Surgical Treatment Of Surgical Site Infection

Patient safety is number one in hospitals. Every staff member that comes into contact with a patient should always have the question, “Will the patient be safe?” in the back of

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

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.

As the Joint Commission aims to nationally improve health care systems through health care organizations collaborations, it publishes recommended patient safety goals. As stated by the Joint Commission, “the first obligation of health care is to “do no harm””. The Joint Commission’s 2015 National Patient Safety Goals for hospitals include : Identify patients correctly; Improve staff communication; Use

An opportunity or metric for Memorial Herman Northeast to improve upon are Bloodstream infections after surgery and mortality rates.

The core purpose of the national patient safety goals is to indeed promote and improve patient safety. The Joint Commission (2015) lists several of them in its 2015 National Patient Safety Goals. One of the goals the author wants to elaborate more upon is: prevent mistakes in surgery. This paper will include an overview about the aforementioned national patient safety goal. It includes three methods to be followed to be able to achieve the said safety goal. The paper also highlights the importance of the issue to the general public, to the health care institutions, and to the health care professionals. Financial implications of not achieving the goal is also explored in this paper. This national patient safety goal is a multidisciplinary issue. The important roles of other professionals will be discussed as well as nursing leadership.

Postsurgical infection treatment cost negatively impact hospital’s finance and creates a financial burden on the hospital. The financial burden of surgery is increased due to the direct costs incurred by the prolonged hospitalization of the patient, diagnostic tests, and treatment. “Infections related to coronary artery bypass graft (CABG) surgery are some of the most serious infections that require additional costs $40,000 to $50,000” (CABG Infections …, CMS Pay 2008). According to, Contemporary…, this serious and costly errors in the care delivery should never happen. Furthermore, “Hospitals can be penalized up to 1% initially of an organization’s baseline annual Medicare reimbursement” (Cherry, Jacob, 2017, p.392) for performing poor patient

One hundred fifty-seven thousand, five hundred – according to Infection Prevention Consultant Victoria Russo, 157,500 is the estimated number of hospital-associated, surgical site infections (SSIs) that occur annually (2017). Why does it matter? Shockingly, the number of deaths linked to SSIs annually is estimated to be around 8,205 (Russo, 2017). This means, on average, 5% of the individuals plagued by an SSI will pass away due to complications related to the acquired infection. With statistics like these, it’s hard to ignore the fact that surgical site infections are a significant problem in healthcare.

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.

Because SSI rates for healthcare facilities are made public, patients are able to gain knowledge of how well their facility SSI prevention practices work. “It is moving fast and furiously because consumers are pleased with the progress that has been made in reducing central line infections,” says Linda Greene, MPS, RN, CIC, director, infection prevention, Rochester General Health System, Rochester, New York. The public now expects the same transparency for SSIs” (Patterson, P., 2011) .Facilities that participate in Medicare must report their SSI for certain procedures; the list of procedures to report continues to grow as patients’ demand for listed procedures grow. ” SSI data will be reported through the National Healthcare Safety Network (NHSN) managed by the Centers for Disease Control and Prevention (CDC), a secure, web-based surveillance system for reporting data on infections and other events. The data can then be used for analysis, facility comparisons, and quality improvement.” (Patterson, P., 2011) Hospitals will, and should, continuously search for new ways to increase their quality of care. Having a great overall rating for a low number of incidences of SSIs can only boost their ratings.

Prepping of patients for surgery, as has been the practice, has involved removal of hair on and around the site of surgical incision. Research has shown that infections at surgical sites can be prevented through shaving the incision sites with several researchers revealing that the removal of hair from the surgical site also eliminates bacteria and other pathogens that thrive on the hair. Other researchers, however, revealed that shaving of the patient's skin before surgery increases the risk of infection rather than reducing it such as ADDIN EN.CITE Celik2007630Celik and Kara (2007)63063017Celik, S EKara, ADoes shaving the incision site increase the infection rate after spinal surgery?Spine (Phila Pa 1976)Spine (Phila Pa 1976)1575-732152007 HYPERLINK l "_ENREF_1" o "Celik, 2007 #630" Celik and Kara (2007) who found that postoperative infections occurred in 4 patients who had been shaved before surgery compared to 1 patient in the group that had not been shaved. Data collected by the Centers for Disease Control and Prevention (CDC&P) shows that infections at surgical sites are among the leading causes of complications for hospital patients and they account for 20 percent of infections associated with healthcare leading to thousands of deaths every year ADDIN EN.CITE Healthcare Infection Control Practices Advisory Committee2011631(Healthcare Infection Control Practices Advisory Committee, 2011)63163143Healthcare Infection

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

* 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

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.