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again.
• Wipes for all. We give CHG wipes to all patients, regardless of
whether they're positive. We give patients who don't test positive a
smaller supply of wipes and instruct them to wipe down their entire
bodies the night before and morning of surgery.
• Right before surgery … Just before the patient goes into the OR, nurs-
es do a final wipe down of the surgical area with the CHG wipes. In
addition, they do a nasal swab with povidone-iodine to clean the
nares.
Our preemptive measures are paying off
For the last 2 years, we've reduced our infection rates to well below
the national average for total hips, total knees, laminectomies and
spinal fusion. Having seen the results, all of our surgeons now fully
embrace the effort. Our plan going forward is to look for other evi-
dence-based initiatives that might further reduce our infection rates.
Since staff education plays a big role in everything we do to reduce
SSIs, we meet periodically to discuss and review our efforts — both
for more in-depth initiatives, like this one, and to review the basics,
like hand-washing. We have people keeping tabs on how compliant
our staff and physicians are, and we make sure we display our results.
We also make sure the staff has a stake in the outcome. Our SSI rate
is one of the metrics they need to meet to achieve performance
bonuses. When you consider how much it costs a facility any time a
patient ends up with an infection, preemptive measures are just good
sense, even if they mean taking a little extra time and spending a little
extra money. OSM
Ms. Roth (terry.roth@hoag.org) is the executive director of
perioperative services at Hoag Orthopedic Institute in Irvine, Calif.
