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Archive September 2020 XXI, No. 9

Infection Prevention: Getting as Close to Zero SSIs as Possible

Improved hand hygiene and proper antibiotic administration are part of the protocols that keep infection rates low at Kaiser Permanente Tysons Corner ASC.

Adam Taylor


KP Tysons ASC
STERILITY MAINTAINED Re-scrubbing, re-gowning and re-gloving between combined procedures are important elements of Kaiser Permanente's efforts to keep SSIs to a minimum.

While the infection rates at Kaiser Permanente Tysons Corner ASC in McLean, Va., were already low, the facility’s leadership wanted to do even better. They researched the issue and realized improved hand hygiene practices and proper antibiotic administration protocols were the best ways to further reduce risks of surgical site infections (SSIs).

The facility set a goal of having an SSI rate of less than 1% for hip and knee replacements, hernia repairs and breast implant surgeries by September 2019. Leadership created a multi-point action plan to achieve the benchmarks and conducted regular education sessions for staff on how to implement it. The center’s successful efforts to reduce most of their target SSI rates garnered the seven-OR facility the 2020 OR Excellence Award in Infection Prevention.

“We think our plan will allow us to get our SSI rates even lower,” says Daiva Mercado, RN, clinical operations manager. “The staff has been very receptive. We explain that the plan’s action items are AORN standards and evidence-based, and that they’re our policy.”

Hand hygiene and antibiotic prophylaxis are known to reduce infections, so the facility took significant steps to fill gaps in these practices, according to Barbara Wolaver, BSN, RN, CNOR, a co-lead of the unit-based team at the ASC. Covert observations of hand hygiene practices took place monthly, and facility leaders tracked whether antibiotics were administered within one to two hours before surgical incisions, depending on the antibiotic used. It turned out that some OR staff weren’t always compliant with the facility’s hand hygiene protocols and, while antibiotics were being administered, there were issues with the types of antibiotics being chosen, the timing with which they were administered, and the following of weight-based dosing and re-dosing protocols.

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