This Surgical Site Infection Prevention course will teach you how to prevent surgical site infection. Get this course and 9 others for free here: www.incision.c...
Topics covered:
- Hospital policies and processes that promote asepsis
- Perioperative responsibilities of personnel in preventing surgical site infection
According to the World Health Organisation (WHO): healthcare-associated infections (HAI) are defined as infections acquired by patients while receiving care and they represent the most frequent adverse events affecting patient safety worldwide. Surgical site infection (SSI) is the most surveyed and frequent type of HAI in low- and middle-income countries and affects up to one-third of patients who have undergone a surgical procedure. Although SSI incidence is lower in high-income countries, it remains the second most frequent type of HAI in Europe and the United States of America (USA) [1]. There are many processes, patient- and procedural-related variables that contribute to the development of an SSI. Moreover, there is a significant degree of variation with regard to definitions of SSI. Recently, systematic reviews conducted by the WHO and the Centers for Disease Control and Prevention (CDC) have contributed to formulating evidence-based guidelines that allow surgical teams, infection prevention teams as well as hospital and regional managers to devise and implement protocols and policies to effectively address the global problem of SSI. The human and financial costs of treating SSIs are increasing as a result of the increase in the number of surgical procedures being performed along with the complexity of comorbidities in surgical patients [2]. The objective of SSI prevention measures is therefore reducing the cost and improving the quality of surgical care, as well as preventing avoidable deaths. These interventions are applied in the pre-, intra- and postoperative phases of care by the aforementioned stakeholders. Measures SSI prevention can be applied to implement policies and processes as well as address patient and procedural factors that contribute to the development of SSI. Guidelines such as the World Health Organization (WHO) “Global guidelines for the prevention of surgical site infection” provide evidence-based recommendations for the application of preventative measures pre-, intra- and postoperatively. The WHO guidelines are comprehensive, account for resource availability and are therefore an extremely useful reference whenever devising and implementing local protocols. The guidelines’ recommendations are reported using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Some examples of recommendations that may be considered for incorporation into local protocols will be discussed briefly in this chapter.
Preoperative Measures
With respect to patient-related variables, measures that are strongly recommended include: optimal timing of surgical antibiotic prophylaxis; use of chlorhexidine-containing alcohol-based solutions for surgical site skin preparation and surgical hand preparation, by scrubbing with antimicrobial soap (and water) or alcohol-based handrub prior to donning sterile gloves. Use of mupirocin 2% ointment to decolonise the nasal passages of staphylococcus aureus (S. aureus) carriers prior to undergoing surgery also carries a strong recommendation. S. aureus is the leading health care associated pathogen in hospitals worldwide and infection with this organism is associated with substantial morbidity and mortality [1]. Both are exacerbated by the rise of methicillin-resistant staphylococcus aureus (MRSA). Isolation precaution protocols for this and other antibiotic resistant organisms should align with surgical site infection prevention protocols. Screening of patients is guided by local protocol with factors such as prevalence of the organism in the community taken into account. With regard to hair removal, there is a strong recommendation that it not be done prior to any surgical procedure unless there is an absolute requirement to do so. If this is the case, only clippers should be used. Shaving is strongly discouraged at all times as use of razors increases the risk of SSI.
After studying this Surgical Site Infection Prevention course you are familiar with concepts such as:
- Isolation precautions
- Asepsis
- Appropriate surgical attire
- Hand hygiene
7 сен 2024
