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factors for all operations. Operations of longer duration, those that involve
entering the bowel, poor wound hemostasis and urgent surgery are some of the
surgery-specific risk factors.
Is aiming for a zero infection rate realistic?
I enthusiastically support the goal of eliminating healthcare-associated infec-
tions, but there are many risk factors that are not within the control of the
healthcare team and make it unlikely that we will achieve a rate of zero infec-
tions for most operations. The Healthcare Infection Control Practices Advisory
Committee recently expressed concern that the drive to "reach zero" may actu-
ally exacerbate the pressure to err on the side of underreporting HAIs in health-
care facilities.
What are some potentially overlooked but key areas
surgical facilities need to focus on to lower infection rates?
The ongoing need to improve proper hand hygiene is an obvious one. Facility
interventions such as effective environmental cleaning, reducing the use of
immediate-use sterilization and reducing unnecessary operating room traffic
may reduce infection rates. There is growing evidence of the impact of patient
hyperglycemia on SSI rates for many operations.
Why is tracking performance and collecting data
important to improving infection control efforts?
As many experts have noted, "Every defect is a treasure." The chance for
improvement lies in the discovery of imperfection. Surgical leaders should moni-
tor performance on standardized process of care measures and patient out-
comes, apply the metrics consistently and use the data collected for feedback to
the entire surgical team to guide their performance-improvement efforts.
OSM