Surgical Safety Quality Measures
Appropriate and timely
antibiotic dosing is one way to prevent surgical site infections. Additional
methods for preventing surgical site infections are also needed because antibiotics
should not be over used. Over-use or incorrect use of antibiotics can lead
to the development of drug-resistant bacteria, which pose a great threat to
persons with weak immune systems.
According to an article in Emerging
Infectious Diseases (April, 2001; 7(2): 220-224), additional approaches that may be used
to reduce the risk of surgical site infections include standard procedures
such as:
- two to five minutes of pre-surgery hand and forearm washing
for all surgical team members
- use of electric clippers instead of razors
for necessary hair removal
- control of blood glucose before, during, and after
surgery
- no tobacco use within 30 days before surgery
- patient shower with antiseptic
soap on night before surgery
Two additional approaches that are being used for some surgical
procedures are:
- normothermia (keeping body temperature close to normal
instead of allowing it to drop during surgery)
- supplemental oxygen
Normothermia involves keeping the body temperature greater
than 96.8 degrees Fahrenheit, which is warmer than usual for surgery. Keeping
the body temperature normal (normothermia) has been shown to reduce infection
rates for certain procedures, but it is not appropriate for all surgical procedures.
The Institute
for Healthcare Improvement recommends normothermia as an option
for reducing surgical site infections.
According to an article in the Journal
of the American Medical Association (JAMA) (October 26, 2005; 294(16): 2035-2042),
supplemental oxygen before, during, and after surgery reduces surgical site
infections for patients undergoing colon or rectal surgery. Supplemental oxygen,
like normothermia, may not be appropriate for all surgical patients.
At
St. Mary's Hospital Medical Center, the following non-antibiotic methods are used to reduce the risk
for surgical site infection:
- two to five minutes of pre-surgery hand and forearm washing for all surical team members
- electric clippers for necessary hair removal
- control of blood glucose
- no tobacco use within 30 days before surgery
- patient shower on night before surgery
- normothermia for eligible patients
- supplemental oxygen for eligible patients