Prevention of Surgical Site Infection: Beyond SCIP

摘要: Surgical site infections (SSIs) are a leading cause of patient morbidity and mortality. Each SSI that occurs is associated with approximately seven to 10 additional postoperative hospital days,1,2 patients SSIs have two 11 times higher risk death compared surgical without SSIs.3,4 now emerged as the most common costly health care–associated infection.5,6 Thus, hospitals care providers must constantly pursue improve adherence evidence-based strategies for preventing these devastating infections. Several core prevention been promoted by Care Improvement Project (SCIP), including appropriate choice timing antimicrobial prophylaxis, avoiding shaving hair, maintaining perioperative normothermia, controlling blood glucose.7 During past decade, many, if not most, quality improvement programs in United States become familiar SCIP recommendations. In fact, placing great effort on improving staff member compliance recommendations because rates performance measures affect payment under Centers Medicare & Medicaid Services Value-Based Purchasing Program.8,9 Compliance some close 100%; thus, retired (eg, hair shaving). If near 100% basic recommendations, yet still occur harm patients, question then becomes, “What else can be done?” This column will summarize several go beyond prevent SSIs: optimizing prophylaxis dosing, preparing colon mechanical bowel preparation oral antibiotics, tissue oxygenation, using safety checklist.