Archive January 2019 XX, No. 1

Ideas That Work: Out With The Old, In With The New

A Closing Protocol That Reduces Infections

Jodi Rennie, BSN, RN, CNOR
CLOSING STATION All the things surgeons need to close — fresh gowns, gloves and instruments — are ready at Abington Jefferson Health.

In an effort to reduce the infection rate among our colon resection patients, we took some advice from our GYN/ONCO surgeons on closing protocol. They had started the practice of changing gowns, gloves, bovie tips, suctions tips and instruments before closing. We took what they did and added to it.

In addition to changing gowns, gloves and instruments, we place a plastic wound protector — it goes in the body and looks like the lid to a Tupperware container — in the patient's wound to hold the skin back and keep the abdomen walls clean. We also no longer allow instruments to be placed under the drapes when we square off the surgical site.

And we built a "closing tray" — with input from a survey of our surgeons — that includes 12 instruments to close a laparoscopic colon resection or an open abdomen procedure. When we start closing now, there is nothing left of what we used during the case, everything is clean and new — gowns, gloves and instruments. We haven't yet collected data, but we anticipate these changes will help reduce our SSIs.

Jodi Rennie, BSN, RN, CNOR
Abington (Pa.) Jefferson Health

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