Quality and infection control are responsibilities taken seriously by healthcare providers. Even so, the U.S. Center for Disease Control and Prevention (CDC) estimates that approximately 1.7 million patients per year develop healthcare-associated infections, resulting in 271 deaths each day. Surgery centers are regularly recognized for maintaining lower infection rates than hospitals, but this does not eliminate concern.
Vigilance is important when it comes to infection control and patient safety. A standardized pre-surgical skin antisepsis protocol is a targeted infection control strategy that has shown to support quality initiatives, increase healthcare professional satisfaction and streamline implementation.
Healthcare providers are no strangers to infection control etiquette, but the most effective protocols are achieved through a standardized approach. Sharon Butler, MSN, RN, a clinical nurse IV of Stanford (Calif.) University Hospital and Clinics and chairperson of the Perioperative Research Council at Stanford University Hospital, details the importance of a standardized practice and the steps to implement an effective, consistent surgical skin antisepsis protocol.
1. Establish protocol based on facts. The foundation of any strong standardized surgical skin antisepsis protocol will be created by guidelines rooted in fact. There are a number of organizations that detail best practices and offer supporting data to craft an evidence-based protocol customized for your surgery center.
The National Quality Forum, Association of Perioperative Registered Nurses, and Association for Professionals in Infection Control and Epidemiology all offer a wealth of information. For example:
• The NQF recommends the use of a 2 percent chlorhexidine-based gluconate (CHG) and isopropyl alcohol solution for patient preparation.
• AORN illustrates the goals of skin antisepsis as the removal of bioburden, decrease in resident microorganisms without irritating the skin and prevention of microorganism re-growth.
APIC recommends that an antiseptic agent should be fast-acting, a non-irritant and have a persistent effect. APIC notes that CHG exhibits excellent activity against gram-positive and good activity against gram-negative vegetative organisms and fungi. CHG is also known to have excellent persistent activity.
Review the available products and procedures performed at your own center. Make an informed decision on what product and how to use it correctly by checking against the guidelines of established organizations.
2. Encourage collaboration. Teamwork between everyone at the surgery center allows for this protocol to work and standardization to take effect. "Establish a culture of safety and continuous improvement that involves a collaborative effort across clinical and financial departments," says Ms. Butler.
Accomplish collaboration by creating a cross-functional team including nurses, physicians and infection preventionists. The cross-functional team is responsible for increasing accountability and promoting individual ownership of patient safety duties.
3. Reinforce compliance. Once a working, standardized protocol has been established, ensure continued compliance from all members of a surgery center's staff and physicians. Readily visible posters and charts detailing the protocol can remind them to complete each steps. Automated tools such as EMR allow surgery centers to report data.
Frequent discussions with physicians about protocol are important. "Take every opportunity to communicate with surgeons about their prepping practices and talk up the agents you've put in place," says Ms. Butler. Quarterly meetings are a good opportunity to review the protocol with the entire team.
4. Measure performance. Producing evidence that the protocol is working is an excellent way to reinforce compliance. In order to know the results of the standardized protocol, surgery center leaders track progress on a regular basis.
Regular tracking and compliance audits allow ASC leaders to compare against other centers. Three months after implementing the standardization and prepping products, Stanford University Hospital was making strides toward achieving its patient-centered goals, says Ms. Butler.
Technology is also available to track individual nurses or teams to mark areas for improvement or highlight areas of excellence. "The act of the tracking process serves as reinforcement for staff and a reminder of the effectiveness of standardization," says Ms. Butler.
This content is based on a webinar supported by CareFusion.
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