After Surgery) protocols in a few of our other surgical service lines, so
we moved our colorectal and abdominal hysterectomy procedures to
the top of the list with the focus being on SSI reduction.
In the fall of 2016, we brought together a team of surgical techs,
nurses, surgeons and infection control personnel and implemented
new practices that have dramatically reduced our infection rates.
Here are 3 of the important steps we took.
1. Pre-op CHG wipes.
Before the intervention, we had 12 surgeons performing colorectal
surgery with little standardization of perioperative care. For example,
some patients were prepped pre-operatively with chlorhexidine glu-
conate (CHG) wipes, while others used different solutions. After we
gathered our multidisciplinary team, we began looking at the research
and ERAS protocols that impacted surgical site infection rates. One of
the measures suggested in the ERAS colorectal protocol includes
using CHG on the patient's surgical site pre-operatively.
Though we always advised patients to shower the night before or the
morning of surgery, we wanted to improve the process. Now, we have
the colorectal surgeons hand out CHG wipes at their office when sched-
uling the patient for surgery. As part of that appointment, the doctor will
give them the wipes and instructions on how to use them before arriving
at the hospital. When the patient arrives and is in pre-op, we wipe them
down again with CHG.
Getting all our surgeons to comply with the new protocol took some
work. Our chief of surgery engaged the colorectal surgeons, letting
them help create the perioperative care protocol. The participating sur-
geons then had to sign off on it. Getting cooperation was relatively
easy with our employed surgeons, but the process took some work
with other surgeons. We found that education was quite helpful. We
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