Surgical Site Infections: A Nursing Research Project

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.

In recent years, surgical site infections are verified as one of the most errors that are common in the healthcare; however, they are also preventable. These research papers will synthesis information about surgical infections, patient experience, hospital-acquired conditions and achievement of expected treatment for specific clinical diagnoses. A surgical site infection is an infected condition in the body after surgery has occurred. Surgical site infections are caused by germs, called bacteria. Different types of bacteria from the environment may cause a delay in healing. The infection may come from surgical tools or bacteria on the skin if it is not clean correctly. Healthcare professionals use certain guidelines and

Sterile Processing compromises a service of which the medical and surgical supplies of any medical facility’s equipment and instrumentation- sterile or non-sterile are cleaned, prepared, processed, stored, and distributed throughout the healthcare facility. There are several functions of this highly skilled team perform on a daily basis from decontamination to the sterilization of high risk medical implant devices. They are the first line of defense in infection prevention for any patient receiving medical treatment in healthcare facilities. Japp (2014) affirmed the importance of properly processing medical devices performed by Sterile Processing technicians for patient safety by stating a critical point “Not following the correct process can be detrimental to the patient as the device that we are assuming is safe for the patient may all actually cause severe illness or death” (p.

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

Burke J.P. (2003). Infection control- a problem for patient safety. New England Journal Medicine, 348(7):651-656.

Elimination of HAI’s are a top priority for many healthcare related organizations and as such, the reduction of certain types of HAIs have been achieved. On the national level, the HAI Progress Report states that there has been, “Au 46 percent decrease in central line-associated bloodstream infections (CLABSI) and a 19 percent decrease in select surgical site infections (SSIs) between 2008 and 2013” as well as “an 8 percent decrease in hospital-onset MRSA bacteremia and a 10 percent decrease in hospital-onset C. difficile infections between 2011 and 2013” (CDC, 2015).

Health Care providers must implement infection control at all times. This is essential in order to avoid any sources of contamination that would put patients at risk for infection as well as all hospital personnel. There are two important aseptic techniques: Medical Asepsis, and Surgical Asepsis. The first one includes hand hygiene, use of gloves, masks, gowns and routine

Researchers will decide to select wound infections that occur after open heart surgery as a topic for their study, because it is significant for staff nurses to know the effect of wound infections that occurs with the adult patients. Researchers will obtain permission from the cardiac surgery center so that they could collect information from adult patients. They will also contact and meet with staff nurses in cardiac surgery center. Nurse educators will provide the form to all staff nurses working in the operating room. The form includes the title of the study, the purpose of the study, place of the work, duration of the study, potential benefits, potential risks, participant signature, and date. The reader can follow that consent

Lastly, non-adherence to Aseptic techniques for surgical patients and with the use invasive of devices such as urinary catheter and central lines can pose as a threat to patients. Bathing patients prior to surgery with a chlorhexidine solution rather than regular soap has proven to reduce the spread of hospital acquired infections. Following protocols with urinary catheters and central lines and also following the guidelines in the care and maintenance of such devices. Another factor is the importance of using chlorhexidine solution for patients who have central lines in an effort to prevent getting an infection in the blood stream. Finally, the importance educating patients on all lines and surgical site care. According to Lobley, “the National Institute for Health and Clinical Excellence found that surgical site infections (SSIs) accounted for 14% of all HAIs and affected 5% of all surgical patients” (Lobley, 2013). Surgical site infection which is another form of hospital acquired infection can

The priority nursing diagnosis of hospital acquired infection is risk for any kind of infection. One of the main goals for each patient in the hospital is the patient will remain free of infection as evidence by absence of heat, pain, redness, or swelling in any area of the patient’s body during each nurse’s shift. (care plan book). Frequently hand washing is the best intervention for preventing infection. Hand washing reduces the risk of transmission of pathogens by inhibiting the growth of or killing the microorganisms. (cb)Proper sterile technique during urinary

Surgical site infections are considered preventable. Because such infections are considered preventable, there are legal consequences directly connected to such a condition. In this paper, I will discuss what an SSI is and the reasons on why it is considered to be preventable. I will also discuss the role of disclosure and legal implications that are related to SSIs, accreditation expectations, and continuous quality monitoring as it relates to SSIs.

The studies have a consistent variable concluding compliance for reducing SSI. By initiating antibiotics during a specific time frame prior to surgery and stopping antibiotics within 24 hours after the surgical procedure shows a decrease in SSI. Initiating antibiotics reduces SSI including the implementation of specific actions to eliminate preventable surgical site infections. Having compliant standards with adherence to preventable practice will affect SSI (Leaper, et al. 2014; Weston, D. 2013). This applies the important aspect of implementing a staff compliance tool to build a method of responsibility to improvement initiatives.

Research shows that Surgical site infections are preventable. According to the CDC, hand hygiene is the simplest approach to preventing the spread of infections and needs to be incorporated into the culture of the organization. Ensuring the use of infection control prevention is an important component of nursing care. Infection control prevention policies must be communicated undoubtedly to all employees. Staffers who do not comply must be re-educated to ensure that all are complying. Speaking up and pointing out that a nurse forgot to wash his or her hands, or notifying the surgical team that surgical instruments were not adequately cleaned may seem like small issues; but at the same time, not acknowledging a break in a sterile technique could mean the difference between life and death for a patient. One hospital that was struggling with high levels of infection related to surgical procedures, implemented a pre-procedure huddle as a team. This innovate way decreased the spread of infection and was a great way to improve the quality of care for patients. As mandated by the Joint commission, infection prevention personnel should provide multidisciplinary education on SSI prevention, to all team members, including

Surgery that involves an incision in the skin can lead to a wound infection afterwards. Most surgical wound infections are seen within 30 days after surgery. There may be pus draining from the wound site, can be red, painful or hot to the touch. It may present with a fever and

* 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