Becker's ASC Review

T he number of outpatient surgeries in the United States continues to increase year-over-year as patients de- mand convenient and cost-effective alternatives to inpatient care. In fact, an estimated 65% of all surgical pro- cedures are performed on a day case basis – meaning non overnight – in North America. 1 Ambulatory Surgery Centers (ASCs) are at the forefront of this trend and have redefined the outpatient experience once dominated by hospital-based models of care. In 2010, there were 18.7 million 2 ambulato- ry surgery cases in the United States, which accounted for 64% of all operations. 3 A recent study published in the jour- nal, Health Affairs, shows that ASCs provide a lower-cost al- ternative to hospitals as venues for outpatient surgeries 4 and since the primary goals of the Patient Protection and Afford- able Care Act (PPACA) are to reduce the cost and improve the quality of healthcare, the volume of cases performed in ASCs is likely to increase. In addition, continued advances in surgical technology, anes- thesia care, pain management and rehabilitation suggest that patients eligible to undergo ambulatory procedures may now have more comorbidities than previously encountered. 5 There- fore, there is even greater importance for healthcare providers to implement and improve patient compliance with evidence- based practices proven to reduce the risk of postoperative sur- gical site infections (SSIs). A growing body of evidence-based scientific and clinical stud- ies support preoperative skin cleansing as part of a compre- hensive strategy to prevent surgical site infections (SSIs). 6, 7 However, the benefits of these protocols are reduced if the prescribed bathing regimen is not followed or if the product is not used correctly by patients. A variety of factors impact patient compliance, but the real- ity is that preparing for any surgery – whether an inpatient or same-day procedure – can be stressful and overwhelming for patients, particularly if the recommended protocols seem complicated or vague. To help support patients and improve adherence to preadmission antiseptic showering regimens, patients should be armed with the tools and information to confidently prepare for surgery at home. Recent studies have shown reminder-based interventions to be beneficial in driving compliance with short-term medica- tions, 8 and according to a study published in the August 2014 issue of the Journal of the American College of Surgeons, 9 the use of electronic reminders such as text messages, emails or voicemails are highly effective ways to get surgical patients to adhere to preadmission antiseptic showering regimens known to help reduce the risk of SSIs. Products with clear instructions and automated reminders, can help take guesswork out of the equation so that patients are prepared on the day of their pro- cedure, and arrive feeling confident in the steps they've taken to help reduce risk factors for infection. The Clorox Healthcare ™ 4% CHG Skin Cleansing Kit is an easy-to-use kit for pre-procedural skin cleansing with tools to improve patient compliance. Two packs contain the essentials for two pre-procedural chlorhexidine gluconate (CHG) show- ers including a 4oz bottle of CHG, 3 cloths and a bilingual, wa- terproof instruction card. Patients can view video instructions for correct product usage online. In addition patients using the kit can sign up for a reminder system offered via email, text or voice message to help them remember how and when to cleanse prior to their scheduled procedure. As such the Clorox Healthcare ™ 4% CHG Skin Cleansing kit offers an ideal solu- tion to empower patients to follow pre-procedural skin cleans- ing protocols. As the demand for outpatient procedures grows, ASCs and hospital-based outpatient settings can increase patient com- pliance by providing products that are easy to use, have clear instructions and come with patient reminder systems. n References 1 Troy AM, Cunningham AJ. "Ambulatorysurgery:anoverview." Current Opinion in Anaesthesiology 15 (2002);647-57. 2 American Hospital Association. Annual Survey Database, 2010. Health Forum LLC 2010. Date accessed: 1 Oct. 2013. 3 National Center for Health Statistics, Centers for Disease Control and Prevention (CDC). Health, United States, 2012: With Special Feature on Emergency Care. Date accessed: 2 Dec. 2014. 4 Munnich EL, Parente ST. "Procedures Take Less Time At Ambulatory Surgery Centers, Keeping Costs Down And Ability To Meet Demand Up." Health Affairs 33.5 (2014): 764-769. 5 Smith BA. "Infection Control: Infection Prevention in Ambulatory Surgery." OR Nurse 2014 7.3 (2013): 11-13. 6 Edmiston CE, et al. "Evidence for Using Chlorhexidine Gluconate Preoperative Cleansing to Reduce the Risk of Surgical Site Infection." AORN Journal 92.5 (2010): 509-518. 7 "The Joint Commission's Implementation Guide for NPSG.07.05.01 on Surgical Site Infections: The SSI Change Project" (2013): 1-48. 8 Fenerty SD, et al. "The effect of reminder systems on patients' adherence to treatment." Journal of Patient Preference and Adherence 6.127 (2012): 135. 9 Edmiston CE, et al. "Empowering the Surgical Patient: A Randomized, Prospective Analysis of an Innovative Strategy for Improving Patient Compliance with Preadmission Showering Protocol." Journal of the American College of Surgeons, 219.2 (2014): 256-264. No Matter the Surgical Setting – Inpatient or Outpatient – Compliant Preoperative Skin Cleansing is Vital By Rosie D. Lyles, MD, MHA,MSc, Head of Clinical Affairs, Clorox Healthcare ADVERTORIAL

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