Diagnosis Of Antibiotic Prophylaxis Before Surgery

Choosing of this dissertation among ED staff especially AMO so that they will be able to perform the procedure correctly, safely and practice according to current research based recommendations, to ensure effectiveness and patient safely. Cases of wound infection from T&S procedure can be reduced and increase patients trust in the provided services. Staff will be able to implement the procedures properly and safe in accordance with the recommendation, based on studies of wound infection from the patients.

During the postoperative period (IPO), it is crucial for the medical team to assess the situation after the surgery, while he patient is still in the post-an aesthetic care unit (PACU), recovering from operation he or she underwent. The nurses should cover 8 major points of interest and patients reactions to these medical tests to ensure well being of the patient, as well monitor the situation after surgery, making their professional qualifications, knowledge and skills highly important. Each of these 8 points needs to be benchmarked against the standard procedures and measurements while taking into account the pre-surgical body behavior of the patient and shall be presented separately. Vital signs are checked by presence of the artificial

Surgical site infections (SSI) occur in 2 – 5% of ‘clean’ non-abdominal surgical procedures (Rothrock, 2007). Staphylococcus epidermidis is the most common cause for SSI in Orthopaedic surgery (NICE, 2008). Guidelines were produced by the National Institute for Health and Clinical Excellence (NICE) to try and reduce this infection rate and include a preoperative phase, (including hair removal and antibiotic prophylaxis), an intra-operative phase and postoperative phase.

The assessment of the patient’s care needs is based on the type of infection. As such, nurses have the responsibility of providing a high quality health care to the patients. The postoperative assessment involves assessing the patient’s perceptions related to behavior and physiologic responses. It also involves the monitoring of the pain from the patient during the treatment period based on the operations performed. In postoperative assessment, the patient’s wound is monitored in relation to the healing frequency, pain felt, and the availability of some foreign substances like the body discharges. Obtaining the information relating to post operative assessment ensures that the patient is well taken care of by the nurse after operations, and avoids incidences of other circumstances that might hinder quick healing (Grocott, 2007). Once the patient gathers the information concerning the postoperative assessment, then a decision is made whether to seek medication from the same hospital or look for other alternatives. In the case of Sophie, it was clear that the nurses were not keen in following the postoperative assessment, therefore, causing the wound to obtain infections.

5. Poulin,P., et al.(2014) Preoperative Skin Antiseptics for preventing surgical site infections: What to do?

According to the Hospital National Patient Safety Goals, Goal 7 is to reduce the risk of health-care associated infections. NPSG.07.0.01 deals with surgical-site infections. The question to be asked is, “Why are surgical site infections a problem?” The prevention of surgical site infections can occur before and during surgery, with certain actions of the nurse, and when the patient is healthy. One way surgical site infections can occur is during surgery, or intra-operation. Sources of bacteria, exogenously, include the airborne route as a significant source of infection. Endogenously, infections can occur from the normal flora of a patient (Edmiston & Spencer, 2014a). Surgical site infections are a problem intra-operatively because of operating room temperatures not being controlled, misuse of sterile procedure, and improper hand hygiene. Operating room temperatures should be kept between 68 to 75 degrees Fahrenheit or 20 to 24 degrees Celsius. There also needs to be positive

The unit utilizes an evidence-based testing and pre-surgical evaluation processes, thereby making it ideal to do the required assessment, testing, and treatment effectively. Although, there continues to be resistance from some surgeons, majority are taking notice of the major impacts of inadequate pre-operative patient preparation. The JC risk assessment recommendations dictate institutions are responsible to reduce infections caused by Multi Drug Resistant Organisms (MDRO) and the initial occurrence of an epidemiologically significant organism (2016).

As a hospital, quality care should be a priority for patients that are going to be treated for a sickness, or any type of procedure that is going to take place. A lot of times a patient gets an infection while they were at the hospital, on top of being treated for what they original came in for. Health facilities should be environments of healing, which they are, but they also have tons of various types of germs and infections, which grasp onto individuals that have weak immune systems/are sick. Some infections that are at hospitals are Tuberculosis, VRE, VAP, C-Diff, UTI, and MRSA. Preventive measures to stop the spread of the infections is lacking tremendously in the work and aim to provide safety for all patient’s health. The work

Perioperative prophylactic antibiotics for total joint replacements have been proven to reduce rates of surgical site infections.2-3 It is recommended that prophylactic antibiotics are administered within one hour prior to surgical incision and are discontinued within 24 hours following the end of surgery.4 First generation cephalosporins, such as cefazolin, are the agents most commonly utilized for antimicrobial prophylaxis in joint replacement procedures.2,5 Vancomycin may be used in addition to a first generation cephalosporin in institutions considered to have a high rate of methicillin-resistant staphylococcus aureus (MRSA) surgical site infections. 2 If there is local data to suggest gram-negative pathogens as a cause of PJI then it is recommended to consider the addition

A Studies done at MNH and MC found high SSI (Akoko et al., 2012)(Mawalla, Mshana, Chalya, Imirzalioglu, & Mahalu, 2011).This is contrary to another study at KCMC which showed low SSI rate(Kitembo & Chugulu, 2013)

Available infrastructure - the hospital should be sufficiently equipped to handle the complicated intra and post- operative course.

Have there been any recent advances in the post-operative management of the selected procedure? Why?

* Hand washing is the most important method of preventing the spread of infection by contact (Ayliffe et al 1999). The Nottingham University Trust Policy on Hand Hygiene (2009) states that there are three types of hand hygiene, the first is ‘routine hand hygiene’ which involves the use of soap and water for 15 – 20 seconds or the application of alcohol hand rub until the hand are dry. The second is ‘hand disinfection’ which should be used prior to an aseptic procedure by washing with soap and water and applying alcohol hand rub afterwards. The third is ‘surgical hand washing’ which is the application of a microbial agent to the hands and wrists for two minutes. In addition to which a sterile, disposable brush may be used for the first surgical hand wash of the day although continued use will encourage colonisation of microbes. The third example is the most appropriate to any O.D.P undertaking the surgical role as it is the best way for the surgical team to eliminate transient flora and reduce resident skin flora (World Health Organization 2010). The first and second are important to any O.D.P undertaking any other role within the Operating Department as this is the best way to reduce the transient microbial flora without necessarily affecting the resident skin flora

Ethical challenges are the most profound when dealing with patient safety; compliance with the prophylaxis antibiotic administration guidelines is paramount to a surgical patient in order to decrease the possibility of a post operative surgical site infection. Antibiotic timing requires

Surgical site infections (SSIs) are the leading type of infections among hospitalized patients. There are so many reasons why people go for surgery; it can be an emergency reasons or elective. According to Beaver, (2008) a primary concern in healthcare today is the prevention of infections. Careful handling of the surgical equipment reduces the chances of surgical site infections, for instance equipment sterilization and careful hand hygiene of surgical equipment.