Reducing surgical site infections is a team effort

Surgical-site infections (SSIs) occur in nearly 3 percent of all surgical procedures in the U.S. When they do, they add a week or more to a patient’s hospital stay and cost the health care system $10 billion annually. Many SSIs can be prevented by following some scientifically proven simple steps. “Our SSI rates were not above national averages, but we knew we could do better,” said Donna Harvey, MS, RN, CNOR, system director, Surgical Services/Endoscopy, who is the team leader for the Hallmark Health System (HHS) program to decrease SSI rates.

HHS joined a national effort to reduce SSIs and adopted a “bundled” approach that encourages a standardized process, pioneered by Johns Hopkins Hospital. Among the action steps  in the bundle are practices such as:

-providing the antiseptic agent chlorhexidine topatients so they can shower with it (instead of soap and water) before their surgery
-administering antibiotics one hour prior to beginning the actual surgery and again if the surgery takes longer than three hours
-keeping patients warm before, during, and after surgery – “research has shown that cold patients are more likely to get an SSI,” said Harvey.

In addition, HHS champions engage in continuous education of staff, monitor and track results and refine the “bundle” as needed. And they review any SSIs that do occur “to see what happened and what we could have done differently,” she added. In the past 18 months, said Harvey, “we have implemented 40 practices, in a systematic way and using the team approach, to improve our SSI rate. And we’re making steady progress in both reducing SSIs and getting all of us ‘in the habit’ of taking all the appropriate infection control steps with each patient.”


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