In order to establish a program to reduce surgical site infections (SSIs) the following implementation plan will require the actionable steps. The following checklist was adapted from the core prevention strategies recommended by the CDC.1
- Hospital governance and senior administrative leadership must champion efforts to raise awareness of the problem in their own institution, in order to prevent and safely manage SSIs.
- Educate patients and families on SSI prevention.
- Implement surveillance and metrics to measure patient outcomes. The results of this monitoring should be reviewed at periodic caregiver education sessions, such as “grand rounds.”
- Administer antimicrobial prophylaxis in accordance with evidence-based standards and guidelines:2
- Administer within 1 hour prior to incision (2 hours for vancomycin and fluoroquinolones)
- Select appropriate agents on basis of:
- Surgical Procedure
- Most common SSI pathogens for the planned procedure
- Known allergies or drug reactions of each specific patient.
- Published recommendations
- Do not remove hair at the operative site unless it will interfere with the operation.
- Use appropriate antiseptic agent and technique for skin preparation.
- Maintain immediate postoperative normothermia.
- If appropriate, mechanically prepare patients for colorectal surgery by enema or cathartic agents. Administer non-absorbable oral antimicrobial agents in divided doses on the day before the operation.
- Keep operating room (OR) doors closed during surgery except as needed for passage of equipment, personnel, and the patient.
- Protect primary closure incisions with sterile dressing for 24-48 hours post-op.
- Discontinue antibiotics within 24 hours after the surgery end time (48 hours for cardiac patients), unless signs of infection are present.
Between the 2017 World Patient Safety, Science & Technology Summit and the 2017 Midyear Planning Meeting a workgroup comprised of experts representing administrators, clinicians, technologists and patient advocates will meet to update this APSS. If you are interested in joining this workgroup, please email us.