Overview of the WHO global guidelines for the prevention of surgical site infection
|
|
- Mitchell Morrison
- 5 years ago
- Views:
Transcription
1 Overview of the WHO global guidelines for the prevention of surgical site infection Dr. Mohamed Abbas, MD, MS Semmelweiss CEE Conference Budapest
2 Outline of presentation General background Burden of surgical site infection (SSI) isk factors for SSI ationale & development of the guidelines Overview of the recommendations Conclusion
3 Outline of presentation General background Burden of surgical site infection (SSI) isk factors for SSI ationale & development of the guidelines Overview of the recommendations Conclusion
4 Surgical Site Infection (SSI) About hospitalised patients in Europe have at least one HAI on any given day In Europe, SSI are the second most frequent type of HAI (19.6%) ( ) SSI episodes/year (HAI prevalence survey 2011) In the US, the overall SSI rate was 0.9% in 2014 (data from 3654 hospitals over surgical procedures) SSI are the most frequent type of HAI on admission (67% in US, 33% in Europe) Surgical sepsis accounts for approximately 30% of all septic patients SSI are the most frequent type of HAIs in LMICs and rates are significantly higher than in HICs (11%, on average) Courtesy: Prof. B. Allegranzi
5 University of Geneva Hospitals GI BSI SST acute care Other SSI 24% Figure courtesy of Walter Zingg LTI UTI ENT LTI Other SST BSI UTI SST Systemic GI BSI Other SSI SSI pneumonia Pneumonia /LTI GI 22% UTI 20% Zingg et al. InfectControl Hosp Epidemiol 2014;35:674 Magill et al. N Engl J Med Mar 27;370(13): ECDC. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals. Stockholm: ECDC; 2013
6 SSI burden in low-/middle-income countries Allegranzi B et al. Lancet 2011;377: Published on 5 May Courtesy: Prof. B. Allegranzi Bagheri Nejad S, et al. Bull OMS 2011;89:
7 SSI cumulative incidence by operation type % 54% 3.5% 1.4% 2.7% 1% 0.7% 0.8% ECDC Annual Epidemiological eport 2013
8 SENIC study Study on the Efficacy of Nosocomial Infection Control Haley W et al. Am J Epidemiol 1985;121(2): elative change in NI in a 5 year period ( ) 30% 20% 10% 0% -10% Without infection control 14% 9% 19% 26% 18% LTI SSI UTI BSI Total 50% -20% -30% -40% -27% -31% -35% With infection control -35% -32% Courtesy: Prof. Didier
9 inadequate antibiotic prophylaxis colonisation with nosocomial pathogens poor hand hygiene inadequately sterilized/disinfected equipment inadequate skin antisepsis hypothermia skin shaving increased O traffic prolonged pre-operative stay inadequate timing of antibiotic prophylaxis prolonged operative duration contaminated antiseptics poor surgical technique poor oxygenation emergency procedure hyperglycaemia prosthetic implants inadequate ventilation inadequate attire
10 Outline of presentation General background Burden of surgical site infection (SSI) isk factors for SSI ationale & development of the guidelines Overview of the recommendations Conclusion
11 Main reasons for developing the guidelines High global epidemiological burden Highly preventable infection No recent -based guidelines Need for a global perspective Need for taking into account balance between benefits and harms, quality level, cost and resource use implications, and patient values and preferences Courtesy: Prof. B. Allegranzi
12 WHO global guidelines for SSI prevention Courtesy: Prof. B. Allegranzi
13 WHO GLOBAL SSI PEVENTION GUIDELINES Abstracts presented at 26 th ECCMID, Amsterdam 2016 The Lancet Infectious Diseases & official launch, 2 November 2016 WHO SSI Prevention Guidelines 27 systematic reviews & meta-analysis 29 recommendations 30 core chapters Key updates on: Timing & duration of surgical ATB prophylaxis ATB use with drains S. aureus carriers decolonization Glucose control Normovolemia Oxygenation Wound irrigation Antimicrobial sutures & A LOT MOE.
14 WHO Global Guidelines for the Prevention of SSI Aim: To provide a comprehensive range of - and consensusbased recommendations for interventions related to the prevention of SSI during pre-, intra-, and post-operative periods Further ensure high quality care for every patient irrespective of resource availability Population: patients of any age undergoing any type of surgical procedure Target audience: the surgical team (surgeons, nurses, technical support staff, anaesthetists, and any professionals directly providing surgical care), infection prevention and control (IPC) professionals, policy-makers, senior managers, hospital administrators, as well as those responsible for staff education and training. Courtesy: Prof. B. Allegranzi
15 Methodology Guidelines Development Group: international multidisciplinary team of experts balance in gender, geographic representation, professional groups Topics were identified PICO questions (Population, Intervention, Comparator, Outcomes) Systematic reviews for each PICO multiple databases searched
16 Methodology (2) Evidence quality assessment: Cochrane Collaboration & Newcastle-Ottawa GADE (Grading of ecommendations Assessment, Development, and Evaluation) Meta-analyses Development of recommendation
17 Methodology (3) Strength of recommendations, based on confidence of experts regarding the : Strong : benefits outweighed risks adaptable for implementation in most (if not all) situations most patients should receive the intervention Conditional : benefits probably outweighed the risks a more structured decision-making process should be undertaken, based on stakeholder consultation and the involvement of patients and health care professionals.
18 Outline of presentation General background Burden of surgical site infection (SSI) isk factors for SSI ationale & development of the guidelines Overview of the recommendations Conclusion
19 PE-OPEATIVE MEASUES
20 Q Q Should immunosuppressive agents be discontinued perioperatively? Immunosuppressive medication should not be discontinued prior to surgery for the purpose of preventing SSI Conditional recommendation Very low quality of Should enhanced nutritional support be used for the prevention of SSI? Consider the administration of oral or enteral multiple nutrient-enhanced nutritional formulas for the purpose of preventing SSI in underweight patients who undergo major surgical operations. Conditional recommendation Very low quality of
21 Q Is preoperative bathing using an antiseptic soap more effective in reducing the incidence of SSI in surgical patients when compared to bathing with plain soap? It is good clinical practice for patients to bathe or shower before surgery. Either a plain soap or an antiseptic soap could be used for this purpose. Conditional recommendation Very low quality of Q Is preoperative bathing with CHGimpregnated cloths more effective in reducing the incidence of SSI in surgical patients when compared to bathing with antiseptic soap? No recommendation formulated due to very low quality
22 Q Is mupirocin nasal ointment in combination with or without a CHG body wash effective in reducing the number of S. aureus infections in nasal carriers undergoing surgery? Patients undergoing cardiothoracic and orthopaedic surgery with known nasal carriage of S. aureus should receive perioperative intranasal applications of mupirocin 2% ointment with or without a combination of CHG body wash. Strong recommendation Moderate quality of
23 Q Is mupirocin nasal ointment in combination with or without a CHG body wash effective in reducing the number of S. aureus infections in nasal carriers undergoing surgery? Consider also treating patients with known nasal carriage of S. aureus undergoing other types of surgery with perioperative intranasal applications of mupirocin 2% ointment with or without a combination of CHG body wash. Conditional recommendation Moderate quality of
24 Q Is mechanical bowel preparation (MBP) combined with or without oral antibiotics effective for the prevention of SSI in colorectal surgery? Preoperative oral antibiotics combined with MBP should be used to reduce the risk of SSI in adult patients undergoing elective colorectal surgery. Conditional recommendation Moderate quality of MBP alone (without the administration of oral antibiotics) should not be used for the purpose of reducing SSI in adult patients undergoing elective colorectal surgery. Strong recommendation Moderate quality of
25 Q 1. Does hair removal affect the incidence of SSI? 2. What method and timing of hair removal is associated with the reduction of SSI? In patients undergoing any surgical procedure, either hair should not be removed or, if absolutely necessary, it should be removed only with a clipper. Shaving is strongly discouraged at all times, whether preoperatively or in the operating room. Strong recommendation Moderate quality of
26 Q How does the timing of surgical antibiotic prophylaxis administration impact on the risk of SSI and what is the precise optimal timing? When indicated (depending on the type of operation), surgical antibiotic prophylaxis should be administered prior to the surgical incision. Strong recommendation Low quality of Surgical antibiotic prophylaxis should be administered within 120 minutes before incision, while considering the half-life of the antibiotic. Strong recommendation Moderate quality of
27 Q 1. What is the most effective type of product for surgical hand preparation to prevent SSI? 2. What is the most effective technique and the ideal duration of surgical hand preparation? Surgical hand preparation should be performed using either a suitable antimicrobial soap and water or a suitable alcohol-based hand rub before donning sterile gloves. Strong recommendation Moderate quality of
28 Q In surgical patients, should alcohol-based antiseptic or aqueous solutions be used for skin preparation and, more specifically, should CHG or PVP-I solutions be used? Alcohol-based antiseptic solutions, particularly based on chlorhexidine gluconate (CHG), are recommended for surgical site skin preparation in patients undergoing surgical procedures. Strong recommendation Low to moderate quality of
29 Q In surgical patients, should antimicrobial sealants (in addition to standard surgical site skin preparation) vs. standard surgical site skin preparation be used for the prevention of SSI? Antimicrobial sealants should not be used after surgical site skin preparation for the purpose of reducing SSI. Conditional recommendation Very low quality of
30 INTA-OPEATIVE MEASUES
31 Q How safe and effective is the perioperative use of increased FiO 2 in reducing the risk of SSI? Adult patients undergoing general anaesthesia with endotracheal intubation for surgical procedures should receive FiO 2 80% intraoperatively and, if feasible, in the immediate postoperative period for 2-6 hours. Strong recommendation Moderate quality of
32 Q In surgical patients, should systemic body warming vs. no warming be used for the prevention of SSI? Warming devices should be used in the operating room and during the surgical procedure for patient body warming with the purpose of reducing SSI. Conditional recommendation Moderate quality of
33 Q 1. Do protocols aiming to maintain optimal perioperative blood glucose levels reduce the risk of SSI? 2. What are the optimal perioperative glucose target levels in diabetic and non-diabetic patients? Protocols for intensive perioperative blood glucose control should be used for both diabetic and nondiabetic adult patients undergoing surgical procedures. Conditional recommendation Low quality of
34 Q 1. Is there a difference in SSI rates depending on the use of disposable non-woven drapes and gowns vs. reusable, woven drapes and gowns? 2. Does changing drapes during operations affect the risk of SSI? 3. Does the use of disposable adhesive incise drapes reduce the risk of SSI? Either sterile disposable non-woven or sterile reusable woven drapes and surgical gowns can be used during surgical operations. Conditional recommendation Moderate to very low quality of Plastic adhesive incise drapes with or without antimicrobial properties should not be used. Conditional recommendation Low to very low quality of
35 Q Does the use of wound protector devices reduce the rate of SSI in open abdominal surgery? Consider the use of wound protector devices in clean-contaminated, contaminated and dirty abdominal surgical procedures for the purpose of reducing the rate of SSI. Conditional recommendation Very low quality of
36 Q Does intraoperative wound irrigation reduce the risk of SSI? Saline irrigation: insufficient to recommend for or against saline irrigation of incisional wounds Aqueous povidone iodine: Consider the use of irrigation of the incisional wound with an aqueous povidone iodine solution before closure, particularly in clean and cleancontaminated wounds. Antibiotic incisional wound irrigation before closure should not be used for the purpose of preventing SSI. Conditional recommendation Low quality of
37 Q Does prophylactic negative pressure wound therapy reduce the rate of SSI compared to the use of conventional dressings? Prophylactic negative pressure wound therapy may be used on primarily closed surgical incisions in high-risk wounds and, taking resources into account, for the purpose of preventing SSI. Conditional recommendation Low quality of
38 Q Are antimicrobial-coated sutures effective to prevent SSI? If yes, when and how should they be used? Triclosan-coated sutures may be used for the purpose of reducing the risk of SSI, independent of the type of surgery. Conditional recommendation Moderate quality of
39 Q 1. Is the use of laminar air flow in the operating room associated with the reduction of overall or deep SSI? 2. Does the use of fans or cooling devices increase SSIs? 3. Is natural ventilation an acceptable alternative to mechanical ventilation? Laminar airflow ventilation systems should not be used to reduce the risk of SSI for patients undergoing total arthroplasty surgery. Conditional recommendation Low to very low quality of
40 POST-OPEATIVE MEASUES
41 Q 1. In the presence of drains, does prolonged antibiotic prophylaxis prevent SSI? 2. When using drains, how long should they be kept in place to minimise SSI as a complication? Perioperative surgical antibiotic prophylaxis should not be continued due to the presence of a wound drain. Conditional recommendation Low quality of The wound drain should be removed when clinically indicated. No was found to allow making a recommendation on the optimal timing of wound drain removal. Conditional recommendation Very low quality of
42 Q In surgical patients, should advanced dressings vs. standard sterile wound dressings be used for the prevention of SSI? Advanced dressing of any type should not be used over a standard dressing on primarily closed surgical wounds for the purpose of preventing SSI. Conditional recommendation Low quality of
43 Q Does continued postoperative surgical antibiotic prophylaxis reduce the risk of SSI compared with preoperative and (if necessary) intraoperative prophylaxis only? Surgical antibiotic prophylaxis administration should not be prolonged after completion of the operation for the purpose of preventing SSI. Conditional recommendation Low to very low quality of
44 Outline of presentation General background Burden of surgical site infection (SSI) isk factors for SSI ationale & development of the guidelines Overview of the recommendations Conclusion
45 Important considerations for implementation in low-resource settings Some recommendations will NOT be resource demanding or they will even allow avoidance of unnecessary costs (e.g. no antibiotic prophylaxis prolongation; no laminar flow) Some recommendations will contribute to reducing AM For others, careful evaluation should be made about: Additional costs involved and/or limited product availability (e.g. alcohol-based hand rubs, chlorhexidine gluconate alcohol-based antiseptic solutions, antimicrobial sutures) Need for staff training (e.g. increased oxygenation) Need for specific expertise (e.g. glucose control; normovolemia) Need for technical laboratory capacity (e.g. S. aureus carrier identification) Involving organisational resources for appropriate administration (e.g. antibiotic timing) euse and contamination risks (e.g. clippers) Infrastructure constraints (e.g. limited access to clean water) Local production and solutions should be encouraged Courtesy: Prof. B. Allegranzi
46 New infographic
47
48 In conclusion The WHO guidelines represent a major piece of work Summarizes the best available An implemenation strategy by WHO will soon be produced
49 Acknowledgements Prof. Benedetta Allegranzi Infection Prevention and Control Global Unit, WHO Prof. Didier Pittet Infection Control Programme & WHO Collaborating Center, Geneva University Hospitals
50 THANK YOU FO YOU ATTENTION
GLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION
GLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION Joseph S. Solomkin, MD Professor of Surgery, University of Cincinnati College of Medicine OASIS Global, Inc. Sources for the WHO SSI Prevention
More informationMeasure pre-op BG early enough so that if it is unexpectedly high, a plan of action can be control (BG) - initiated [2,11].
Crosswalk of Surgical Site Infection (SSI) Prevention Guidelines and Minnesota Hospital Association (MHA) SSI Gap Analysis Topics Last updated June 22, 2017 Note: This is a summary of four major SSI prevention
More informationEvidence-Based Recommendations for Intraoperative Prevention of SSI. Intraoperative Antiseptic Skin Preparation of the Patient
Sven Scheffler, MD PhD Sporthopaedicum Berlin, Germany Symposium: Prevention and Management of Infection in ACL Reconstruction General Considerations for Prevention of Infection Intraoperative Precautions
More informationSurgical Site Infections: the international guidelines for best practices and effective actions
Surgical Site Infections: the international guidelines for best practices and effective actions SSIs are the second most common type of adverse event occurring in hospitalised patients. SSIs have been
More informationEMERGING EVIDENCE AND BEST PRACTICES TO PREVENT SSI IN COLON PROCEDURES
EMERGING EVIDENCE AND BEST PRACTICES TO PREVENT SSI IN COLON PROCEDURES Clifford Ko, MD, MS, MSHS, FACS, FASCRS Professor of Surgery UCLA Director, ACS NSQIP, American College of Surgeons EVIDENCE Ban
More informationSurgical Site Infection Prevention: International Consensus on Process
Surgical Site Infection Prevention: International Consensus on Process Joseph S. Solomkin, M.D. Professor of Surgery (Emeritus) University of Cincinnati College of Medicine and Executive Director, OASIS
More informationClinical guideline Published: 22 October 2008 nice.org.uk/guidance/cg74
Surgical site infections: prevention ention and treatment Clinical guideline Published: 22 October 08 nice.org.uk/guidance/cg74 NICE 18. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationProcess audit for SSI. CME on Infection Prevention & Control Breach Candy Hospital Trust
Process audit for SSI CME on Infection Prevention & Control Breach Candy Hospital Trust Introduction SSIs are the most common healthcare-associated infection, accounting for 31% of all HAIs among hospitalized
More informationModifiable Risk Factors in Orthopaedic Infections
Modifiable Risk Factors in Orthopaedic Infections AAOS Patient Safety Committee Burden US Surgical Site Infections (SSI) by the Numbers ~300,000 SSIs/yr (17% of all HAI; second to UTI) 2%-5% of patients
More informationSurveillance report Published: 30 January 2017 nice.org.uk
Surveillance report 2017 Surgical site infections: prevention ention and treatment (2008) NICE guideline Surveillance report Published: 30 January 2017 nice.org.uk NICE 2017. All rights reserved. Subject
More informationPresentation at ACS NSQIP National Conference in July Surgical Site Infection Reduction Strategies
Presentation at ACS NSQIP National Conference in July 2015 Surgical Site Infection Reduction Strategies PeaceHealth Sacred Heart Medical Center at RiverBend Level II Trauma Center 379 Beds 15,060 cases
More informationPrevention of Surgical Site Infections Pola Brenner and Patricio Nercelles
Chapter 11 Prevention of Surgical Site Infections Pola Brenner and Patricio Nercelles Key points In many countries surgical site infections are the most common healthcare-associated infections accounting
More informationBest Products for Skin Antisepsis
Best Products for Skin Antisepsis John M. Boyce, MD J.M. Boyce Consulting, LLC Middletown, CT Disclosures: JMB is a consultant to Diversey, Global Life Technologies Corp and GOJO Industries 1 Antiseptic
More informationGLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION
GLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION GLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION WHO Library Cataloguing-in-Publication Data Global Guidelines for the Prevention
More informationSurg Cmde Sudeep Naidu Prof & HOD Surgery
Surg Cmde Sudeep Naidu Prof & HOD Surgery Sir Joseph Lister 1827-1912 Before his times. Clean Care is Safer Care WHO Alcohol based Handrub Save Lives Clean hands Cleaning hands at the right times and
More informationAppendix A: Summary of evidence from surveillance
Appendix A: Summary of evidence from surveillance 8-year surveillance (2017) Surgical site infections: prevention and treatment (2008) NICE guideline CG74 Summary of evidence from surveillance... 1 Research
More informationNHSN and Public Reporting. Linda R. Greene, RN,MPS,CIC Manager Infection Prevention Highland Hospital Rochester, NY linda_
1 NHSN and Public Reporting Linda R. Greene, RN,MPS,CIC Manager Infection Prevention Highland Hospital Rochester, NY linda_ greene@urmc.rochester.edu 2 Objectives Describe challenges and opportunities
More informationSSI. Ren yu Zhang MD
Ren yu Zhang MD 3 27 2014 1 SSI 16 million operative procedures in 2010. Overall SSI rate 1.9% for 2006 8. Accounts 31% of healthcare associated infection. Leads to further morbidity and mortality. Economic
More informationSébastien LUSTIG MD, PhD, Prof *,** Tristan Ferry ** Frederic Laurent ** *Albert Trillat Center- Lyon, **CRIOA Lyon
SICOT Meeting Roma September 2016 Risk factors of periprosthetic infection and my experience of how to prevent an infection Sébastien LUSTIG MD, PhD, Prof *,** Tristan Ferry ** Frederic Laurent ** *Albert
More informationItems For Discussion Today
Moving Beyond Surgical Dogma: Development of an Evidence-Based Surgical Care Bundle to Improve Patient Outcomes Charles E. Edmiston Jr., PhD., CIC Emeritus Professor of Surgery Department of Surgery Medical
More informationPrevenzione dellee infezioni del sito chirurgico
Prevenzione dellee infezioni del sito chirurgico Nicola Petrosillo Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani, Roma, Italy Post-operative infections in Italy Prospective national
More informationSURGICAL SITE INFECTIONS
30 September 2016 No. 22 SURGICAL SITE INFECTIONS I Alturki Moderator: M Ramnarain School of Clinical Medicine Discipline of Anaesthesiology & Critical Care CONTENT INTRODUCTION 1, 2, 3... 3 DEFINITION
More informationPreventing Surgical Site Infections: The SSI Bundle
Preventing Surgical Site Infections: The SSI Bundle 1 Why SSI? New York State 30,000 hospital discharges 1984 3.7% of patients experience serious adverse events related to medical management The top three
More informationNational Institute for Health and Care Excellence. NICE Quality Standards Consultation Surgical Site Infection. Closing date: 5pm 17 June 2013
National Institute for Health and Care Excellence NICE Quality Standards Consultation Surgical Site Infection Closing date: 5pm 17 June 2013 Organisation Title (e.g. Dr, Mr, Ms, Prof) Name Job title or
More informationActivity C: ELC Prevention Collaboratives
Surgical Site Infection (SSI) Toolkit Activity C: ELC Prevention Collaboratives S.I. Berríos-Torres, MD Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Draft - 12/21/09
More informationPreoperative Chlorhexidine Preparation and the Incidence of Surgical Site Infections After Hip Arthroplasty
The Journal of Arthroplasty Vol. 25 No. 6 Suppl. 1 2010 Preoperative Chlorhexidine Preparation and the Incidence of Surgical Site Infections After Hip Arthroplasty Aaron J. Johnson, MD,* Jacqueline A.
More informationUpdate on the Prevention of Surgical Site Infections
Update on the Prevention of Surgical Site Infections Scientific Seminar on Infection Control May 9, 2012 Tom R. Talbot, MD MPH Associate Professor of Medicine and Preventive Medicine Vanderbilt University
More informationDisclaimer Caveat I DON T HAVE ALL OF THE ANSWERS
Moving Beyond Surgical Dogma: Development of an Evidence-Based Surgical Care Bundle to Improve Patient Outcomes Charles E. Edmiston Jr., PhD., CIC, FIDSA, FSHEA, FAPIC Emeritus Professor of Surgery Department
More informationSSI: Superficial and Deep Space Infections
Goals of this Presentation SSI: Superficial and Deep Space Infections Discuss the problem of surgical site infection (SSI) in colorectal surgery Review the specific measures that may reduce the rate of
More information수술부위감염은수술중절개부위를통해들어가는박테리아에의해발생합니다. 그박테리아는매년수백만명의환자생명을위협하고항생제저항의확산에기여합니다. 저소득및중간소득국가에서수술을받는환자의 11% 가이과정에서감염됩니다. 주제권고사항권고정도
INSIDabcdef_:MS_0001MS_0001 INSIDabcdef_:MS_0001MS_0001 병원명부서명 [2017 년 6 월호뉴스레터기사 3] WHO 의수술부위감염예방을위한국제지침 WHO는지난 2016년수술부위감염예방을위한국제지침 ( Global Guidelines for the Prevention of Surgical Site Infection )
More informationClick to edit Master subtitle style
Does Enhanced Recovery Improve Outcomes? Click to edit Master subtitle style Kaare Weber, MD Director of Surgery Associate Medical Director, Surgery A MEMBER OF THE MONTEFIORE HEALTH SYSTEM mes? Click
More informationSTANDARD OPERATING PROCEDURE #203 LARGE ANIMAL SURGERY
STANDARD OPERATING PROCEDURE #203 LARGE ANIMAL SURGERY 1. PURPOSE This Standard Operating Procedure (SOP) describes procedures for general surgery of large animal species such as swine, dogs, rabbits,
More informationPrevention of Surgical Site. infections. Chapter 15. Pola Brenner and Patricio Nercelles. Key points
Prevention of Surgical Site Infections Chapter 15 Prevention of Surgical Site Infections Pola Brenner and Patricio Nercelles Key points Surgical site infections are one of the most common healthcareassociated
More informationAntimicrobial prophylaxis in the surgical patient. Anton Sharapov, R 3 POS, Dec. 17, 2003
Antimicrobial prophylaxis in the surgical patient Anton Sharapov, R 3 POS, Dec. 17, 2003 Introduction Significant cause of morbidity important part of perioperative care many choices available Why does
More informationPre-Operative Protocol
Pre-Operative Protocol HAVE YOU OPTIMIZED YOUR PRE-OP PROTOCOL TO IMPROVE PATIENT OUTCOMES? 4/28/2017 Disclosure Sponsored by 3M Health Care 3M Health Care is a provider approved by the California Board
More informationCentral Line-Associated Infections (CLABSI) Settings Toolkit
Central Line-Associated Infections (CLABSI) in Non-Intensive Care Unit (non-icu) Settings Toolkit Activity C: ELC Prevention Collaboratives Alex Kallen, MD, MPH and Priti Patel, MD, MPH Division of Healthcare
More informationPreventing Surgical Site Infections. Deverick J. Anderson, MD, MPH Associate Professor of Medicine
Preventing Surgical Site Infections Deverick J. Anderson, MD, MPH Associate Professor of Medicine Disclosures Research funding from the AHRQ, NIH/NIAID, and CDC Royalties from UpToDate, Online Outline
More informationGLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION
GLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION GLOBAL GUIDELINES FOR THE PREVENTION OF SURGICAL SITE INFECTION Global guidelines for the prevention of surgical site infection, second edition
More informationPrevention of Surgical Site Infections: Beyond Core Measures
Prevention of Surgical Site Infections: Beyond Core Measures Ed Septimus, MD, FACP, FIDSA, FSHEA Medical Director Infection Prevention and Epidemiology Clinical Services Group, HCA, Inc Cl Professor Internal
More informationDoc: 1.9. Course: Patient Safety Solutions. Topic: Infection prevention and control. Summary
Course: Patient Safety Solutions Topic: Infection prevention and control Summary Health care-associated Infection (HCAI) is defined as an infection acquired in a hospital by a patient who was admitted
More information1.40 Prevention of Nosocomial Pneumonia
1.40 Prevention of Nosocomial Pneumonia Purpose Audience Policy Statement: The guideline is designed to reduce the incidence of pneumonia and other acute lower respiratory tract infections. All UTMB healthcare
More informationCentral Venous Access Devices and Infection
Central Venous Access Devices and Infection Dr Andrew Daley Microbiology & Infectious Diseases Women s & Children s Health Melbourne Background Types of infection! Local site infection! Blood stream infection!
More informationTITLE: Preoperative Skin Preparation: A Review of the Clinical Effectiveness and Guidelines
TITLE: Preoperative Skin Preparation: A Review of the Clinical Effectiveness and Guidelines DATE: 31 August 2010 CONTEXT AND POLICY ISSUES: A surgical site infection (SSI) is defined as an infection that
More informationDIVISION OF QUALITY & PATIENT SAFETY. The National Comparative Effectiveness Summit, Washington D.C. 11/6/2012
Cost Effectiveness of MRSA Screening & Decolonization Joseph A. Bosco, MD, Vice Chair of Clinical Affairs James Slover, MD, MS, Associate Professor, Orthopaedic Surgeon Lorraine Hutzler, Quality Project
More informationPolicy Title: Clinical Asepsis Policy Policy Number :19. Effective Date: 6/10/2013 Review Date: 6/10/2016
Policy Title: Clinical Asepsis Policy Policy Number :19 6.4.9. Take/send instruments and handpieces to the decontamination/sterilization area. 6.4.10. Remove and dispose of the disposable gown (if used)
More informationCOMPARATIVE MEDICINE LABORATORY ANIMAL FACILITIES STANDARD OPERATING PROCEDURE FOR RODENT SURGERY
2.A.3 COMPARATIVE MEDICINE LABORATORY ANIMAL FACILITIES STANDARD OPERATING PROCEDURE FOR RODENT SURGERY 1.0 Purpose: Post-operative infections in rodents can and do occur. Such infections, which may not
More informationThe Efficacy of NPWT on Primary Closed Incisions
The Efficacy of NPWT on Primary Closed Incisions Pieter Zwanenburg Researcher / PhD Candidate Marja Boermeester Professor of Surgery, Academic Medical Center, Amsterdam Incisional Negative Pressure Wound
More information8. Infection Prevention And Control
PATIENT SAFETY 436 TEAM 8. Infection Prevention And Control Objectives: List The Modes Of Infection Transmission In Health-care Settings Explain Main Causes And Types Of Health Care-associated Infection
More informationOf 72 different ways to prevent surgical
SURGICAL TECHNIQUES Joseph D. DiRocco, MD Lucio A. Pavone, MD Carl A. Weiss III, MD, PhD State University of New York Upstate Medical University Syracuse The evidence-based way to prevent wound infections
More informationPrevention of surgical site infections
1 Prevention of surgical site infections Matthias Maiwald Consultant in Microbiology Assoc. Prof., Natl. Univ. Singapore Dept. Pathology & Lab. Medicine KK Women s & Children s Hospital Singapore matthias
More informationNew Strategies to Reduce MRSA in ICUs
New Strategies to Reduce MRSA in ICUs Susan Huang, MD MPH Associate Professor, UC Irvine Health Medical Director, Epidemiology & Infection Prevention Division of Infectious Diseases & Health Policy Research
More informationHAIs in the USA. March 23, 2017 Department of Public Health Sciences. Infectious Disease Epidemiology BMTRY 713 (Healthcare Associated Infection )
Infectious Disease Epidemiology BMTRY 713 (A. Selassie, DrPH) Lecture 17 Healthcare-Associated Infections (HAIs) Learning Objectives 1. Describe magnitude and implication of HAIs 2. Identify the main risk
More informationA Comparative Study for the Role of Preoperative Antibiotic Prophylaxis in Prevention of Surgical Site Infections
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 13, Issue 4 Ver. IV. (Apr. 2014), PP 27-31 A Comparative Study for the Role of Preoperative Antibiotic
More informationIt s the solution that counts. 3M skin antiseptic products
It s the solution that counts 3M skin antiseptic products SoluPrepTM Brand The impact of surgical site infections Surgical site infections (SSIs) are a major burden on healthcare systems, providers and
More informationPre-operative Care For Surgery of Forearm Fracture. WONG Mei Chee OT (CMC)
Pre-operative Care For Surgery of Forearm Fracture WONG Mei Chee OT (CMC) Pre-operative Nursing Considerations for Surgery of Forearm Fracture 1. Patient s problems - Diagnosis: Clinical features, x-ray
More informationEXECUTIVE SUMMARY. DATE: 13 June 2011
TITLE: Preoperative Skin Antiseptic Preparations and Application Techniques for Preventing Surgical Site Infections: A Systematic Review of the Clinical Evidence and Guidelines DATE: 13 June 2011 EXECUTIVE
More informationAmerican College of Surgeons Critical Care Review Course 2012: Infection Control
American College of Surgeons Critical Care Review Course 2012: Infection Control Overview: I. Central line associated blood stream infection (CLABSI) II. Ventilator associated pneumonia (VAP) I. Central
More informationElectromicyn WHO Essential Medicines List
Electromicyn WHO Essential Medicines List Lance Gravatt PhD Founder Te Arai BioFarma Ltd Finding a Global Partner Oculus Innovative Sciences, Petaluma, CA Launched Microdacyn at NZWCS Conference, Blenheim
More informationTied with pneumonia as the second most common type of healthcareassociated
Tied with pneumonia as the second most common type of healthcareassociated infection. > 15% of HAIs reported to NHSN Estimated > 560,000 nosocomial UTIs annually Increased morbidity & mortality Estimated
More informationGUIDE TO INFECTION CONTROL IN THE HOSPITAL. Carbapenem-resistant Enterobacteriaceae
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 47: Carbapenem-resistant Enterobacteriaceae Authors E-B Kruse, MD H. Wisplinghoff, MD Chapter Editor Michelle Doll, MD, MPH) Topic Outline Key Issue Known
More informationDiscussion of Complex Clinical Scenarios and Variable Review ACS NSQIP Clinical Support Team
Discussion of Complex Clinical Scenarios and Variable Review CS NSQIP Clinical Support Team SCR Open Q& Calls The CS NSQIP Clinical Team is trialing Open format Q& calls for NSQIP SCRs Participation in
More informationA Comprehensive Multi-disciplinary Approach to Improve Surgical Outcomes Following Elective Colon and Rectal Surgery
A Comprehensive Multi-disciplinary Approach to Improve Surgical Outcomes Following Elective Colon and Rectal Surgery Tripurari Mishra MD, Deepa Bhat MD, Mina Saeed MD, Jan Kaminski MD, Mihaela Banulescu
More informationSURGICAL SITE INFECTIONS: SURVEILLANCE & PREVENTION
SURGICAL SITE INFECTIONS: SURVEILLANCE & PREVENTION Facts There were an estimated 157,500 surgical site infections associated with inpatient surgeries in 2011. SSIs were the most common healthcare-associated
More informationSurgical site infection: prevention and treatment
National Institute for Health and Care Excellence Guideline version (Draft) Surgical site infection: prevention and treatment Evidence reviews for effectiveness of nasal decontamination in prevention of
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Centre for Clinical Practice Surveillance Programme
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Centre for Clinical Practice Surveillance Programme Clinical guideline CG74: Prevention and treatment of surgical site infection Publication date October
More informationAntisepsis Bath and Oral.. Should We Change Practice? DR AZMIN HUDA ABDUL RAHIM
Antisepsis Bath and Oral.. Should We Change Practice? DR AZMIN HUDA ABDUL RAHIM Chlorhexidine Exposure in ICU Chlorhexidine gluconate Long acting topical antiseptic In use since 1954 Water soluble Remains
More informationWhat Ursidae is the most insouciant. Arek Wiktor M.D.
GRAND ROUNDS 2011 What Ursidae is the most insouciant Arek Wiktor M.D. PGY-4 Chlorhexidine + Alcohol (ChloraPrep) vs All Other Skin Preparations for Prevention of Surgical Site Infections Objectives Surgical
More informationInfection Control: Surgical Site Infections
Infection Control: Surgical Site Infections Infectious Disease Epidemiology Section Office of Public Health Louisiana Dept of Health & Hospitals 800-256-2748 www.oph.dhh.louisiana.gov Your taxes at work
More information6/1/2011. Objectives. Reducing the Risk of Surgical Site Infections: What is the evidence?
Reducing the Risk of Surgical Site Infections: What is the evidence? Matthew Saltzman, MD 2010 CareFusion Corporation. All rights reserved. ChloraPrep is a registered trademark of CareFusion Corporation
More informationThe Impact of Healthcare Associated Infection (HCAI)
Instructions for use Save this presentation Feel free to add or delete slides as necessary, change information to suit local needs and as new guidance or evidence is published Disclaimer: Whilst the working
More informationPerineal Suturing and Surgical Drapes/Gowns
Date of Search: 11 January 2017 Sources Searched: Medline, Embase, CINAHL, TRIP Database, Cochrane Library Perineal Suturing and Surgical Drapes/Gowns Summary Surgical site infection has been estimated
More informationOptimising Perioperative Pain Management And Surgical Outcomes
Optimising Perioperative Pain Management And Surgical Outcomes Dr Chew Ghee Kheng MBBS FRCOG MD FAMS Senior Consultant Gynaecologist Subspecialist in Gynaecology Oncology Surgery Singapore General Hospital
More informationpart of the Best Practice in General Surgery.
Best Practice in General Surgery Guideline #1: Strategies to Prevent Surgical Site Infections (Updated June 2012) Administrative Office: 600 University Ave, 449 Toronto, ON M5G 1X5 T: 416.586.4800 x8534
More informationPostoperative Surgical Site Infection after Incisional Hernia Repair: Link to Previous Surgical Site Infection? Zulfiqar Ali, AG Rehan
Original Article Postoperative Surgical Site Infection after Incisional Hernia Repair: Link to Previous Surgical Site Infection? Zulfiqar Ali, AG Rehan ABSTRACT Objective: Aim of the study was to determine
More informationMr Sanjeev Sarin MS FRCS. Aortic Aneurysms Patient Information Sheet
Aortic Aneurysms Patient Information Sheet The aim of this information sheet is to ensure that you understand the nature of the treatment you wish to undertake. Please read it carefully and discuss any
More informationQI Successes & Failures Learning from Both
QI Successes & Failures Learning from Both E. Patchen Dellinger, MD, FACS, FIDSA, FSHEA Professor of Surgery University of Washington Medical Center (UWMC), Seattle, Washington Conflict of Interest Over
More informationTargeted literature review:
Targeted literature review: What are the key infection prevention and control recommendations to inform a minimising ventilator associated pneumonia (VAP) quality improvement tool? Part of HAI Delivery
More informationPAPER. Significant Reduction in Incidence of Wound Contamination by Skin Flora Through Use of Microbial Sealant
PAPER Significant Reduction in Incidence of Wound Contamination by Skin Flora Through Use of Microbial Sealant Shirin Towfigh, MD; William G. Cheadle, MD; Stephen F. Lowry, MD; Mark A. Malangoni, MD; Samuel
More informationSurgical Site Infection (SSI) Surveillance Update (with special reference to Colorectal Surgeries)
Surgical Site Infection (SSI) Surveillance Update (with special reference to Colorectal Surgeries) Where we started and where we re going Anjum Khan MBBS MSc CIC Infection Control Professional Department
More informationIncidence and risk factors of surgical wound infection in children: a prospective study
Scandinavian Journal of Surgery 99: 162 166, 2010 Incidence and risk factors of surgical wound infection in children: a prospective study K. Varik, Ü. Kirsimägi, E.-A.Värimäe, M. Eller, R. Lõivukene, V.
More informationMRSA Positive. An information guide
TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION MRSA Positive An information guide MRSA Positive What is MRSA? Staphylococcus aureus is a germ often found on the skin and up the nose of
More informationHand Hygiene in Healthcare Settings
Hand Hygiene in Healthcare Settings Irenic co.(p.j.s) Dr.M.YAMOHAMMADY (PHA.D) راههاي پيشگيري از عفونتهاي بيمارستان What can I do to protect myself from catching influenza A(H1N1)? Updated 11 June 2009
More informationThe incidence of surgical site infections continues to be unacceptably
REVIEW Updated Recommendations for Control of Surgical Site Infections J. Wesley Alexander, MD, ScD, Joseph S. Solomkin, MD, and Michael J. Edwards, MD Objective: The objective of this study is to provide
More informationDecember 2014
Reducing Harm Improving Healthcare Protecting Canadians PREVENT SURGICAL SITE INFECTIONS Getting Started Kit December 2014 www.saferhealthcarenow.ca Safer Healthcare Now! We invite you to join Safer Healthcare
More informationReducing Surgical Site Infection after Major Gynecologic Cancer Surgery
Reducing Surgical Site Infection after Major Gynecologic Cancer Surgery Sharon J. Kim Mayo Medical Student Mayo Clinic, Rochester, MN ACS NSQIP National Conference July 27, 2015 2015 MFMER slide-1 Disclosure
More informationPRINCIPLES AND PRACTICES OF ASEPSIS OBJECTIVES
Module E PRINCIPLES AND PRACTICES OF ASEPSIS Role of hands and the environment in disease transmission OBJECTIVES Describe the principles and practice of asepsis. Understand hand hygiene. 1 DEFINING ASEPSIS
More information3/26/2014 OBJECTIVES PRINCIPLES AND PRACTICES OF ASEPSIS DEFINING ASEPSIS MEDICAL ASEPSIS PRINCIPLES OF MEDICAL ASEPSIS
Module E OBJECTIVES Describe the principles and practice of asepsis. PRINCIPLES AND PRACTICES OF ASEPSIS Understand hand hygiene. Role of hands and the environment in disease transmission DEFINING ASEPSIS
More informationThe past. The evolving role of epidemiology in infection prevention and control: past present and future. Overview. Epidemiology
The evolving role of epidemiology in infection prevention and control: past present and future Professor Jacqui Reilly EM Cotterall Lecture IPS 2010 Overview Past: The historical contribution of epidemiology
More informationOnline Evaluation, Self-Assessment and CE/CME Credit
December 10, 2018 Update on the Prevention of Surgical Site Infections Faculty Speaker: Tom Talbot, MD, MPH, FSHEA, FIDSA Professor of Medicine and Health Policy, Vanderbilt University School of Medicine
More informationDo you have skin in the game?
Do you have skin in the game? The high stakes of SSIs Date: Presenter Disclosure Name Terri Sontheimer RN, CNOR, CRNFA 3M Medical Market Clinical Specialist 2 Objectives Examine the relationship between
More informationLecture 1 Surgical preparation
Lecture 1 Surgical preparation 1. Standard instrument set 2. Preparation for surgery 3. Suture Patterns 1. Standard instrument set female set Preparation of instrument pack Video: Female set preparation
More informationPrevention of Perioperative Infection
Prevention of Perioperative Infection Author(s): Fletcher, Nicholas MD; Sofianos, D'Mitri BS; Berkes, Marschall Brantling BS; Obremskey, William T. MD MPH Issue: Volume 89(7), 1 July 2007, p 1605 1618
More informationPREVENTING SURGICAL SITE INFECTIONS
PREVENTING SURGICAL SITE INFECTIONS Surgical site infections (SSIs) are costly for the NHS and the patient increasing the length of hospital stay and the need for further treatment. This article examines
More informationBloodstream Infections
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER NUMBER 30: Bloodstream Infections Authors Larry Lutwick MD Gonzalo Bearman MD, MPH Chapter Editor Ziad A. Memish, MD, FRCPC, FACP Topic Outline Definition
More informationOBJECTIVES PRINCIPLES AND PRACTICES OF ASEPSIS
Module E OBJECTIVES PRINCIPLES AND PRACTICES OF ASEPSIS Statewide Program for Infection Control and Epidemiology (SPCE) UNC School of Medicine Describe the principles and practice of asepsis Discuss the
More informationUrinary Catheters. Prevalence of Infections
Urinary Catheterisation Urinary catheterisation is defined as an intervention to enable the emptying of the bladder by insertion of a catheter. Catheters can be short term less than 28 days or long term
More informationStudent Orientation Module #1
Student Orientation Module #1 1. Welcome / HFM Mission & Values 2. Infection Prevention: Hand Hygiene 3. Blood borne Pathogens 4. Patient Safety 5. Patient Rights and Responsibilities 1 Holy Family Memorial
More informationInstituting preventive warming measures for patients who are normothermic. A variety of measures may be used, unless contraindicated.
Patient Warmer Perioperative Hypothermia specifies that a preoperative patient management assessment should include: Identification of a patient s risk factors for unplanned perioperative hypothermia Measurement
More informationPreventing Infection in the Operating Room. What do we know? Where do we go from here? Ventilation
Preventing Infection in the Operating Room. What do we know? Where do we go from here? Ventilation Hilary Humphreys Royal College of Surgeons in Ireland (RCSI) & Beaumont Hospital, Dublin, Ireland Meet-the-Expert
More informationTo standardize wound care and prevent infection in compromised patients who have a Berlin Heart Ventricular Assist Device (VAD).
PURPOSE To standardize wound care and prevent infection in compromised patients who have a Berlin Heart Ventricular Assist Device (VAD). POLICY STATEMENTS Dressing change should be done no sooner than
More information