Surgical site infections (SSIs) contribute significantly to patient mortality and healthcare costs, impacting two to five percent of individuals undergoing surgery.
Prevention of surgical site infections (SSIs) can be achieved through targeted interventions and careful oversight of the surgical field, in which perioperative nurses play an integral role.
Hand Hygiene
One key to preventing surgical site infections among healthcare workers lies in maintaining adequate hand hygiene practices, such as washing hands before and after performing patient care as well as before donning sterile gloves.
Hand hygiene includes applying antiseptic soap or alcohol-based hand sanitizer and vigorously rubbing for 15-20 seconds across all surfaces including front, back, sides, cuticles and cuticle beds before thoroughly rinsing and drying your hands afterwards.
Infections from healthcare worker infections during surgery threaten millions of patients each year and contribute to antibiotic resistance, yet most can be avoided with proper hygiene compliance and targeting interventions that will improve clinical practice. This initiative seeks to address this challenge program’s work on patient safety by targeting behavioral determinants for hand hygiene compliance; further work was conducted under its second challenge program on patient safety launched by WHO in 2009. Within its next phase this work program, new guidelines and tools on this topic were released by the World Health Organization in 2009.
Surgical Site Preparation
Surgery-associated infections represent a substantial health care burden, particularly in low- and middle-income countries. They result in longer hospital stays, higher costs for care delivery and contribute to antibiotic resistance.
Surgical site infections may result from bacteria present on a patient’s native skin flora, mucous membranes, or hollow viscera. Risk factors for such infections can include diabetes, smoking cigarettes and obesity.
Perioperative nurses play an integral part in preventing surgical site infections (SSIs). Skin preparation is key to creating an ideal operating environment and should use alcohol-based products applied sterilely by nurses using an alcohol-based skin prep product with no microorganism load on it, instead shaving before or using vacuum assisted devices to remove hair prior to starting surgery is also recommended for optimal outcomes. Finally, maintaining proper drapement throughout surgery and monitoring the sterile field are also vital aspects in avoiding SSIs.
Aseptic Technique
Surgical site infections are an enormous strain on patients and healthcare systems alike, often leading to extended hospital stays, increased costs, higher readmission rates and even jeopardized patient health. Most surgical site infections can be avoided or reduced through better pre-, peri- and postoperative practices.
Making everything as sterile as possible reduces the risk of contamination, including tools, equipment and the patient’s skin. Surgeons must always wear gloves when performing surgeries in an operating room (OR) that requires frequent decontamination. Specialized automated decontamination technologies exist that make this process quick and efficient while minimising downtime between procedures.
Microorganisms that cause infection at wound incision sites may come from either within a patient’s own body (from natural bacteria on their skin, mucous membranes or hollow viscera) or from outside sources like instruments or the OR. Patients with certain medical conditions such as diabetes, smoking and obesity are particularly at risk of post-surgery infections.
Appropriate Use of Antibiotics
An infection at a surgical site can be life-threatening for low-income countries and contributes to spreading antibiotic resistance.
Strict adherence to protocols for antisepsis and aseptic technique in the operating room can greatly reduce infections. Appropriate short-term use of antibiotics before and during surgery may also help, provided it is actually needed.
These guidelines from the World Health Organization aim to save lives, reduce costs and combat superbugs. Their 29 recommendations come from 20 experts analyzing 26 reviews of relevant evidence.
The Compendium Expert Panel was comprised of members with expertise in healthcare epidemiology, surgical practices and infection prevention who reviewed a draft manuscript once consensus had been reached by writing-panel members. Furthermore, all five Compendium partners, professional organizations involved with its production and CDC reviewed it prior to distribution; all panel members complied with SHEA/IDSA policies regarding conflict of interest disclosure.
