A plan for fixing sterile reprocessing
Every morning when the central service (CS) staff arrived for work, they were greeted by a jumble of unprocessed sets left from the previous day. There were service problems with the OR, and morale was low. “When the first shift came in, there was a never-ending pile of sets. They…
Sepsis, pneumonia after surgery take heavy toll in lives and costs
Two common hospital-acquired conditions, sepsis and pneumonia, killed 48,000 patients and cost $8.1 billion in 2006 alone, according to a large national study. In a separate analysis of outcomes associated with surgery, the researchers found that nearly 20% of patients who developed sepsis after surgery died as a result. Patients…
Total joints: Toward zero infections
The Hospital for Special Surgery (HSS) in New York City has one of the highest volumes of total joint replacements in the world. It also has one of the lowest surgical site infection (SSI) rates. The hospital, which performs about 8,000 joint replacements a year, was recently commended by the…
CMS anesthesia rules are stiffened
A guest column on regulatory standards. In mid-December, the Centers for Medicare and Medicaid Services (CMS) issued an 18-page Survey and Certification memorandum that clarifies and adds new requirements and interpretive guidelines for anesthesia services in Medicare-certified hospitals. Given the Joint Commission's requirement to mirror CMS regulation, we should anticipate…
With checklist, Michigan ICUs hold infections down for 3 years
The state of Michigan, which used a 5-step checklist to virtually eliminate central-line bloodstream infections in ICUs, has been able to keep the number near zero for 3 years. Peter Pronovost, MD, PhD, a patient safety expert at Johns Hopkins University School of Medicine who developed the checklist, says the…
Preventing S aureus infections: What's needed for screening?
A new study in the New England Journal of Medicine finds that treating patients who are Staphylococcus aureus nasal carriers with mupirocin nasal ointment and chlorhexidine gluconate soap for 5 days reduces hospital-associated postoperative S aureus infection by 60%. "This well-designed, well-executed study contributes more to our knowledge that screening…
SSI prevention: How's your practice?
Preventing surgical infections is what perioperative nursing is all about. From the moment they don a scrub suit and cap, they engage in well-practiced steps to protect patients from harmful micro-organisms. Surgical site infections (SSIs) are a well-known cause of suffering and death. An estimated 500,000 SSIs occur each year.…
AAAHC adds infection control chapter to standards handbook
Ambulatory surgery centers (ASCs) accredited by the Accreditation Association for Ambulatory Health Care (AAAHC) can expect noteworthy changes in the 2010 accreditation handbook to be published in February 2010. For the first time in 30 years, a new core chapter is being added, focusing on infection control and safety. The…
Tackling an outbreak of MRSA SSIs
In late 2007 and early 2008, an Arizona hospital saw an alarming increase in surgical site infections (SSI) with methicillin-resistant Staphylococcus aureus (MRSA). For the first quarter in 2008, the infection rate for total hip replacements and revisions averaged 3.73%, well above the national average of 1.6%, with most involving…
HHS launches action plan to prevent HAIs
The US Department of Health and Human Services (HHS) has launched an action plan with 5-year targets for preventing health care-associated infections (HAIs). The plan was developed by an HHS steering committee involving a number of federal agencies. "This plan will serve as our roadmap on how the department addresses…
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