Advances in Surgical Site Infection Prevention To Receive
Advances in Surgical Site Infection Prevention To Receive Credit, You Must Register Expo Mobile App Online http://expo.pfiedlereducation.com
Expo Evaluation Center Deadline for Registration is May 10, 2019 Continuing Education Provider Funds Provided by Learner Objectives
Review the impact of SSI on patients and healthcare facilities Discuss current evidence-based recommendations related to SSI prevention Describe advanced strategies to prevent SSI in order to deliver high-quality care, reduce costs, and promote positive patient outcomes Introduction
Increased value-based incentives Result of SSIs Patient outcomes are compromised Healthcare costs rise Reimbursement may be denied
Types of SSIs SSI Incidence Procedure group 90-day SSI prevalence Amputation
17.84% Biliary, liver, and pancreas 9.38% Breast 2.57%
Hernia 4.70% Impact on Patients 3% mortality rate 75% of SSI-associated deaths directly attributed to the SSI Pain Loss of income
Reduced quality of life Burden on patient and their families Cost Implications $10-25k+ per infection $90k+ if prosthetic implant involved $3-10 Billion annual cost in US 1 million inpatient days per year No reimbursement for preventable conditions such as SSI
SSI Risk Factors Preoperative factors Perioperative team factors Organizational and management factors Patient factors Surgeon factors Work-environment factors Care-delivery problems
SSI Prevention World Health Organization Centers for Disease Control and Prevention American College of Surgeons/Surgical Infection Society Society for Healthcare Epidemiology of America Association of periOperative Registered Nurses 7 S Bundle Safe operating room practices
Showers with chlorhexidine Screening for MRSA and methicillin-susceptible Staphylococcus aureus (MSSA) Skin preparation with alcohol-based antiseptics Sutures containing an antimicrobial Solution with chlorhexidine for irrigation Skin adhesive and/or antimicrobial dressings to protect the incision Safe Operating Room Practices
Traffic control Limiting the number of staff in the OR during surgery Compliance with surgical attire recommendations Proper surgical skin scrub Proper skin preparation with alcohol-based antiseptics Effective sterilization of instruments Monitoring & preventive maintenance of airhandling systems
Adequate surgical antibiotic prophylaxis Warming of the patient before and during surgery Hair clipping (no shaving) outside the operating room Use of wound protectors to prevent tissue contamination Careful handling of tissues by surgical staff
Disinfection of the environment during room turnovers and terminal cleaning Safe medication-handling procedures Safe storage of supplies Chlorhexidine Gluconate Patient Showers Supported by: CDC ACS AORN
WHO SHEA MRSA & MSSA Screening & Decolonization Two options: Screen for and treat carriers only Universally treat everyone Risk of worsening bacterial resistance and changing the microbiome of both the patient and the facility
Alcohol-Based Antiseptics for Surgical Site Prep CDC, ACS, and WHO alcohol-based AORN most appropriate based on patient needs WHO specific to alcohol-based CHG Intraoperative Surgical Wound Irrigation
Hydrate the wound bed Assist in allowing better examination of the area immediately before closure Expedite the healing process, by removing superficial and deep incisional contamination and lowering the bioburden Antimicrobial-Impregnated Sutures Skin Adhesives & Antimicrobial Dressings
Knee Arthroplasty 12% reduction in length of hospital stay, 31% reduction in probability of discharge to skilled nursing facility or other non-home setting Reduced 30-day readmission rates (1.8%) when compared with skin staples (4.4%) Potential cost savings of $12,839 per patient, by avoiding readmission within 30 days Patient may be able to shower immediately Patient may experience less pain
Implementation Strategies Engagement phase Clear and effective communication of the reasons why SSI implementation strategies are important for patient care Education phase Senior leadership, physicians, nurses, and patients and families are taught about practices to prevent SSI
Execution phase Focuses on implementation strategies to reduce barriers and improve adherence to evidence-based practices Evaluation phase Focuses on the use of measurement and evaluation tools to determine the effectiveness of implementation strategies Summary
To Receive Credit, You Must Register Expo Mobile App Online http://expo.pfiedlereducation.com Expo Evaluation Center
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