Becker's Clinical Quality & Infection Control

Becker's Infection Control & Clinical Quality May 2017

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68 Executive Briefing At 3M, we believe that solving complex problems starts with thinking big. Our teams draw on science applied across multiple industries to help you accelerate your fight against one of healthcare's most complex chal- lenges—SSIs. Together with dedicated healthcare professionals all over the world, we work to create positive change and help improve surgical care for every patient. Learn more at go.3M.com/FightSSIs. Conclusion Preventing SSIs requires the implementation of clinically effec- tive interventions to counteract or offset the variables known to cause infection. The goal is to prevent bacterial contamination of the surgical site and neutralize bacteria that could otherwise infect the wound. Using guidelines and evidence-based best practices — like those above — can have a positive effect on reducing the risk of SSIs. n References: 1 Institute of Medicine. 2000. To Err Is Human: Building a Safer Health System. Wash- ington, DC: The National Academies Press. doi:https://doi.org/10.17226/9728. 2 Meeks DW, Lally KP, Carrick MM, et al. Compliance with guidelines to prevent surgical site infections: as simple as 1-2-3? Am J Surg. 2011; 201(1):76–83. [PubMed: 20573335] 3 Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Es- timating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol. 2011; 32(2):101–114. [PubMed: 21460463] 4 CDC National and State Healthcare-Associated Infections Progress Report, pub- lished March 2016, available from: www.cdc.gov/hai/surveillance/progress-re- port/index.html 5 Anderson DJ, Pyatt DG, Weber DJ, Rutala WA. Statewide costs of health care– associated infections: estimates for acute care hospitals in North Carolina. Am J Infect Control. 2013; 41(9):764–768. [PubMed: 23453162] 6 Lewis SS, Moehring RW, Chen LF, Sexton DJ, Anderson DJ. Assessing the relative burden of hospital-acquired infections in a network of community hospitals. Infect Control Hosp Epidemiol. 2013; 34(11):1229–1230. [PubMed: 24113613] 7 Zimlichman E, Henderson D, Tamir O, et al. Health care– associated infections: a meta-analysis of costs and financial impact on the us health care system. JAMA Intern Med. 2013; 173(22):2039–2046. [PubMed: 23999949] 8 Agency for Healthcare Research and Quality. Healthcare Cost and Utilization Project—statistics on hospital stays. 2013. http://hcupnet.ahrq.gov/. Accessed February 15, 2013 9 Scott, RD. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Centers for Disease Control and Pre- vention; Atlanta: 2009. http://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf. Accessed December 14, 2013. 10 Anderson DJ, Kaye KS, Chen LF, et al. Clinical and financial outcomes due to methicillin resistant Staphylococcus aureus surgical site infection: a multi-center matched outcomes study. PLoS ONE. 2009;4:e8305. 11 Mangram AJ, Horan TC, Pearson ML, Silver LC, and Jarvis WR. Guideline for prevention of surgical site infection. Infection Control and Hospital Epidemiology. 1999;4:247-278. 12 Masic, Izet, Milan Miokovic, and Belma Muhamedagic. "Evidence Based Med- icine – New Approaches and Challenges." Acta Informatica Medica 16.4 (2008): 219–225. PMC. Web. 6 Apr. 2017. 13 Resar R, Pronovost P, Haraden C, Simmonds T, et al. Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia. Joint Commission Journal on Quality and Patient Safety. 2005;31(5):243-248. 14 Perl TM, Cullen JJ, Wenzel RP, et al. Intranasal mupirocin to prevent postopera- tive Staphylococcus aureus infections. N Engl J Med. 2002;346:1871-1877. 15 Kalmeijer MD, van Nieuwland-Bollen E, Bogaers-Hofman D, et al. Nasal carriage of Staphylococcus aureus is a major risk factor for surgical site infections in ortho- pedic surgery. Infect Control Hosp Epidemiol.2000;21:319-323. 16 Kluytmans JAJW, Mouton JW, Ijzerman EPF, et al. Nasal carriage of Staphylococ- cus aureus as a major risk factor for wound infections after cardiac surgery. J Infect Dis. 1995;171:216-219. 17 Phillips M, Rosenburg A, Shopsin B, et al. Preventing surgical site infections; A randomized, open-label trial of nasal mupirocin ointment and nasal povidone-io- dine solution. Infect Control Hosp Epidomiol. 2014;35:826-832. 18 Bebko SP, Green DM, Awad SS. Effect of a preoperative decontamination pro- tocol on surgical site infections in patients undergoing elective orthopedic sur- gery with hardware implantation. JAMA Surg. Published online March 04,2015. doi:10.1001/jamasurg.2014.3480. 19 3M Study-05-011100. 20 Garibaldi RA Prevention of intraoperative wound contamination with chlorhexi- dine shower and scrub. J Hosp Infect 1988;11(Suppl B):5–9. 21 Hayek L, Emerson JM, Gardner AMN. A placebo-controlled trial of the effect of two preoperative baths or showers with chlorhexidine detergent on postopera- tive wound infection rates. J Hosp Infect 1987;10:165–72. 22 Murray MR, et al. Efficacy of preoperative home use of 2% Chlorhexidine Glu- conate cloth before shoulder surgery. J Shoulder Elbow Surg 2011; 20: 928-33. 23 Feldman G, Fertala A, Freeman T, et al. Recent advances in the basic orthopedic sciences: osteoarthritis, infection, degenerative disc disease, tendon repair and inherited skeletal diseases. In: Austin MS, Klein GR, ed. Recent Advances in Ortho- pedics. 1st ed. New Delhi. Jaypee Brothers Medical Publishers (P) Ltd; 2014: 256. 24 Edmiston CE Jr. et al. Preoperative shower revisited: Can high topical antiseptic levels be achieved on the skin surface before surgical admission? J Am Coll Surg 2008;207(2):233-9. 25 Karki S, Cheng AC. Impact of non-rinse cleansing with Chlorhexidine Gluconate on prevention of healthcare-associated infections and colonization with multi-re- sistant organisms: a systematic review. J Hosp Infect 2012; 82:71-84. 26 AORN. Guideline for Preoperative Patient Skin Antisepsis. Guidelines for Periop- erative Practices. Denver, Colorado: AORN, Inc. 2017. 27 Casey AL, Karpanen TJ, Nightingale P, Conway BR, Elliott TSJ. Antimicrobial ac- tivity and skin permeation of iodine present in an iodine-impregnated surgical incise drape. J Antimicrobial Chemotherapy. 2015. 28 Chen et al. Incise Draping (Ioban) is Protective against Surgical Site Contamina- tion during Hip Surgery: A Prospective Randomized Trial. Abstract presented at MSIS Annual Conference, Aug 5-6, 2016 29 Bejko et al. Comparison of efficacy and cost of iodine impregnated drape vs. standard drape in cardiac surgery: Study in 5100 patients. J Cardiovasc Trans. Res. 2015; 8:431-437 30 Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the inci- dence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med 1996;334:1209e1215. 31 Sessler DI. Complications and treatment of mild hypothermia. Anesthesiology 2001;95:531e543. 32 Seamon MJ, Wobb J, Gaughan JP, et al. The effects of intraoperative hypother- mia on surgical site infection: an analysis of 524 trauma laparotomies. Ann Surg 2012;255:789e795. 33 Schmied H, Kurz A, Sessler DI, Kozek S, Reiter A. Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty. Lancet. 1996;347:289–292. 34 Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008; 108(1): 71-77. 35 Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the inci- dence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med. 1996; 334(19):1209-15. 36 Mahoney, C.B., and Odom, J. Maintaining intraoperative normothermia: a me- ta-analysis of outcomes with costs. American Association of Nurse Anesthetists Journal. 1999 Apr;67(2): p. 155-63. 37 Sessler DI. Perioperative heat balance. Anesthesiology. 2000; 92(2):578-96. 38 Andrzejowski, J. Hoyle, J. Eapen, G. et. al. Effect of prewarming on postinduction core temperature and the incidence of inadvertent perioperative hypothermia in patients undergoing general Anaesthesia. BJA. Nov.2008;101(5):627-631.

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