Outpatient Surgery Magazine

OR Excellence Awards - September 2020 - Subscribe to Outpatient Surgery Magazine

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 45 of 71

4 6 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 2 0 the rooms. Some dispensers were moved to more user-friendly locations if old spots were hard to reach. Locations were also added based on staff feedback and suggestions. • Long sleeves in the OR. Before prepping patients, staff must practice proper hand hygiene, slip on long sleeve scrub jackets and don sterile gloves. A large inventory of jackets is always available for nurses to wear. The jackets are laun- dered at the facility and are never allowed to be taken home. "We had to educate the staff on why they're so important and we incentivized the practice until everyone got used to it," says Ms. Salinas. "Now, everyone wears a jacket — nurses, techs, anesthe- sia staff, surgeons — until they're scrubbed in." One of Georgia's Best Colon Care Bundles HONORABLE MENTION In 2015, surgical leaders at St. Joseph's/Candler Hospital in Savannah, Ga., began to research ways to reduce risks of surgical site infections in patients undergoing colon surgery. They eventu- ally implemented best practices outlined by the Association of periOperative Registered Nurses (AORN), the Agency for Healthcare Research and Quality, and the National Healthcare Safety Network. Now their colon surgery SSI rates are among the lowest in hospitals across the state of Georgia. "The prevention bundle we created was implemented at other St. Joseph's/Candler cam- puses, resulting in a system-wide reduction in colon SSIs," says Mary Owen, RN, MSN-Ed, BSN, CNOR, St. Joseph/Candler's perioperative clini- cal nurse educator. The bundle starts with pre-screening inter- views of patients and educating them on proper SSI prevention protocols, including instructions on the use of chlorhexidine gluconate (CHG) wipes the night before their scheduled proce- dures. On the day of surgery, staff members prep patients again using CHG wipes and remove hair around the surgical site using vacu- um clippers. During procedures, the surgical team performs skin antisepsis with CHG, prac- tices correct hand antisepsis, uses wound pro- tectors, administers copious amounts of irriga- tion fluid in the abdomen, changes gowns and gloves before closing incisions, and uses sepa- rate closure instruments. The health system implemented nursing and surgeon education about the SSI prevention bun- dle. The education is ongoing and provided during morning huddles, monthly in-service programs and via computer-based learning modules. The bundle was incorporated into the hospi- tals' electronic health record — nurses check the boxes of supplies used and processes fol- lowed. This documentation method was tested by the nursing team before full deployment, says Ms. Owen. Staff created a list of practice stan- dards using the latest evidence-based guidelines for colon surgery that is tracked and monitored. A monthly retrospective chart audit of nursing and surgeon documentation is conducted to assess these standards and report the results to the quality improvement team, which identifies any problems and discusses areas of opportuni- ty for improving practices. "We're constantly reassessing and re-educating," says Ms. Owen. — Adam Taylor NOSE TO TOES Staff at St. Joseph's/Candler Hospital prep patients undergoing colon procedures with CHG wipes and nasal decolonization. St. Joseph's/Candler Hospital INFECTION PREVENTION

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