Feb 25, 2016

Nosocomial Infection: Reduce the Risk of a Surgical Site Infection

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Ways to help reduce the risk of a nosocomial infection during surgery

Prevention of nosocomial infections is critical. These infections are more commonly known as healthcare-associated infections (HAIs).

Healthcare facilities and operating rooms are fast moving places with many things to keep track of. But, there are four principles that can help reduce the risk of spreading a HAI during surgery to always keep top of mind:

  1. Diligent hand hygiene. Hand hygiene should be practiced by everyone in a healthcare facility. Patients, visitors, and healthcare professionals should understand and practice the World Health Organization (WHO) Five Moments for Hand Hygiene. The perioperative team uses more specific guidelines from the Association of perioperative Registered Nurses (AORN). The periop team should know and remind each other when to practice hand antisepsis.
  2. Reduce Bacteria on the Patient. Bacteria from the skin are the leading cause of surgical site infections. Microorganisms such as Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus (MRSA) are serious threats that can cost a hospital as much as $60,000.1 The skin cannot be sterilized, but by using a surgical skin prep and an incise drape, a sterile operating field can be created. Evidence now suggests bacteria from the patient’s own nares can contribute to surgical site infections (SSIs). Clinical evidence demonstrates that using a nasal antiseptic helps reduce the risk of SSI when part of a comprehensive preoperative protocol.
  3. Maintain normothermia. Operating rooms are typically cold and patients are often exposed. Maintenance of normothermia is important to help reduce the risk of SSIs.2-5 Even a 1.6°C decrease in body temperature can produce inadvertent perioperative hypothermia.6-7 Forced-air warming is a technology that has been proven safe and effective for over 25 years. Maintaining normothermia is one of the easiest, least expensive, and most effective benefits you can offer to patients.
  4. Mitigate cross-contamination. In a clinical study, 77% of reusable ECG leadwires were found to be contaminated with antibiotic-resistant nosocomial pathogens even after being cleaned.8 This is one reason to use disposable leadwires. Disposable leadwires can also remain with the patient even while they are being transported.

Prevention and reduction of HAIs are a priority for the U.S. Department of Health and Human Services (HHS).

For more information on the HHS plan, visit the National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination. There is no one way to stop HAIs, prevention relies on people. By practicing proper protocols and looking out for the patient, we can all work together to improve infection rates.

1 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(12): doi: 10.1371/journal.pone.0008305
2Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. N Engl J Med. 1996;334:1209-15.
3 Melling AC, Ali B, Scott EM, Leaper DJ. Effects of preoperative warming on the incidence of wound infection after clean surgery: A randomized controlled trial. Lancet. 2001;358:876-880.
4 Barie PS. Surgical site infections: epidemiology and prevention. Surg Infect. 2002;3:S9-S21.
5 Seamon, M.J., et. al. The effects of intraoperative hypothermia on surgical site infection: An analysis of 524 trauma laparotomies. Ann of Surg. 2012;255(4)
6 Sessler DI. Current concepts: mild perioperative hypothermia. N Engl J Med. 1997; 336:1730-1737.
7 Barie PS. Surgical site infections: Epidemiology and prevention. Surg Infect. 2002; 3: S-9 – S-21.
8 Jancin, Bruce. Antibiotic-resistant pathogens found on 77% of ECG lead wires. Cardiology News. 2004;2(3):14.

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