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INFECTION PREVENTION
the only ones who may do it. Anyone who's not been validated can
observe, but not prep.
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Instrument segregation. Our techs noted that sometimes instruments are used in both the abdomen and the rectum — that is,
used in both "clean" and "dirty" areas. So we created 2 separate tables
for the surgeons to use instruments from. Used instruments from the
rectum go right into a bucket to begin decontam and don't get used
again. Surgeons also now re-glove and re-gown when changing which
part of the anatomy they're operating on.
It's through these simple interventions that we decreased our colorectal SSI rates from 27.3% before intervention to 18.2%, a 33%
decease (p<0.05).
• The correct dosing of gentamicin compliance increased from 33%
before intervention to 92% afterward.
• Normothermia, defined as post-operative temperatures >36°C,
improved from 83% to 95%.
• Chlorhexidine skin prep was standardized to all circulating nurses,
and communication regarding segregation of instruments was disseminated. OSM
Mr. Driscoll (kdrisco1@jhmi.edu) is a CRNA at the Johns Hopkins Hospital
in Baltimore, Md.
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | D E C E M B E R 2012
