...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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...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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...of chemotherapy and Apheresis. While CVCs can be lifesaving they also have significant risks of surgical-site infection (SSIs). Providone-iodine (Betadine) has been the primary cleanser for central line placement for the last decade, but surgical- site infections (SSI) continue to increase raising the question if betadine is a sufficient agent for surgical insertion of a CVC or is there an alternative proven through evidence- based practice to be a more effective anti-microbial. A2a. Basis for Practice Procedures and protocols are researched by the safety committee who release their findings to the clinical practice committee for review and evaluation. In a culture that use to accept betadine as the primary anti-microbial agent to cleanse the skin prior to CVC insertion has been questioned and through evidence based practice is in favor of using chlorhexidine gluconate (CHG) as the primary agent by identifying and concluding that it is superior to betadine by reducing the risk of SSIs by approximately 50% (Chaiyakunapruk, Veenstra, Saint, and Lipsky (2009). If the clinical practice committee approves the use of CHG for CVC insertion it is communicated to the department of nursing followed by the nurse managers, educators and staff nurses. A2b. Rationale CHG and betadine are anti-microbial agents that reduce the incidence of primary SSIs. Cleansing the surgical incision site of the CVC is practiced by disinfecting the skin...
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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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...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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...The quality improvement project I chose to critique focused on decreasing the occurrence of postoperative surgical site infections following a cesarean delivery. This project was initiated in August 2014 at the hospital in which I am employed. It was started in response to our elevated number of surgical site infections. The rates of surgical infections had been slowly increasing over the previous year but stayed below our benchmark of 1 out of every 100 procedures. When our infection rate rose to 3.32, it was clear that an intervention needed to occur and the quality improvement project was launched. During this quality improvement initiative, a bundle of recommendations was created to address several areas of concern in regards to infection...
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...facilitate this process? Give a specific example. Use an example that is different than the postings of other students. There are six links in the Chain of Infection. Those areas include: 1. The infectious agent itself- 2. The reservoir where the infectious agent can live and multiply or lie dormant until the organism can find the opportunity to cause disease 3. The susceptible host 4. A means of Transmission 5. A portal of exit 6. A portal of re-entry Each link in this chain must be intact for a disease to be transmitted and infect another person. There is the potential to defeat a communicable disease process by disrupting the link in this chain at any point along the way thus preventing infection in another person. An example of the simplest chain of infection is an infected patient cared for by a health care worker who doesn't wash their hands before caring for another patient. Human sources of microorganisms are healthcare workers, patients themselves and visitors, any of whom may be individuals who are in some stage of an incubation period of a disease process, may already have a disease, or may be a chronic carrier of an infectious agent. The patient may be their own source of infection. (Baldwin, 2008) The bacteria must be able to find a susceptible host. Some individuals are immune to infection or are able to resist colonization by an infectious agent while others will develop a full blown clinical disease process. Then there are those who are able...
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...Executive Summary - Infection Control and Prevention Current Compliance Status for Joint Commission Accreditation Nightingale Community Hospital is committed to providing healthcare excellence, a healing environment and to be the choice for patient care. In order to continue to provide quality healthcare services in accordance with our values of safety, community, teamwork, and accountability Joint Commission Accreditation provides guidelines and standards for the Priority Focus Areas (PFA) for the welfare and quality of patient care. Infection control and prevention extends beyond treating the patient. It encompasses all who work and visit the facility including medical staff, administrative staff, volunteers, vendors, and visitors. Implementing activities and programs to control, treat, prevent and identify sources of infection will help ensure the overall satisfaction and quality of patient care. Based on previous fiscal year data Joint Commission has identified Infection Control as one of the PFAs. In order to be in compliance with the standards and guidelines of Joint Commission Accreditation five areas of Infection Control and Prevention have been identified: 1. The hospital implements its infection prevention and control activities, including surveillance, to minimize, reduce, or eliminate the risk of infection. 2. Comply with either the current Centers for Disease Control and Prevention (CDC) hand hygiene guidelines or the current World Health Organization...
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...Sutures versus Staples for Cesarean Sections Victoria Fath Kent State University Absorbable Sutures versus Staples for Cesarean Sections Introduction The Merriam-Webster Dictionary (n.d.) defines a Cesarean section as, "A surgical operation for giving birth in which a cut is made in the mother's body so that the baby can be removed through the opening." "Cesarean delivery is the most common major surgical procedure performed in the United States and elsewhere. Currently, approximately a third of pregnant women in the US and 15% worldwide deliver by cesarean, and this prevalence is on the rise" (Dana Figueroa et al., 2013, p. 33). Since Cesarean sections are incredibly common and are only increasing, the risks for complications, such as infections, increase with it. To try and decrease the risks as much as possible, this study aims to look at the differences between two types of closing material used in Cesarean sections; absorbent sutures and staples. Are absorbable sutures more effective and safer than staples for Cesarean sections? The purpose of this study is to compare absorbent sutures and staples for clients undergoing a Cesarean section and to see which material has a lesser risk for infection and wound complications, which is more cost effective for the hospital, and patient satisfaction. This paper will help shed light on this subject by compiling multiple research articles and journals to create a better understanding on which material is...
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... 4 y/o Post incision and drainage Cues | Diagnosis | Inference | Plan of care | Nursing Interventions | Rationale | Evaluation | Subjective:“ sakit sugat ko dito ma” as verbalized by the patientObjective: * Localized erythema and edema * (+) pruritus on the site of the incision. * (+) Facial grimace * (+)Irritability * (+) Guarding behavior * (+) Crying * (+) VS normal T= 36.8 ‘ c PR= 77 RR= 25 * Pain assessment>Location: Right post auricular area>Interval: frequent | Acute pain related to tissue trauma secondary to incision and drainage as manifested by * Localized erythema and edema * Pruritus on the site of the incision * Facial grimace * Irritability * Crying * Guarding behavior * Frequent interval of pain | Nociceptive stimuli(wound/inflammation)↓Nerve fibers (nociceptor) ↓ ↓A-delta fiber C-fiber (fast) (slow) ↓ ↓ Spinal cord & Dorsal horn pain modulating circuit (primary touch fiber) Neospino- Paleospino- thalamic thalamic tract (sharp, tract (dull,bright pain) aching pain) Substantia Gelatinosa (synapse) Thalamus (center of awareness...
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...URINARY TRACT INFECTION Elizabeth Quartey Abstract According to the CDC estimates in 2002 there were 1.7 million Healthcare-Associated Infections (HAI), and 99,000 HAI- associated deaths in the hospital. The report stated that the four largest categories of HAI, responsible for more than 80% of all reported HAI, are central line-associated bloodstream infections (CLABSI, 14%), ventilator-associated pneumonia (VAP, 15%), surgical site infections (SSI, 22%), and catheter-associated urinary tract infections (CAUTI, 32%). HAI are a great financial costs to health care facilities. The Centers for disease Control and Prevention (CDC) estimates the medical cost of HAI in the U.S. hospitals as $6.65 billion in 2007, and that number has increased to almost $10 billion a year currently. Statement and Significance of the Problem One in 20 patients who are admitted to a hospital will be a victim to an infectious agent they are exposed to during their hospitalization according to the Centers for Disease Control (CDC) (Goodman, Brenda, 201, Hospital-Acquired Infections cost $10 Billion a year). The five most common infections are surgical site infections, infections associated with the use of devices like central lines, catheters, ventilators and clostridium dificile are costing the health care System in the USA almost $10 billion a year to treat. In the article Vitamin D has the potential to reduce the risk of Hospital-Acquired Infections, the writer...
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...WHO Guidelines on Hand Hygiene in Health Care: a Summary First Global Patient Safety Challenge Clean Care is Safer Care a WHO Guidelines on Hand Hygiene in Health Care: a Summary © World Health Organization 2009 WHO/IER/PSP/2009.07 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable...
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...Capstone Project Abstract Background Hand washing and hand hygiene are consider to be the number one, cheap essential measure of preventing and controlling spread of hospital acquired infections (HAIs). Hand washing and hygiene can significantly reduce the burden of disease, in particular in hospitalized patient Unfortunately compliance to hand hygiene recommended standard procedures by the health care workers (HCWs) has been unacceptably poor. In order to design education program, identification of several risk factors associated with poor hand hygiene (HH) compliance is of extreme importance. Objective: The purpose of this study is to implement a hand hygiene program for increase compliance with hand hygiene among health care worker in 97 beds hospital. The key target for compliance to HH is not only health-care workers but also policy-makers and organizational leaders and managers. Methods.: Compliance to hand hygiene will be evaluated through direct observation of HCWs ,to helps pinpoint areas of strength or weaknesses in HH behavior, so as to develop training program that will help HCWs to complaint with HH . Evaluation will be based on direct observation and survey audit, observing the HCWs during routine patient care to ensure that hands hygiene are performed before and after getting in contact with patient and patient environment. In addition, survey audit based on the HCWs perception, knowledge and attitude...
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...By Jonas Wilson, Ing. Med. Vascular Surgery The surgical branch dealing with disorders of the circulatory system, which includes arteries, veins and lymphatic vessels, is called vascular surgery. These specialists treat varying conditions, such as aneurysms and atherosclerosis. These are abnormal dilations in vessel walls and narrowing/ hardening of the arteries, respectively. Vascular surgeons are focused on fixing vessels in nearly all parts of the body with the exception of the brain and heart. They also deal with peripheral vascular disorders like ulcers on the lower extremities and poor circulation. Surgical approaches to vascular repair may be endovascular (i.e. closed) or open surgery. Endovascular surgery Procedures that fall...
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...The thickened, scarred pericardium becomes nondistensible and decreases diastolic filling of the cardiac chambers and cardiac output. Chronic pericardial effusion is a gradual accumulation of fluid in the pericardial sac. The pericardium is slowly stretched and can accommodate more than 1 L of fluid at a time. Between 26% and 86% of people with pericarditis have illnesses that are considered idiopathic (occurring without a known cause). Pericarditis may also be classified etiologically into three broad categories: infectious pericarditis, noninfectious pericarditis, and pericarditis presumably related to hypersensitivity or autoimmunity. Infectious pericarditis may be caused by a viral infection such as the coxsackie B virus. Pyrogenic, tuberulous, mycotic, syphilitic, and parasitic infections may also cause pericarditis. Noninfectious pericarditis may be caused by a number of factors, including acute myocardial infarction, trauma, aortic aneurysm (with leakage into the pericardial sac), uremia, sarcoidosis, and...
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