Issue link: https://beckershealthcare.uberflip.com/i/774606
18 INFECTION CONTROL & PATIENT SAFETY WHO Updates SSI Prevention Guidelines: 29 Ways to Prevent Infections By Heather Punke T he World Health Organization released a list of 29 concrete recommendations to prevent surgical site infections in Novem- ber, published in e Lancet Infectious Diseases. "Preventing surgical site infections has never been more important but it is complex and re- quires a range of preventive measures," said Dr. Marie-Paule Kieny, WHO's assistant direc- tor-general for health systems and innovation. "ese guidelines are an invaluable tool for pro- tecting patients." Of the 29 total recommendations to prevent SSIs, 13 are for preoperative preparation and 16 are for intraoperative and postoperative periods. e recommendations are valid in any country and should be used to complement the WHO's Surgical Safety Checklist. e recommendations were distilled by 20 leading experts from 26 re- views of the latest evidence available. Some of the major recommendations include: • Do not use antimicrobial sealants aer surgical skin preparation • Do not remove patients' hair unless it's abso- lutely necessary, and if it is, removal should be done only with a clipper. "Shaving is strongly discouraged at all times," the recommendations read • Have patients bathe or shower with either plain soap or antimicrobial soap prior to surgery • Use warming devices in the operating room and during the procedure • Do not use antibiotic incisional wound irriga- tion before closure • Use antibiotics before and during surgery only — they should not be used aer surgery "By applying these new guidelines, surgical teams can reduce harm, improve quality of life and do their bit to stop the spread of antibiotic resistance," said Ed Kelley, MD, PhD, director of the WHO's Department of Service Delivery and Safety. n Senate Committee Deems Concurrent Surgeries Unsafe, Urges Hospitals to Ban Them By Brian Zimmerman A fter a nine-month review of 20 hospitals' concurrent surgery processes, the Senate Finance Committee released a report in December calling for all hospitals to forbid the practice, according to The Boston Globe. For purposes of the report, the committee defined "concurrent surgery" as two operations managed by the same surgeon with critical parts of the surgery occurring at the same time. The report calls on all hospitals to end the practice, along with other recommendations mentioned below. The committee's report follows guidelines issued by the American College of Surgeons in April 2016, which called for patients to be informed prior to operation if their surgeon would be performing a separate procedure on another patient simultaneously. The Senate Finance Committee does not think those guidelines went far enough. "While we are encouraged by the steps taken by the American College of Surgeons and a number of hospitals to address the concerns with con- current surgeries, we remain concerned that the nearly 5,000 hospitals in America may lack thorough and complete policies covering these proce- dures and patient consent," reads a joint statement by committee chairman Sen. Orrin G. Hatch (R-Utah), and Sen. Ron Wyden (D-Ore.) ranking Demo- crat on the committee, according to the Globe. The committee also asks hospitals, not surgeons, to clarify the circumstanc- es under which it is safe for surgeons to schedule operations that overlap even for a brief time; suggests authorizing anesthesiologists to cancel op- erations if surgeons violate policies; and urges hospitals to explicitly tell patients about any overlapping surgeries far enough in advance that they can decide whether to cancel the procedure. The report clashes with a recent study conducted at the Mayo Clinic in Rochester, Minn., which compared 10,614 overlapping surgeries with 16,111 non-overlapping procedures. Researchers found the practice of concurrent surgery at Mayo to be safe and not associated with an increased risk for adverse outcomes. Among the 20 hospitals reviewed by the Senate committee, 17 revised or created new policies to address the practice of concurrent surgeries during the time of the committee's study, according to the Globe. The oth- er three are currently in the process of revising their policies. n "We remain concerned that the nearly 5,000 hospitals in America may lack thorough and complete policies covering these procedures and patient consent."