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Archive September 2019 XX, No. 9

Infection Prevention: Stepping Up to Prevent SSIs

Staff at Saint Francis Health System has worked hard to significantly lower infection risks - and they're not done yet.

Joe Paone

Joe Paone


Saint Francis Health System
ON THE SPOT A surgical staffer pre-cleans and moistens instruments to prevent the build-up of bioburden.

Last fall, Saint Francis Health System in Tulsa, Okla., made a big push to improve point-of-use instrument cleaning by posting a new regimen for staff to follow in every OR. "We're keeping our instruments soaking and wiped down during cases," says Tamra Luna, MSN, RN, CNOR, the OR manager of surgery services at Saint Francis. "As soon as the case is done and the patient's out of the room, we make sure we get all the "chunks and hunks' off the instruments."

Doing away with the "chunks and hunks" — along with the significant strides the staff has made over the past year toward eliminating SSIs — has earned Saint Francis the OR Excellence Award for Infection Prevention.

The changes staff made to infection prevention protocols over the past year are comprehensive, and have nearly eliminated infection rates among total joint and colorectal surgery patients.

  • Pre-screening. When patients arrive at the pre-admission testing clinic, numerous actions are taken with SSI prevention in mind. Clinicians note the patient's A1C levels and comorbidities, and institute enhanced recovery protocols by giving patients nutritional supplement drinks 5 days before surgery. On the day of surgery, patients are pre-warmed with a focus on maintaining core body temperatures.
  • Instrument care. Ms. Luna and her team trialed multiple products for maintaining the wetness of surgical instruments and to eliminate bioburden buildup. They ultimately decided on a pre-cleanse wetting solution rather than an enzymatic soak because they found it best maintained wetness until delivery to sterile processing.
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