The Surgical Care Improvement Project-Focusing on Infection Control

ArticleinPlastic surgical nursing: official journal of the American Society of Plastic and Reconstructive Surgical Nurses 27(3):163-7 · July 2007with3 Reads
DOI: 10.1097/01.PSN.0000290287.42359.91 · Source: PubMed
  • [Show abstract] [Hide abstract] ABSTRACT: Surgical site infections are a frequent cause of morbidity following surgical procedures. Gram-positive cocci, particularly staphylococci, cause many of these infections, although gram-negative organisms are also frequently involved. The risk of developing a surgical site infection is associated with a number of factors, including aspects of the operative procedure itself, such as wound classification, and patient-related variables, such as preexisting medical conditions. Both nonpharmacologic measures and antimicrobial prophylaxis for selected procedures are used to prevent development of these infections. Compliance with these generally accepted preventive principles may lead to overall decreases in the incidence of these infections.
    Article · May 2009
  • Article · Dec 2009
  • [Show abstract] [Hide abstract] ABSTRACT: The National Surgical Quality Improvement Program (NSQIP) began with the Veterans Affairs system to reduce morbidity and mortality by evaluating preoperative risk factors, postoperative occurrences, mortality reports, surgical site infections, and patient variable statistics. Our institution enrolled in NSQIP July 2006. The Surgical Care Improvement Project (SCIP) was developed to reduce surgical complications, including surgical infections. We began instituting SCIP protocols in July 2007. This is a retrospective review of the NSQIP data collected by our NSQIP nurse. The colorectal surgical site infection (SSI) data pre- and post-institution of SCIP guidelines are analyzed. Data from the July 2006 to June 2007 and July 2007 to June 2008 reports are compared. Rates of SCIP compliance are analyzed. There were 113 colorectal cases in the July 2006 to June 2007 NSQIP report. The rate of superficial SSI was 13.3%, with an expected rate of 9.7% (p = 0.041). The observed-to-expected ratio was 1.39. Compliance with SCIP was 38%. There were 84 colorectal cases in the July 2007 to June 2008 NSQIP report. The rate of superficial SSI was 8.3%, with an expected rate of 10.25% (p = 0.351). The observed-to-expected ratio was 0.81. Compliance with SCIP measures was 92%. Participation in NSQIP can identify areas of increased morbidity and mortality. Our institution was a high outlier in superficial SSI in colorectal patients during the first NSQIP evaluations. SCIP guidelines were instituted and a statistically significant reduction in our rates of SSI was realized. As our compliance with SCIP improved, our rates of superficial SSI decreased. Reduction in superficial SSI decreases cost to the patient and decreases length of stay.
    Article · May 2010
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