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Running head: CHLORHEXIDINE GLUCONATE PREOPERATIVE SHOWER
Chlorhexidine Gluconate Preoperative Shower
Christine Elizabeth Costlow
Annapolis Hospital
POHA / PACU
September 30, 2012
Chlorhexidine Gluconate Preoperative Shower “Each year, more than 18 million surgical procedures are preformed in US hospitals. The Center for Disease Control and Prevention (CDC) estimates that 2.7% of these are complicated by surgical-site infections (SSIs), accounting for at least 486,000 nonsocomial infections each year” (Kirkland et al, 1999, p. 725). According to Scott each infection burdons the health care system with expenses ranging from “$10,443 to$ 25,546” (2009, p. 5). In addition to the increased cost associated with treating the SSI Berrios (2009) sites in the Surgical Site Infection (SSI) Toolkit that each individual with a SSI has an increased rate of mortality. Among all patients diagnosed with a SSI, there is a 3% mortality rate, which is 2-11 times higher risk of death than the average surgical patient. Berrios continues by stating, “75% of deaths among patients with SSI are directly attributable to SSI” (2009, p. 2). At this time there is not an agreed upon method to preventing SSIs. There have been many studies and discussions over the best practice to avoid infection; however, to date it is the responsibility of each individual surgical center to determine the method that will be used to achieve the desired outcome of zero surgical site infections among their surgical patients. The following paper will outline the current state of Annapolis’ pre-operative practice in regards to SSI prevention. Research which supports a change in practice will be examined. The outline of the implementation plan for the use of Chlorhexidine Gluconate Preoperative Shower will be detailed. Staff compliance and Annapolis’ most recent post surgical site infection data will be evaluated. In conclusion, the plans going forward for SSI
Chlorhexidine Gluconate Preoperative Shower
Christine Elizabeth Costlow
Annapolis Hospital
POHA / PACU
September 30, 2012
Chlorhexidine Gluconate Preoperative Shower “Each year, more than 18 million surgical procedures are preformed in US hospitals. The Center for Disease Control and Prevention (CDC) estimates that 2.7% of these are complicated by surgical-site infections (SSIs), accounting for at least 486,000 nonsocomial infections each year” (Kirkland et al, 1999, p. 725). According to Scott each infection burdons the health care system with expenses ranging from “$10,443 to$ 25,546” (2009, p. 5). In addition to the increased cost associated with treating the SSI Berrios (2009) sites in the Surgical Site Infection (SSI) Toolkit that each individual with a SSI has an increased rate of mortality. Among all patients diagnosed with a SSI, there is a 3% mortality rate, which is 2-11 times higher risk of death than the average surgical patient. Berrios continues by stating, “75% of deaths among patients with SSI are directly attributable to SSI” (2009, p. 2). At this time there is not an agreed upon method to preventing SSIs. There have been many studies and discussions over the best practice to avoid infection; however, to date it is the responsibility of each individual surgical center to determine the method that will be used to achieve the desired outcome of zero surgical site infections among their surgical patients. The following paper will outline the current state of Annapolis’ pre-operative practice in regards to SSI prevention. Research which supports a change in practice will be examined. The outline of the implementation plan for the use of Chlorhexidine Gluconate Preoperative Shower will be detailed. Staff compliance and Annapolis’ most recent post surgical site infection data will be evaluated. In conclusion, the plans going forward for SSI
References: AORN (2011). Perioperative Standards and Recommended Practices. For Inpatient and Ambulatory Settings. (2011 ed.). Denver: AORN. Berrios-Torres, S. I,. (2009). Surgical SiteInfection (SSI) Toolkit. Retrieved May 15, 2012, from http://www.cdc.gov/HAI/pdfs/toolkits/ssi_toolkit021710sibt_revised.pdf Bosco, J. A., Slover, J. D., & Haas, J. P. (2010). Perioperative Strategies for Decreasing Infection: A Comprehensive Evidence Based Approach Surgery. Retrieved April 30, 2012, from http://jbjs.org/article.aspx?Volume=92&page=232 Eiselt, D Graves, N., Halton, K., Curtis, M., Doidge, S., Lairson, D., McLaws, M., & Whitby, M. (2006). Emerging Infectious Diseases, 12(5), 831-834. Retrieved July 12, 2012, from www.cdc.gov/eid The Joint Commission. (2012). Surgical Care Improvement Project. Retrieved July 18, 2012, From http://www.jointcommission.org/specifications_manual_for_national_hospital_inpatient_quality_measures.aspx Kirkland, K. B., Briggs, J. P., Trivette, S. L., Wilkinson, W. E., & Sexton, D. J. (1999). The Impact of Surgical-Site Infections in the 1990’s: Attribuatble Mortality, Excess Length of Mangram, A. J., Horan, T. C., Pearson, M. L., Silver, L. C., Jarvis, W. R. (1999). Guidelines for Prevention of Surgical Site Infection, 1999 Scott, R. D. (2009). The Direct Medical Cost of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention. Retrieved June 11, 2012, from http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf