Surgical Site Infections

The APIC/JCAHO Infection Control Workbook
Workbook developed through a collaboration between APIC and JCR.  See full product description and ordering information.


Infection Prevention and Control:  Current Research and Practice
This book features research as well as practical tips to avoid or mitigate infections.  See full product description and ordering information.


Decreasing Surgical Site Infections in Ambulatory Care
Joint Commission Perspectives on Patient Safety, Volume 7, Number 2, February 2007, pp. 9-20(2)

Viera Outpatient Clinic, in Brevard County, Florida, had a policy in place that encouraged its physicians to self-report any patient complications or infections after surgery. When no infections were reported, the infection control practitioner began a project to capture data about every surgery occurring in the facility and identify possible surgical site infections. In this case study, Viera Outpatient Clinic explains how it captured data about its surgical site infections and improved documentation, data collection, and safety practices to reduce the infection rate. BONUS ONLINE MATERIAL: Snapshots of Viera Outpatient Clinic's infection surveillance database and preoperative medication administration template.

Monitoring Patient Safety in Health Care: Building the Case for Surrogate Measures
Joint Commission Journal on Quality and Patient Safety, Volume 32, Number 2, February 2006, pp. 95-101(7)

Background: Objective measurements are notably lacking for many adverse events in health care. A new approach to monitoring such events is based on the experience in measuring hospital-associated infections. Developing Objective and Universal Measures: An essential tenet of the current goal of surveillance—focusing only on rigorously confirmed adverse events—is neither necessary nor achievable across the entire health care system. Efforts should be directed instead to creating objective measures of quality of care and of outcomes that can be used by all health care facilities. Adopting objective measures would be easier if health care was open to surrogate measures of important outcomes. Surrogate measures of interest for infection surveillance are used to identify objective, readily ascertained events that are sufficiently correlated with infections to provide useful information about organizations' infection rates. For example, the surgical site infection rate following coronary artery bypass appears to correlate closely enough with the proportion of patients who receive extended courses of inpatient antibiotics to be a useful indicator of a hospital's outcomes for the procedure. Conclusion: Developing clinically relevant process or surrogate measures that clinicians would use to improve patient outcomes is essential. These measures could be relevant not only to hospital-acquired infections but other health care-related adverse events that are relatively common yet require substantial resources to identify.

Reducing Surgical Complications
Joint Commission Journal on Quality and Patient Safety, Volume 33, Number 11, November 2007, pp. 660-665(6)

Background: One of the 12 interventions that the Institute for Healthcare Improvement (IHI) recommends for its 5 Million Lives Campaign is "Reduce Surgical Complications...by reliably implementing all the changes in care recommended by the Surgical Care Improvement Project (SCIP)." Many surgical patients experience complications from surgery, some of which are preventable with the reliable application of evidence-based medicine. Despite promotion and dissemination of recommendations and practices, overall national compliance remains less than optimal. Methods: IHI's 5 Million Lives Campaign is supporting the recommended practices in the SCIP to accelerate adoption for reduction in surgical complications by 25% by December 2008. Practices relate to surgical site infection prevention, prophylaxis for venousthromboembolism, continuation of beta blockers, and prevention of postoperative pneumonia. Strategies used in hospitals that have achieved improvement in the recommended SCIP measures include practices that increase reliability and minimize practice variation. These changes, along with efforts to improve teamwork and communication, are essential to reduce surgical complications. Conclusion: Organizations that strive for high reliability in their processes should see improvement in the associated outcomes and a reduction in harm to patients.