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Surgical safety program greatly reduces surgical site infections for heart operations
Date:7/27/2014

ent Safety Institute in collaboration with other organizations.

The team called the SSI reduction program CLEAN, an acronym that stood for the collected best practices, both existing and new:

  • C: Clean hands before touching the dressing, chlorhexidine wipes applied to the body before surgery, clippers used for hair removal instead of shaving, and nasal decolonization (disinfecting the nostrils with ultraviolet light) performed
  • L: Leave the dressing on for 72 hours postoperatively, and leave the pink chlorhexidine disinfectant on the skin for 6 hours after the operation
  • E: Engage patients and staff on best practices for SSI prevention
  • A: Appropriately use antibiotics
  • N: Normothermia (normal body temperature), normal blood glucose (sugar), nutritious meals, and no smoking for patients

Using the ACS NSQIP data sampling of 12 to 16 cardiac surgery cases a month, which is 20 percent of the surgical volume, the number of SSIs was tracked. From January 2012 to June 2013 the NSQIP SSI rate was 7 percent. Once the CLEAN protocol was fully implemented in July 2013, the SSI rate fell to 1.6 percent by the end of March 2014.

Our infection control practitioner monitors all cardiac inpatients who receive cardiac bypass and/or valve surgery for 90 days. An average of one sternal infection a month was reported. Since July 2013, only two sternal infections have been recorded. No sternal infection was observed for eight consecutive months from July 2013.

At an approximate cost of $30,000 to treat a sternal infection, she estimated that the hospital saved $300,000 in the past year. The new dressings cost $35,000 per year.

"This project," Dr. Klein said, "shows it is possible to really improve patient outcomes and obtain excellent compliance from physicians in changing clin
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Contact: Sally Garneski
pressinquiry@facs.org
312-202-5409
American College of Surgeons
Source:Eurekalert

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