Archive March 2014 XV, No. 3

Make Orthopedic SSIs All But Disappear

We're zeroing in on zero, using these 9 steps.

Gabrielle White, RN, CASC


hand-hygiene compliance WINNING HANDS With our 'secret shoppers' always on the lookout, we raised our hand-hygiene compliance rate to more than 90%.

Like most surgical facilities, we take infection prevention seriously and we pride ourselves on our low SSI rates. We know the risk of infection accompanies any surgery, and that the risk with orthopedic procedures, many of which require implants, is even higher. So we're proud of the fact that for 2013 and prior years, our infection rate has averaged 0.2%, compared with the national average of 1.43%, the figure cited by the Ambulatory Surgery Center Association.

We've discovered that infections can be caused by many easy-to-overlook factors and they can usually be prevented by a series of relatively simple precautions. On the whole, surgical facilities do a terrific job of keeping infection rates down, but we should all be striving for zero. Here's our formula for keeping infections to an absolute minimum:

1. Anoint an infection preventionist
It's valuable to have someone in your team who is responsible for infection prevention education and patient follow-up. We have a dedicated RN who attends classes and conferences and is certified in this role. She follows up with our physicians monthly, and when an infection occurs, she completes a chart review and looks into the sterile processing logs for clues. She also reports quarterly to the QI committee, the medical advisory committee and the governing board. We always have timely information about potential and actual infections, our charge nurses and teams are able to stay up to date with current infection prevention practices, and we always know how well we're doing.

2. Explain the reason behind their actions
Frequently remind your teams that they aren't just cleaning a room or piece of equipment, processing instrument trays or cleaning their hands. They're preventing infections. When teams view their roles and actions from that perspective, it can improve their attitudes and help them realize that what they do is important — that they themselves can help prevent infections and keep patients safe.

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