Surgical Site Infections Plague Among The World On A Daily Basis

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.

Before bathing/showering with soap and water prior to a procedure/surgery was accepted. It has been proven that antiseptic showering decreases skin microorganism count. Chlorhexidine gluconate products necessitate the need for several applications for the maximum antimicrobial benefit. Thus, each patient receives two preoperative antiseptic showers.

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).

As this is a joint surgical case (total knee), I am including Infection Control to seek their expert opinion if patient needs monitoring for possible SSI. The Biologicals are negative but this will not provide complete safety blanket to the extent that contamination has been probably spread during the

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

Healthcare-associated infections (HAIs) have been found to be number ten on the list of the leading causes of death in the United States. The Centers for Disease Control and Prevention (CDC) have estimated that in a year HAIs cause 1.7 million infections, 99,000 associated deaths, all of which cost approximately $30 billion (Masud & Vykoukal, 2011). HAIs are the kind of infections that are acquired by patients during the course of receiving treatment for other conditions. HAIs in most cases affect those patients who are receiving medical surgical treatments or those with reduced host defenses as a result of age, underlying diseases, or even other conditions. For many years those patients that were affected by these infections were reported

By Joseph Lister using antiseptics in surgery, the cleanliness of modern surgery is very sanitary and does not cause infection to patients and many of the infections led to amputations and death.

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.

“I have neither given nor received help on this assignment, and pledge this work to be my original composition.” –Ashley Salinas

Thank you, Melinda, for the feedback and all the supports. It is exciting to realize that, we are almost at the finishing point. As you mentioned, people with diabetes have difficulties healing. The surgical site infections (SSIs) increase the treatment cost of the healthcare related infections. As the Centers for Medicare & Medicaid services place penalties for the hospital readmission, the hospitals take all the measures to lower the SSIs (Barclay, 2016). Under such situations, diabetes and surgical site infections are always a concern.

Surgical site infection (SSI) has been the most frequently occurring, healthcare-associated infection (HAI), causing 21.8% of reported infections in the United States (Magill et al. 2014). Despite the advances made in antimicrobial drugs, asepsis, sterilization and operative techniques, SSI continues to be a major problem in all branches of surgery in the hospitals (Saeed et al. 2015).

* 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

Griffin (2005) reports that most 'hospital acquired infections' (HAIs) are "largely preventable" and that surgical site infections (SSIs) "account for about 40% of all HAIs." (p.20) Griffin additionally notes that according to studies "surgical patients who develop SSI are twice as likely to die as those who don't. These patients are also 60% more likely to require an ICU admission, remain in the hospital twice as long, and have a 6 times higher rate of readmission that those with no infection." (Griffin, 2005, p.21) According to Griffin (2005) "appropriate use of prophylactic antibiotics is fundamental in preventing SSI and includes three core elements: (1) appropriate selection; (2) timing of the first dose; and (3) discontinuation postoperatively. (p.21) This is reiterated in the work of Stefansdottir, et al (2009) entitled "Inadequate Timing of Prophylactic Antibiotics in Orthopedic Surgery" which reports that prophylactic antibiotics are in important part of the preventive measures" following surgery to combat SSIs. (paraphrased) Kasteren, et al (2007) in the work entitled "Antibiotic Prophylaxis and the Risk of Surgical Site Infections Following Total Hip Arthroplasty: Timely Administration Is the Most Important Factor" reports that SSIs following "total hip arthroplasty can lead to prolonged hospitalization, increased morbidity and mortality and high costs." (p.921)

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.