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Archive November 2019 XX, No. 11

5 Steps to Fewer SSIs

Don't ignore the bacteria-fighting benefits of a back-to-basics approach to infection control.

Adam Taylor


Pamela Bevelhymer, RN, BSN, CNOR
SKIN IN THE GAME Make sure your surgical, nursing and anesthesia teams are compliant with SSI prevention protocols.

Simple solutions are almost always best. No one will accuse your facility of providing groundbreaking surgical care if you make sure patients clean their skin before they arrive for surgery, your staff follow proper skin prepping and hand hygiene protocols, and nasal decolonization is part of your pre-op routine. Still, it's always a good idea to brush up on infection prevention's basic protocols and make sure they're being followed in your facility for a very practical reason: They work.

1. Skin prepping

Instruct patients to use chlorhexidine gluconate (CHG) wipes or bathing solution on the days leading up to surgery, and make sure they understand the solution and the importance of doing so, says Luci Perri, RN, BSN, MSN, CIC, FAPIC, founder and president of Infection Control Results, a North Carolina-based consulting firm.

Patients can be educated on how to use CHG wipes or bathing solution during a pre-op clinic appointment. You can also distribute the wipes or solution in kits that include directives on how and when to apply the CHG and bottles containing the specific amount of solution that should be used during each application. Some facilities even use engagement apps to send patients text message reminders when it's time to apply the CHG.

Ms. Perri says you can't always be certain of how well — or if —patients prep their skin before they arrive for surgery, so she suggests applying CHG in pre-op on and around the intended surgical site to ensure the bacterial count on the area is decreased.

Providing patients with clear wound care directives in discharge instructions is just as important as the efforts you make before surgery to reduce infection risks, notes Ms. Perri, recalling a case where a patient, due to inadequate discharge information, didn't bathe for a week after his procedure.

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