng

The University of Florida, Gainesville, USA

Leng Fei

lengf@bch.edu.cn

Beijing Children's Hospital, Capital Medical University, Beijing, China

Address correspondence to

Leng Fei, Beijing Children's Hospital, Capital Medical University, Beijing, China. Email: lengf@bch.edu.cn

2026 Jun;1(2):87-92

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Abstract

Background: Sepsis and surgical site infections (SSIs) are major causes of morbidity and mortality following traumatic injury. While prompt surgical intervention and antibiotics are critical, the role of protocolized, nurse driven anti infective care in the emergency setting remains underexplored. This study evaluated the effectiveness of a structured, multi component anti infective nursing bundle on clinical outcomes in emergency surgical trauma patients. Methods: A quasi experimental, pre post intervention study was conducted at a Level I trauma center. The control group consisted of 415 patients admitted between July and December 2022, receiving standard care. The intervention group consisted of 428 patients admitted between January and June 2023, managed with a novel "TIME" nursing bundle: Timely administration of antibiotics and cultures, Intensive metabolic control (glycemic & temperature), Meticulous wound and catheter care, and Early source control coordination. Primary outcomes were the incidence of sepsis within 72 hours and SSI within 30 days. Secondary outcomes included antibiotic days, length of ICU stay, and 30 day mortality. Data were analyzed using chi square tests, t tests, and multivariate logistic regression. Results: Implementation of the TIME bundle was associated with significant improvements. The sepsis rate decreased from 18.1% to 11.0% (p<0.01), and the SSI rate decreased from 12.3% to 7.0% (p<0.01). Patients in the intervention group had fewer mean antibiotic days (5.2 vs. 7.8, p<0.01), shorter ICU stays (4.5 vs. 6.1 days, p<0.05), and lower 30 day mortality (8.6% vs. 12.8%, p<0.05). After adjusting for injury severity, the TIME bundle was an independent protective factor against sepsis (aOR 0.52, 95% CI 0.34 0.79) and SSI (aOR 0.49, 95% CI 0.30 0.80). Conclusion: A structured, nurse led anti infective care bundle significantly reduced the incidence of early sepsis and surgical site infections in emergency trauma surgery patients, and was associated with improved antibiotic stewardship and clinical outcomes. These findings highlight the pivotal role of targeted nursing interventions in the multidisciplinary effort to prevent infections in trauma care.

Keywords: Trauma Nursing; Infection Control; Sepsis; Surgical Site Infection; Emergency Surgery; Nursing Bundle; Antibiotic Stewardship.

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Journal of Contemporary Surgical Science

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Volume 1, Issue 2

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