...Surgery at a Pennsylvania Hospital, states that a hospital in Pennsylvania reported that at least eight people who got an infections and from those eight, four have died. According to the lectures from class, we learned that nosocomial infections are infections that are transmitted from hospitals to patients through septic technique. The development of this infection was from a medical device that was used during an open-heart surgery. We also learned about Surgical Site Infections (SSI). According Central Disease Control and Prevention, CDC, this infections is basically is an infection that occurs in the body after surgery has taken place The Food and Drug Administration, F.D.A., have...
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...Reducing the risk of surgical site infection Joy Ibeh Walden University NURS 4001, Section 7, Research & Scholarship for Evidence-base practice September 7, 2014 Reducing the risk of surgical site infection A surgical site infection is a preventable event and also a national concern. There are numerous publication on national awareness and guidelines for infection prevention in different surgical settings. The benefit of providing information and acquiring knowledgeis to prevent patient mortality rate by following the national clinical guideline. Therefore the purpose of this paper is to discuss information from the the clinical practice guideline for preventing and reducing the risk of surgical site infection. Practice Setting Problem The Practice seting problem chosen for this assignment is reducing the risk of surgical site infection by using clinical practice guideline. Surgical site infections (SSI)is an infection patient acquired from hospital after surgery, It has a significant representation of healthcare associated infections. According to Center for Dieases Control and Prevention (CDC) SSI is defines as “ an infection that occurs after surgery in the part of the body where the surgery took place.” (Spruce, 2014). The author, Spruce (2014) addressed the mortality rate of surgical site infection and further noted that SSI is the second most prevalent healthcare associated infection that are estimated to be 40% to 60% preventable. Spruce reported that $28.4...
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...Executive Summary of Surgical Site Infections Patient safety and decreased mortality The data show that while the facility may be performing at optimum levels in some areas there are indications for significant improvement in other areas. 100% compliance in all areas will have positive benefits for the patient as well as for the hospital. The goal is to improve compliance in order to ensure patient safety and decrease mortality rates for surgical patients. Assessment Appropriate hair removal and normathermia are two areas that show consistent compliance. Maintaining current processes and procedures is recommended. While antibiotic selection was meeting the desired goal as set forth in the Surgical Care Improvement Project (SCIP) Inf-2, after May a significant decrease in compliance is noted. Use of prophylactic antibiotics prior to incision (SCIP Inf-1), stopping the antibiotic within 24 hrs. of surgery end time (SCIP Inf-3), beta blockers given during perioperative period (SCIP Card-2), recommended VTE prophylaxis ordered (SCIP VTE-1) and given within 24 hrs. prior through 24 hrs. after surgery (SCIP VTE-2) Corrective Action Plan The goal of the prophylactic antibiotic before and after surgery is to promote serum levels and gain bactericidal tissue. There is no known benefit for the patient to continue these antibiotics greater than 24 hrs. post-surgery (qualitymeasures.ahrq.gov, 2013). Physicians have been educated regarding the selection of antibiotics and...
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...NRS-433V Week 1 Literature Search: Prevention of Surgical Site Infection To purchase this tutorial visit here: http://mindsblow.us/question_des/NRS-433VWeek1LiteratureSearchPreventionofSurgicalSiteInfection/2852 contact us at: help@mindblows.us NRS-433V Week 1 Literature Search: Prevention of Surgical Site Infection Details: Conduct a literature search to locate research articles focused on a practice problem of interest. This literature search should include both quantitative and qualitative peer research articles to support your practice problem or issue of interest in 350-750 words. Identify six peer research articles which will be utilized through the next 5 weeks as reference sources. Create a reference list in which the six articles are listed. Beneath each reference include the article's abstract. The completed assignment should have a title page and a reference list with abstracts. Suggestions for locating qualitative and quantitative research articles from credible sources: 1. Use a library database such as CINAHL Complete for your search. 2. Using the advanced search page check the box beside "Research Article" in the "Limit Your Results" section. 3. When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative. To narrow/broaden your search, remove the words qualitative and quantitative and include words...
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...The role of preoperative Chlorhexidine as an antiseptic solution to reduce the risk of postoperative surgical site infection C1369366-MET319 Word count: 3546 Contents: Introduction: 3 Objective: 4 Methods: 4 Table 1: Search strategy 5 Critical appraisal of the literature: 5 Discussion: 17 Conclusion: 17 References: 18 Introduction: Surgical Site Infection (SSI) is a common complication in surgical practice. The incidence depends on multiple factors including the type and location of surgical procedure ranging from 2%-4% in simple skin lesions (Rogues et al., 2007) to 36% in cases of reversal of stoma (Liang et al., 2013). Incidence of SSI can be kept low by simple measures such as rescheduling elective procedures in presence of infection; e.g.: Urinary Tract Infection, Respiratory Tract Infection which can seed Bacteria to surgical wounds (Ollivere et al., 2009). Prophylactic Antibiotics given prior to elective surgery remains debatable and of questionable value considering the risk of side effects, emergence of Multi-drug resistant Pathogens and Anaphylaxis, and therefore should be used according to guidelines like in patients with higher risk for developing SSI (Wright et al., 2008, Dixon et al., 2006). Also, procedures at certain body sites and those involving surgical reconstruction are better covered with prophylactic Antimicrobial agent (Rosengren and Dixon, 2010). Use of antiseptic scrub has been...
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...attributes or characteristics of the concept. * Concept Analysis of the Surgical Wound Infection ? I will like to identify patients conditions and other factors contribute to the development of Surgical Wound infections. * Determine the aims or purposes of analysis The purpose is to understand the effect of environment in surgical wound infections. Prevention of infection requires the application of the principles of microbiology and accept practice. Measure of this concept is based on the stages of wound healing and the Centers of Disease Control and Prevention guidelines defining surgical site infection as occurring 30 days postoperative. * Identify all uses of the concept The Merriam-Webster Dictionary was used to explore the general definition of surgical wound infection Surgical of or relating to the process of performing a medical operation: of or relating to surgery. Wound an injury that is caused when a knife, bullet, etc., cuts or breaks the skin. Infection is the act or process of infecting someone or something: the state of being infected. The Oxford English Dictionary (OED) was also used to explore the definition. Surgical relating or used in surgery. Wound is an injury to living tissue caused by a cut, blow, or other impact, typically one in which the skin is cut or broken. Infection is the process of infecting or the state of being infected History of Surgical Wound Infection Hippocrates (Greek physician and surgeon, 460-377 BC), known as the...
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...Perioperative Shavings Victor A. Moore Western Governors University Prepping a patient for a surgical procedure usually involves removing the Hair at the incision site. The surgical care improvement project commonly known as SCIP is a national partnership of organizations focused on improving surgical care by significantly reducing surgical complications. One complication is surgical site infections SCIP has developed recommendations for hair removal. There are several SCIP measures, antibiotic within one hour before incision, received prophylactic antibiotic consistent recommendations, prophylactic antibiotic discontinued within 24 hours, control of postoperative serum glucose and appropriate hair removal. (Patterson, 2011, p. 120) What is appropriate hair removal? Razors can remove hair and has been the traditional method of hair removal, powered surgical clippers can trim hair at surgical site and does not leave cuts and microscopic abrasions where microscopic Flora can colonize in the surgical site causing postoperative infection. The National Quality Forum has endorsed to SCIP infection control measures. According to the Surgical Quality Alliance, which is a collaboration among specialty societies that provide surgical and perioperative care to improve the quality of care for the surgical patients, states that” following the endorsement by the National Quality Forum SCIP measures were incorporated into Medicare's reporting of Hospital Quality data for annual...
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...Glenda Doctor Western Governor’s University Procedure, basis for practice, rationale and explanation The procedure for the use of povidone-iodine for surgical cite antisepsis is: skin preparation for surgery includes the use of sterile drapes to drape the patient and square off surgical area with sterile towels to absorb excess solution. The incision site is where the prep begins and proceeds outward from that point. Iodine soap or scrub, wet the skin with sterile water the iodine scrub will be added to the point of lather, the site is to be scrubbed for 5 minutes. Excess solution is to be blotted with sterile towels or sterile gauze. When iodine paint is used the iodine paint will be applied and allowed to dry before first incision. This practice of surgical skin preparation has been a standard for many years. At this facility povidone-iodine is used predominantly however a few surgeons do use chlorhexidine, it has typically been surgeon choice for skin preparation. Studies have shown that Chlorhexidine-alcohol is a superior product to povidone-iodine to reduce skin colonization and reduce surgical site infection, (Darouiche, Wall, Itani, Otterson, Webb, Carrick, & ... Berger, 2010). No specific use for either product was found in the policy and procedures for the hospital on the hospital web site. There were no available protocols involving the products that were found. It is not apparent that there has been any evidenced based practice involved. ...
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...practice settings (Beyea S 2004:97). In this essay exploration of research evidence around skin care preparation will be discussed. Based on the findings from the research material, conclusion will be drawn. Surgical site infections are reported to be the third most frequently occurring nosocomial infection among hospitals patients. It can increase the length of stay up to 7.3 days, and increase the cost by prolonged postoperative stay as well as increase morbidity & mortality ( The impact of Preoperative 2003:1). SSIs can occur both peri and postoperatively, and skin is a potential source of microbial contamination. Therefore, it is important to prepare peri operative skin preparation. Skin preparation is a pre-operative procedure, which is performed to reduce the risk of postoperative wound infection and to prepare patient for surgery by removing soil and transient microorganisms from the skin. Peri operative skin preparation involves two processes- the first is physical cleansing, the physical removal of bacteria and dirt by washing with soap, detergent and water. Second process involves disinfection of the skin by bacterial agent (I. Mackenzie 1988:27). The surgical site should be assessed before skin preparation, and presence of any rashes, warts or other surgical site condition should be documented. The length of time patient is in hospital preoperatively is directly related to the risk of SSI. Since many of the micro-organisms...
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...NURSING PRACTICE In the United States there are approximately 5% of sterile surgical operations that will become infected each year. The number one nosocomial infections regarding surgical patients are infections at the surgical site (Kalb, Lefevre, Dididze, & Levi, 2013). For reductions of infections on any surgical site, this skin will need to be cleaned (or prepped) and covered with a sterile towel or drape. The site of the incision is prepped so that bacteria or microbes that cause the infection are found on the skin surface. Due to these microbes, prepping a patient’s skin will be the most important step prior to any surgery. Different hospitals throughout the United States use many different products for the cleaning or prepping stage. At the hospital of my place of employment, there are three different agents that can be used. This list includes Chlorhexidine gluconate, chlorhexidine alcohol, and povidone iodine. Any type of infection involving the incision site can cause complications that could be long term for any patient to deal with and may have financial consequences to any hospital. This particular hospital is considering a change to standardize the prepping solution and needs to determine the cost factor if it were to change to a new product or to add premixed applicators of particular type of surgical prep solution. At this hospital, the current standard is using a surgical prep cleanse that the primary surgeon chooses to use. The hospital’s policy has...
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...Screening and Decolonization of MRSA in the Preoperative Patient Suzanne Miller Aspen University HUM410 Abstract Staphylococcus aureus is the most common organism responsible for surgical site infections. The colonization of Methicillin-resistant staphylococcus aureus (MRSA) has been identified as a significant risk factor for patients undergoing orthopedic surgery, putting this patient at a higher risk of developing a surgical site infection. Screening preoperatively and treating colonization is a tool to aid in the prevention of surgical site infections in patients undergoing elective joint surgery. Results of various studies of patients undergoing elective joint replacement surgery have been reviewed. A nasal swab was obtained and cultured during preadmission testing. If the culture showed that the patient was positive for MRSA colonization they were treated with nasal mupirocin. They also were instructed to bathe with surgical wipes containing chlorhexidine prior to the procedure. The results of the research suggest that the use of a screening protocol prior to surgery can decrease the risk of MRSA in the postoperative patient. Table of Contents 1. Literature Review........................................................................................................................4 2. Discussion....................................................................................................................................7 3. Conclusion................
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...Back to Basics: Preventing Surgical Site Infections Chamberlain College of Nursing Back to Basics: Preventing Surgical Site Infections When going into a hospital for surgery, people do not think about the chances of becoming more ill due to a surgical site infection. People generally worry about the surgery itself and trust the fact that the staff performing the surgery and the staff caring for the surgical site are well trained to do so. Most people do not know what takes place to ensure the safety of the patients and the training that the staff must go through to prevent surgical site infections. With patient safety being a major concern in healthcare settings, we are looking at surgical site infections; what they are and how to help prevent them. Article Review According to the Center for Disease Control and Prevention (CDC), a surgical site infection (SSI) is defined as “an infection that occurs after surgery in the part of the body where the surgery took place” (CDC, 2012). With healthcare facilities trying to close the gap in preventable infections, many pieces of literature can be researched. The Back to Basics’ Preventing Surgical Site Infections article outlines interventions that are in place and that have been updated to help with reducing these infections. The author, put together a compiled list of perioperative interventions and the research that has gone into each one, along with any updates that the Joint Commission the National Institute for Health and...
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...Perioperative Skin Preparation Practices A. Select a perioperative procedure (e.g., routine shaving of the surgical site) that you would commonly find on a surgical floor. 1. Describe the process or procedure you have chosen and why you think it needs change. Surgical site infection accounts for forty percent of all hospital-acquired infection (Griffin, 2005). The Association of Operating Room Nurses (AORN) recommendations provide guidelines for achieving skin preparation of the surgical site. These are practices are achievable and represent what is believed to be an optimal level of practice (Association of Operating Room Nurses, 2002). Variation of the area where the surgical procedure is to be performed may occur, but the recommended procedures for this preoperative skin preparation remains the same. The AORN has recommended seven practices that should be followed for skin preparation prior to surgery. Recommended Practices for Skin Preparation of Patients (Association of Operating Room Nurses, 2002). I. The surgical site should be assessed before skin preparation. II. Whenever possible, hair should be left at the surgical site. I it is determined that hair should be removed; removal should be performed according to policies and procedures in the practice setting. III. The surgical site and surrounding areas should be clean. IV. When indicated, the surgical site and surrounding area should be prepared with an antiseptic agent. V. Personnel who are knowledgeable...
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...preparation on post-operative surgical site infections in abdominal surgery”. This quantitative research article is an experimental study to determine the effect of preoperative skin preparation procedures by nurses on post-surgical site infections in abdominal surgeries. The research question that the authors Dizer et. al are asking is if pre-operative skin preparation will decrease the risk of post-operative skin infections in abdominal surgeries. This study was based on previous research done that states pre-surgical skin cleansing with antibacterial agents greatly reduce the risk of infections. This study is to provide more evidence to support its use into nursing practice. The research design was experimental in that there was an intervention; preoperative skin preparation, a sample group that received the intervention and a control group to compare the sample group to. The methods used to answer the question were that the experimental subjects of the study were 272 patients that had been hospitalized and underwent abdominal surgery during a specified time period. The population of patients that made up the two groups met certain criteria for the study, and then were randomly separated into the sample and control groups. In the control group of patients; the amounts of wound colonizing bacteria was determined by smears from axillary and inguinal sites. Routine pre-operative skin preparation of removing the hair from the operation site the night prior to the procedure...
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...as a secondary diagnosis. Surgical site infection (SSI) is classified as a HAC and considered a preventable condition. For an eligible patient with a SSI coded as a secondary diagnosis, the hospital will only be reimbursed based on the primary diagnosis. (Medicare Learning, 2012) The hospital is left to absorb the remainder of the cost for the care of this patient. Much research has been done on ways to prevent SSI. This is a review of one quantitative study related to the effects of postoperative dressings on surgical complications, including surgical site infections. Protection of Human Participants In the study “Are Postoperative Dressings Necessary?” (Borkar & Khubalkar, 2011), 123 patients were recruited and signed informed consent. The researchers demonstrated protection of the participants from harm by way of the selection criteria. Only patients undergoing clean or clean-contaminated surgical procedures were included. Those with co-morbidity factors like diabetes or jaundice were excluded from the study, as well as those with contaminated wounds such as ruptured appendix or peritonitis. No particular benefit or risks to the participants were clearly identified by the authors; however, this reviewer could infer benefits such as closer monitoring of the surgical site during the recovery period which would also enable prompt diagnosis and treatment of infection. The inferred risks to the participants would be the increased risk of infection. The participants were free...
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