ronmental services (EVS) both before and after the procedure.
• Remove equipment that isn't going to be used for a given proce-
dure from the procedure room.
• Don't open or set up instruments or wrapped sterile items until
both the patient and the physician are in the room.
• Post signage on the door that lets staff know that a procedure is in
progress, and that no one is to enter.
• EVS terminally cleans the procedure room after every case. That
includes taking the gurney apart and cleaning underneath it. That
added step is key, says Ms. Spallino, who cites recent literature.
"When infection preventionists swabbed the top of the gurney, noth-
ing grew, but when they swabbed the bottom of the gurney, every-
thing grew," she says. "So I in-service the housekeeping staff on how
to clean the gurney, along with everything else."
• Wheel patients to the procedure room on a terminally cleaned gur-
7 4 • O U T PA 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 1 6
After taking the initiative to do a root-cause analysis that turned up
some interesting potential culprits, the Lakeland (Fla.) Surgical and
Diagnostic Center took several innovative steps to help reduce its SSI
rate. Among them: They instructed a surgeon who was bringing in pil-
lows for his patients to take them directly to PACU and not bring them
into the OR. They instructed patients to keep pets away from their sur-
gical sites once they were home. They asked a vendor to do an in-ser-
vice on proper surgical prep technique. And they told patients with
artificial nails to either remove them or wash the nails with a 4% CHG
antimicrobial skin cleanser at admission. Those and other steps
worked. They reduced their SSI rate to 0.09%, well below national
benchmark rates.
Lakeland's Search Uncovers Unlikely Causes
UNUSUAL SUSPECTS
Awards Issue
