Archive Infection Control 2017

Inside Our Journey to Zero SSIs

It took evidence-based practices and hard work to eliminate infections.

Diane Kimsey

Diane Kimsey, MSN, MHA, RN, CNOR, CLO


removing hair SHORT CLIP Removing hair in the pre-op area was one of the key elements to the initiative's success.

The quest to do away with surgical site infections began in July 2014 when our hospital's COO put us on notice that the 9% infection rate in our heart and total joint patients was unacceptably high. Challenge accepted. We built a team comprised of representatives from all specialties, gathered in a conference room and got to work. By October, we reduced the infection rate to 2.7%; we reached zero a month later. Our success built momentum, and we soon applied the enhanced infection prevention protocols to all procedures. Here's how we turned a problem into a point of pride.

No stone unturned
The multidisciplinary team was made up of executive leaders, infection preventionists, surgical managers, anesthesia providers, surgeons, nurses and educators. We mapped out all aspects of the care provided to surgical patients, from pre-admission to discharge and beyond into extended care. Getting feedback from representatives from every discipline that would touch patients along the perioperative path was instrumental to our ultimate success. The team came up with these evidence-based action items:

Glucose monitoring. We previously had only checked point-of-care glucose levels if physicians ordered the test or patients were known diabetics. Part of our initiative involved checking blood glucose levels for every surgical patient, and we discovered what had long been suspected: Many patients present for surgery without knowing they're diabetic or have elevated blood glucose levels, which increase SSI risk.

Hair removal. We used to clip hair around surgical sites in the OR and collect the trimmings with tape. To limit the infection risk those hair trimmings posed, we now use clippers with a built-in hair collection system, and primarily in the pre-op area. However, we still clip patients in the OR if the location of the surgical site demands privacy or the prep needs to be revised.

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