Outpatient Surgery Magazine

Special Outpatient Surgery Edition - Orthopedics - August 2018

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 48 of 86

A U G U S T 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 4 9 from the care continuum came together to form the Surgical Unit Safety Program (SUSP), which performed a tracer methodology to assess every patient touch and developed a standardized SSI preven- tion bundle and a checklist tool called the Travel Tag, which moves with the patient from the surgeon's office through to discharge. Every staff member who cares for patients adds a checkmark to the docu- ment to show she's done her part to prevent SSIs. Since implementing the program in 2015, rates of infection at Einstein steadily declined before bottoming out at zero last year. If Einstein's efforts are any indication, there's likely plenty more you can do to prevent infections in joint replacement patients. 1. Pre-operative nasal screening. Some evidence suggests that testing for the presence of bacteria (particularly the Staphylococcus species) in the nasal passages 2 to 6 weeks before surgery may help prevent joint infection. Patients who have staph in their nasal pas- sages receive an intranasal antibacterial ointment before surgery. "Direct correlation studies have found that bacterial isolates that come from the nares match those found in periprosthetic joint infec- tions, so shedding from the nose can affect the surgical site," says Antonia Chen, MD, MBA, a joint replacement specialist at Brigham and Women's Hospital in Boston, Mass. "Screening and treating patients reduces S. aureus colonization, which therefore lowers the risk of SSI." Treat patients who test positive for Methicillin-sensitive Staphylococcus aureus (MSSA) or Methicillin-resistant Staphylococcus aureus (MRSA) with intranasal mupirocin and instruct them to take a chlorhexidine body wash for 5 days before sur- gery. Ms. Yerkes's team also swabs each patient's nasal cavities in pre-

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