The Clinical Problem Presented Was An Increase In Surgical

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

The Joint Commission Accreditation Body assesses health care organization’s compliance with National Patient Safety Goals. The goal of the Joint Commission Body is to focus on critical aspects and patient safety issues in health care organizations, which can vary according to the setting of the health care being performed (Chassin, 2008). Infections occurring in surgical sites of patients account for 15% of all infections that transpire in a hospital setting, and the risk of death doubles in patients who develop infections. The dangers of surgical site infections include superficial, deep, and organ or space infections. The different infections include cellulitis, gangrene, MRSA, and wound sinus, which can lead to amputation, organ

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

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).

In the last five years, Enhanced Recovery After Surgery (ERAS) pathways for colorectal resection have been thrust into spotlight with evidence of expedited recovery time and improved postoperative outcomes1–5. However, there exists little uniformity in the recommendations and results of published ERAS pathways, and there is some evidence suggesting that the wrong cocktail of bundle elements can increase Surgical Site Infection (SSI) rates6. This inconsistency can be attributed to a lack of consensus on the efficacy of some common bundle elements, such as preoperative antibacterial showering, maintenance of normothermia, and high intraoperative Fraction of Inspired Oxygen (Fi02) 7–15. Such dissonance in studied ERAS efforts

This essay will examine and compare the different methods of hand washing in the perioperative environment and how hand washing influences the prevention of healthcare acquired infections (HCAIs). It will show the importance of washing hands thoroughly to remove bacteria to prevent HCAIs. It will include the differences between the surgical hand wash, the social hand wash and the use of alcohol rubs.

The International Wound Infection Institute declares that because of increasing mortality rates due to SSI, it is imperative to identify patients at risk, as well as follow preventive measures to try and contain these infections. Further, groups like the National Institute for Health and Care Excellence in the U.K. and the Surgical Care Improvement Program in the U.S. along with the National Health and Medical Council of Australia, agree that health care workers should be educated and have the information to prevent the spread of SSI 's. (Clinical Practice). In order to reduce the number of surgical site infections (SSIs) a number of procedures and practices can be bundled for the optimal prevention of the spread of these infections. There are procedures that can be done pre-op, during the surgical procedure, as well as post-op to ensure that a patient does not contract an infection at the surgical site. These procedures include patient safety practices, patient assessment, healthcare worker safety practices, operating room safety procedures, along with basic education of the health care workers, patient and caregivers once the patient is discharged.

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.

In this article, the National Patient Safety Goal 07.01.01 addresses the reduction of hospital-acquired infections (Joint Commission, 2008). The Joint Commission (2008), the World Health Organization (WHO, 2009), the CDC (2006), and the Society for Healthcare

We do not have a set policy in place guiding or supporting us on when sterile/clean technique should be used. Us, primary care nurses are often deciding based on clinical judgment. This as highlighted previously leaves risk for inconsistencies in care if proper aseptic technique is not practiced by all providers. Similarly to other health care settings, the risk for transmission of antibiotic resistant microbes between patients exist with the potential for wound cross contamination and infection. As outlined in Cow et al (8), strengthening the knowledge and skill of health care provides regarding proper wound care, aseptic technique, and prevention of infection is critical in improving wound care

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

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

Those who incorporate the best practice standards can reduce the morbidity and mortality associated with surgical site infections.