Essential best practices for the prevention of surgical site infection in developing countries Benedetta Allegranzi
|
|
- William Brice Holt
- 5 years ago
- Views:
Transcription
1 Essential best practices for the prevention of surgical site infection in developing countries Benedetta Allegranzi Lead, Clean Care is Safer Care, WHO Service Delivery and Safety, HQ Faculty of Medicine, University of Geneva, Geneva, Switzerland ICAN Conference, 4 November 2014, Harare Zimbabwe
2 SSI prevention is complex
3 2014
4 Recommendations In the 1999 CDC guideline, there are 65 recommendations to control SSI In the new CDC draft guidelines, there are 30 research questions For the new WHO guidelines, there are 22 topics undergoing systematic review
5 SSI prevention guidelines WHO perspectives Lessons learned from the WHO HH guidelines: need for global approach Valid for any country, but including specific issues depending on regional differences and/or peculiar to low-/middle-income countries Strong component on implementation strategies and surveillance Associated implementation tools Lessons learned from checklists and other programmes
6 Key Elements in Reducing SSI Courtesy by J. Solomkin
7
8 Surgical Care Improvement Project (SCIP)* SCIP INF 1: Prophylactic antibiotic received within one hour prior to surgical incision SCIP INF 2: Prophylactic antibiotic selection for surgical patients SCIP INF 3: Prophylactic antibiotics discontinued within 24 hours after surgery end time (48 hours for cardiac patients) SCIP INF 4: Cardiac surgery patients with controlled 6 a.m. postoperative serum glucose SCIP INF 6: Surgery patients with appropriate hair removal (retired) SCIP INF 7: Colorectal surgery patients with immediate postoperative normothermia *USA, 2002-present Goal: to reduce SSI by 25% by the year 2010
9 Impact of SCIP (A) odds ratio of SSI and (B) percentage change in SSI 18% decrease in the odds of developing SSI and a cumulative 4% decrease in SSI Munday GS, et al. The American Journal of Surgery,
10 METHODS Prospective quasi experimental cohort study 4-year ( ) SSI prospective surveillance of colorectal surgery with the introduction of bundle for SSI prevention Bundle: 1) perioperative antibiotic prophylaxis; 2) hair removal before surgery 3) perioperative normothermia; 4) discipline in the operating room 1537 surgical interventions RESULTS SSI decrease over time (borderline significant) Significant SSI decrease (36%) in 2010/2011 after adjustment for confounders SSI patients had a higher likelihood to die within 6 m (Logistic regression analysis) Bundle compliance increase from introduction in % to % (p< 0.01)
11
12 METHODS 34-month, single-institution, blinded randomized controlled trial 211 pts undergoing elective trans-abdominal colorectal surgery included, 197 in ITT analysis Intervention: (1) omission of mechanical bowel preparation; (2) preoperative and intraoperative warming; (3) supplemental oxygen during and immediately after surgery; (4) intraoperative intravenous fluid restriction; (5) use of a surgical wound protector RESULTS SSI overall rate 45% vs 24% in the intervention vs standard arm (P=.003) Main difference was in superficial SSI rate (36% vs 19%, p<0.04) Allocation to the standard arm independent RF for SSI (2.49-fold risk; 95% CI, , P=.003) Compliance with the bundle: 99% of subjects received at least 4 of 5 of the bundle interventions. Complete compliance with all of the 5 interventions was 84%
13 Systematic review on HAI prevention in LMIC - Studies on SSI prevention Total: 84 (infection type most frequently addressed) 59 studies in which the intervention is ANTIMICROBIAL PROPHYLAXIS only 25 studies in which other type IP interventions are included: 6 Surgical technique 5 Post-surgery wound management 3 Skin or surgical site preparation 3 Hand hygiene 2 ATB impregnated materials 2 Multimodal/checklist 1 Guidelines implementation 1 Surveillance and feedback 1 Mechanical bowel preparation 1 Anesthesia J. Hopman, B. Allegranzi et al. ICPIC 2013
14 Global perspective on SSI
15 Haynes et al. NEJM 2009; 360:491-9.
16 The Checklist was piloted in 8 cities PAHO I Toronto, Canada EURO London, UK EMRO Amman, Jordan PAHO II WPRO I Manila, Philippines Seattle, USA AFRO Ifakara, Tanzania SEARO New Delhi, India WPRO II Auckland, NZ
17 Results All Sites Baseline Checklist P value Cases Death* 1.5% 0.8% Any Complication** 11.0% 7.0% <0.001 SSI 6.2% 3.4% <0.001 Unplanned Reoperation 2.4% 1.8% *Significant death rate reduction only in low/middle-income countries (p=0.006) **Significant complication rate reduction in both high-income and low/middle-income countries Haynes et al. New England Journal of Medicine 2009; 360:491-9.
18 Changes in safety attitudes following the checklist implementation Before/after survey Modified Safety Attitudes Questionnaire (SAQ) 7 sites Haynes et al. BMJ Qual Saf 2011;20:102e107 Degree of improvement of mean SAQ score correlated with a reduction in postoperative complication rates (R=0.7143, p=0.0381) Implementation and use of the checklist is a cost saving quality improvement strategy.
19 Vats A et al. BMJ 2010
20 Surgical Unit-based Safety Programme (SUSP) Patient safety climate improvement (CUSP): Science of safety education Staff safety assessment Leadership Learning from defects Team work & communications + + Safe Surgery Checklist Infection prevention & control Best practices Improvement of the patient safety climate Reduction of: Surgical site infections Surgical complications
21 The Vision of CUSP The Comprehensive Unit-based Safety Program (CUSP) is designed to: Improve patient safety awareness and systems thinking at the unit level Mobilize staff to identify and resolve patient safety issues Create a patient safety partnership between executives and frontline caregivers Provide tools to help CUSP teams investigate and learn from defects and improve teamwork and safety culture
22 SUSP pilot study Before/after study in colorectal surgery Intervention: CUSP + standardization of skin preparation; administration of preoperative chlorhexidine showers; selective elimination of mechanical bowel preparation; warming of patients in the preanesthesia area; adoption of enhanced sterile techniques for skin and fascial closure; addressing previously unrecognized lapses in antibiotic prophylaxis. Results: mean SSI rate decrease (from 27.3% to 18.2%), 33.3% (95% CI, 9 58%; p=0.05) Wick EC, et al. J Am Coll Surg 2012
23 Technical versus Adaptive Technical Specific actions Protocols Procedures Adaptive Behaviours Attitudes Values Beliefs WHAT WE DO HOW WE DO IT
24 Safety culture Risk is acknowledged by the organisation, incl SSI Non-punitive approach to incidents Collaboration across the ranks Resources are allocated to safety Ultimate aim to make safety an integral part of everything we do
25 Tools for adaptive work Science of safety video Hospital survey of patient safety Executive engagement and walk around Staff safety assessment Barrier identification and mitigation Learning from defects
26 KIJABE HOSPITAL, KENYA
27 HSOPS results: Mistakes blamed on an individual Page 27
28 HSOPS results Staff suffer in silence for fear of victimization if they voice concerns Many staff feel incident reports are for intimidation and victimization because those who write go through that Leaders do not have time to listen to us but blame us Ward meetings should be held regularly for an improved patient care Resource constraints limit effective system optimization for patient safety and reporting of adverse events There is need for a well- organised system of monitoring patient safety issues and reporting, analyzing and feedback of events or errors Page 28
29 Identify at least one actionable idea to improve unit results in this area Create a culture to build trust between the senior and the front line staff Organize focus groups for leaders to reflect on the concepts of "leadership" and "followership" (challenge them to understand what type of leaders they are) Include concepts on "leadership" and "followership" in the safety culture presentations Organize events and use opportunities to effectively create the team work and spirit
30
31 An actual case at Kijabe...
32
33 SSI prevention activities Infection control measures Patient pre-operative bathing Hair removal (not necessary or with clippers) Optimization of surgical site skin preparation Optimization of surgical hand preparation Optimization of surgical antibiotic prophylaxis (timing, dose, type of ATB, re-dosing) Discipline in the OR (limiting number of people and door opening during operation) 33
34 Available tools Set of updated presentations (main topics: science of safety, epidemiology of SSI, interventions to reduce SSI) Updated Fact Sheets Poster on SUSP IPC measures Pocket leaflet Poster on handrubbing technique
35 SUSP tools and WHO checklist Page 35
36
37 Pocket leaflet
38 Intervention phase Printed learning materials and training sessions
39 Patient preparation for surgery Intervention steps 1. Pre-operative bathing (bath or shower) Use soap, ideally antimicrobial soap Ideally 1-2 hours before the operation CDC Require patients to shower or bathe (full body) with either soap (antimicrobial or non-antimicrobial) or an antiseptic agent on at least the night before the operative day (Category IB) Preoperative bathing or showering with skin antiseptics to prevent surgical site infection Webster J, Cochrane DSR 2012
40 Example 1 of Kijabe approach to technical elements of SUSP intervention identifying problems +solutions 1. Patient pre-operative bathing Challenges Cost Patient acceptability to change soap Bathing times not linked to time of surgery. Nurses fetching hot water for bedside bathing Interventions Sourced for fair priced soap Did a survey for tolerability to new soap. Well received by patients SOP created and nurses educated Instant showers to lessen work
41 Antiseptic soap survey
42
43 Discipline in the OR 1. Use adequate attire and maximum asepsis 2. Organization & planning: make sure that all the equipment needed is in the OR before starting 3. Limit the number of people in the OR to those essential to the operation only 4. If students, limit the number and make sure they are trained according to the asepsis rules 5. Keep door and windows closed during the operation Page 43
44 Example 2 of Kijabe approach to technical elements of SUSP intervention identifying problems +solutions 6. Discipline in the OR - limiting number of people and door opening during operations Challenges Too many door openings during cases Posters and barrier notices Staff education Phones in every theater room for communication to avoid unnecessary movement Standardized protocols/equipment for every case. Carry out internal survey
45
46
47 Antibiotic prophylaxis best practices Protocols according to most frequent pathogens and ideally, local resistance patterns Correct pre-operative administration timing: 60 minutes before surgical incision. Correct antibiotic type according to the procedure and patient history (of allergy or severe adverse events) Correct dose and intraoperative redosing: Standardized doses should be used Increased doses based on patient weight According to the antibiotic type, doses should be repeated during the operation at specific time intervals (see table) if the duration of the procedure is prolonged or if excessive blood loss (e.g., >1500 ml) or extensive burns. Appropriate discontinuation after surgery: single dose or duration of less than 24 hours.
48 Procedure Drug/dosing pre-operatively Alternative drug for history of anaphylactic reactions Colorectal Cefazolin* 2 g (3g for pts Ciprofloxacin 400 mg + weighing > 120kg) + metronidazole 500 mg metronidazole 500 mg OR Cefotetan 2 g OR Cefoxitin 1g High-risk gastro-duodenal and biliary Cefazolin 2 g (3g for pts weighing > 120kg) Breast Orthopedic (total joint replacement, closed fractures / use of nails, bone plates, other internal fixation devices, functional repair without implant /devices, trauma) Noncardiac thoracic thoracic (lobectomy, pneumonectomy, wedge resection, other noncardiac mediastinal procedures), closed tube thoracostomy Appendectomy (prophylaxis needed only in complicated or suppurative cases) Cefazolin 2 g (3g for pts weighing > 120kg) Cefazolin 2 g (3g for pts weighing > 120kg) Cefazolin 2 g (3g for pts weighing > 120kg) Cefazolin 2 g (3g for pts weighing > 120kg) + metronidazole 500 mg OR Cefotetan 2g OR Cefoxitin 2g Recommended re-dosing interval, hours Cefazolin, 4 Metronidazole, not needed, unless operation >8 hrs Cefotetan, 6 Cefoxitin, 2 Ciprofloxacin, not needed, unless operation >7 hrs Ciprofloxacin 400 mg Cefazolin, 4 Ciprofloxacin, not needed, unless operation >7 hrs Clindamycin 900 mg or Cefazolin, 4 Vancomycin 15 mg/kg Clindamycin, 6 Gentamicin 5 mg/kg + Clindamycin 900 mg Clindamycin 900mg Cefazolin, 4 Clindamycin, 6 Ciprofloxacin 400 mg + Metronidazole 500 mg Vancomycin, not needed, unless operation >8 hrs Cefazolin, 4 Gentamicin, not needed, unless operation >8 hrs Clindamycin 6 Cefazolin, 4 Metronidazole, not needed, unless operation >8 hrs Cefotetan, 6 Cefoxitin, 2 Ciprofloxacin, not needed, unless operation >7 hrs Obstetric and gynecologic Cefazolin 2 g (3g for pts weighing > 120kg) Ciprofloxacin 400 mg + Metronidazole 500mg Cefazolin, 4 Metronidazole, not needed, unless operation >8 hrs Ciprofloxacin, not needed, unless operation >7 hrs Urologic (may not be beneficial if urine is sterile) Cefazolin 2 g (3g for pts weighing > 120kg) Ciprofloxacin 400 mg + Metronidazole 500mg Cefazolin, 4 Metronidazole, not needed, unless operation >8 hrs Ciprofloxacin, not needed, unless operation >7 hrs Cardiac surgery Cefazolin 2 g (3g for pts Clindamycin 900mg Cefazolin, 4 Page 48
49 Procedure Antibiotic Prophylaxis Recommendation HEAD AND NECK (INTRACRANIAL) Craniotomy A Antibiotic prophylaxis is recommended Cerebrospinal Fluid (CSF) Shunt A Antibiotic prophylaxis is recommended Spinal surgery A Antibiotic prophylaxis is recommended HEAD AND NECK (OTHER) Head, facial or neck surgery (clean, benign) D Antibiotic prophylaxis is not recommended Head and neck surgery (clean, malignant; C Antibiotic prophylaxis should be considered neck dissection) Head and neck surgery (contaminated/cleancontaminated) A Antibiotic prophylaxis is recommended C D The duration of prophylactic antibiotics should not be more than 24 hours Ensured broad spectrum antimicrobial cover for aerobic and anaerobic organisms THORAX Breast cancer surgery A Antibiotic prophylaxis should be considered Open heart surgery C Antibiotic prophylaxis is recommended C The duration of prophylactic antibiotics should not Page be more 49 than 48 hours Pulmonary Resection A Antibiotic prophylaxis is recommended Etc
50 Initial SAP protocol Operation Group Antibiotics for PROPHYLAXIS Dose Timing General Surgery abdominal (eg laparotomy, appendisectomy (if no perforation), biliary tract surgery, colorectal surgery, gastroenteric surgery Ampicillin 2g Flagyl 500mg Single pre-op dose, no post-operative antibiotics General Surgery non-abdominal (eg hernia repair, mastectomy, thyroidectomy, plastic surgery, burns grafting, fasciotomy, cardiothoracic and vascular surgery, ) Ampicillin 2g Single pre-op dose, no post-operative antibiotics CLEAN Orthopaedic surgery (eg ORIF, craniotomy, interlocking nail) ANY Contaminated or Dirty/Infected operation Including Surgical Toilet, Abscess drainage, arthrotomy for septic arthritis, traumatic wound closure, any gastro-intestinal perforation, amputation for gangrene. Any patient with an infection at the time of surgery (eg chorioamnionitis, infected wound, abscess). Ceftriaxone 2g Ampicillin 2g Flagyl 500mg Single pre-op dose, no post-operative antibiotics Pre-operative PROPHYLAXIS AND then to received TREATMENT after operation as per clinicians prescription. Patient with reported allergy to penicillin, for any surgery *Note: there is a small risk of cross-allergy between Penicillins and Cephalosporins (approx 10% risk) Omit Ampicillin from AP if good history of allergy. Can use Ceftriaxone* (2g) instead if necessary. Single pre-op dose, no post-operative antibiotics
51
52 Page 52
53 Initial SAP protocol Operation Group Antibiotics for PROPHYLAXIS Dose Timing General Surgery abdominal (eg laparotomy, appendisectomy (if no perforation), biliary tract surgery, colorectal surgery, gastroenteric surgery Ampicillin 2g Flagyl 500mg Single pre-op dose, no post-operative antibiotics General Surgery non-abdominal (eg hernia repair, mastectomy, thyroidectomy, plastic surgery, burns grafting, fasciotomy, cardiothoracic and vascular surgery, ) Ampicillin 2g Single pre-op dose, no post-operative antibiotics CLEAN Orthopaedic surgery (eg ORIF, craniotomy, interlocking nail) ANY Contaminated or Dirty/Infected operation Including Surgical Toilet, Abscess drainage, arthrotomy for septic arthritis, traumatic wound closure, any gastro-intestinal perforation, amputation for gangrene. Any patient with an infection at the time of surgery (eg chorioamnionitis, infected wound, abscess). Ceftriaxone 2g Ampicillin 2g Flagyl 500mg Single pre-op dose, no post-operative antibiotics Pre-operative PROPHYLAXIS AND then to received TREATMENT after operation as per clinicians prescription. Patient with reported allergy to penicillin, for any surgery *Note: there is a small risk of cross-allergy between Penicillins and Cephalosporins (approx 10% risk) Omit Ampicillin from AP if good history of allergy. Can use Ceftriaxone* (2g) instead if necessary. Single pre-op dose, no post-operative antibiotics
54 Operation Group General Surgery abdominal (eg laparotomy, appendectomy (if no perforation), biliary tract surgery, colorectal surgery, gastroenteric surgery General Surgery non-abdominal (eg hernia repair, mastectomy, thyroidectomy, plastic surgery, burns grafting, fasciotomy Cardiothoracic and vascular surgery CLEAN Orthopaedic surgery (eg ORIF, craniotomy, interlocking nail) ANY Contaminated or Dirty/Infected operation Antibiotics for PROPHYLAXIS Cloxacillin 2 g + Gentamicin 5mg/kg + Metronidazole 500 mg Cloxacillin 2 g + Gentamicin 5mg/kg Second option Penicillin G dose 4 MU + Gentamicin 5mg/kg + Metronidazole 500 mg Dose Timing Single pre-op dose. No post-operative antibiotics, repeat Cloxacillin if > 4h intervention duration. Metronidazole and Gentamicin, no need to repeat, unless operation >8 h Single pre-op dose, no post-operative antibiotics, repeat Cloxacillin if > 4h intervention duration. Chloramphenicol 1 g Vancomycin 15 mg/kg Single pre-op dose, no post-operative antibiotics, repeat Chloramphenicol if > 4h and Vancomycin if >8h intervention duration. Gentamicin 5 mg/kg + Clindamycin 900 mg Cloxacillin 2 g X 6 times a day or 12 g in 500 cc continuous perfusion (over 24hrs) + Gentamicin 5mg/kg once daily for 5 days + Metronidazole 500 mg X times a day Vancomycin 15 mg/kg For severe cases - Imipenem 4x500mg Single pre-op dose, no post-operative antibiotics, repeat Clindamycin if > 6h and Vancomycin if >8h intervention duration. Single dose pre-operative PROPHYLAXIS and then TREATMENT after operation. Page 54
55 % of operations given prophylaxis Antibiotic prophylaxis Is it possible to get to 100% of patients getting - Right DRUG+DOSE - Right TIME - Right DURATION in an African Hospital? Thika Hospital, Kenya, , Aiken et al, PLOS ONE % 80% 60% 40% AP Policy introduced Feb % 0% % given PRE-op prophylaxis % given POST-op antibiotics
56 SSI : Overview of existing guidelines UK High impact intervention bundle (March 2011) USA Institute of Health Improvement Surgical Site Infection (Jan 2012) USA Institute of Health Improvement Hip & knee arthroplasty (Nov. 2012) Scottish Health Protection bundle (Oct 2013) Ireland : Royal College of Physicians (2012) SHEA (June 2014) CDC (Draft 2014) SKIN PREPARATION 2% Chlorhexidine gluconate (CHG) in 70 % isopropyl alcohol solution; povidone-iodine with alcohol for patients who are allergic to Chlorhexidine None Local preparation of 2% chlorhexidine isopropanol solution 1. Isopropanol: 62.7 % g/g Combination either an iodophor or CHG with alcohol is better than povidone-iodine alone 2% CHG in 70 % isopropyl alcohol solution; povidone-iodine with alcohol for patients who are allergic to CHG 1A 2% CHG in 70 % isopropyl alcohol solution; povidone-iodine with alcohol for patients who are allergic to CHG 35ml Povidone-iodine or chlorhexidine, though alcohol-based solutions may 200ml be more effective than aqueous solutions. Most effective antiseptic for skin preparation before surgical incision remains Up uncertain to 1 liter I Wash and clean skin around incision site. Use a dual agent skin preparation containing alcohol, unless contraindications exist 1A Perform intraoperative skin preparation with an appropriate antiseptic agent. Use an antiseptic agent with alcohol, unless contraindicated. 2. Chlorhexidin digluconate 18.8% g/g solution: 12.1 % g/g 3. Distilled water up to 100% Chlohexidine gluconate 2% w/v NICE Distilled / cool boiled water (June 2013) Ethanol 95%
57 Surgical hand and skin preparation Intervention steps 2. Surgical hand preparation Antimicrobial soap+water = 2 5 mins Alcohol-based = mins Good technique is crucial! Nail-brushes not recommended Page 57
58 Surgical handrubbing technique
59 WHO MODIFIED FORMULATIONS Formulation I Final concentrations: Ethanol 80 % w/w, glycerol % v/v, hydrogen peroxide % v/v. Ingredients: 1. Ethanol (absolute), 800 g 2. H 2 O 2 (3%), 4.17 ml 3. Glycerol (98%), 7.25 ml (or 7.25 x 1.26 = g) 4. Top up to 1000 g with distilled or boiled water Formulation II Final concentrations:isopropanol 75 % w/w, glycerol % v/v, hydrogen peroxide % v/v. Ingredients: 1. Isopropanol (absolute), 750 g 2. H 2 O 2 (30%), 4.17 ml 3. Glycerol (98%), 7.25 ml (or 7.25 x 1.26 = g) 4. Top up to 1000 g with distilled water Page 59
60 Handwashing quality score high low med
61 Inappropriate reprocessing of medical devices and surgical instruments Washed under running water Immersed in 2% glutaraldehyde for 8-10 hrs
62 Expert group on safe reprocessing of medical devices and sterilization Mehtar Shaheen South Africa Christina Bradley UK Dianne Trudeau Canada Lisa Huber USA Nizam Damani UK/Pakistan Oonagh Ryan UK 62
63 Thank you for your attention For more information: Contact information WHO SERVICE DELIVERY AND SAFETY Web sites tsafety/en/
64 2015 Save the Date: 3 rd ICPIC, June 2015, Geneva, Switzerland Semmelweis at ICPIC
SSI PREVENTION - CORRECT AND SAFE SURGICAL ANTIBIOTIC PROPHYLAXIS
SSI PREVENTION - CORRECT AN SAFE SURGICAL ANTIBIOTIC PROPHYLAXIS Things you should know! There is wide consensus on specific procedures that warrant antibiotic prophylaxis as well as in which procedures
More informationThe role of Infection Control Nurse in Prevention of Surgical Site Infection (SSI) April 2013
The role of Infection Control Nurse in Prevention of Surgical Site Infection (SSI) April 2013 Impact of SSI 2 nd common health- care associated infection (HCAI) 14-16% of HCAI Post operation SSI prolong
More informationAntimicrobial Prophylaxis in the Surgical Patient. M. J. Osgood
Antimicrobial Prophylaxis in the Surgical Patient M. J. Osgood Outline Definitions surgical site infection (SSI) Risk factors Wound classification Microbiology of SSIs Strategies for prevention of SSIs
More informationAntimicrobial Prophylaxis in Digestive Surgery
Antimicrobial Prophylaxis in Digestive Surgery Toar JM. Lalisang, MD, PhD Digestive Surgery Division Cipto Mangunkusumo Hospital Medical Faculty Universitas Indonesia Antibiotic must be present before
More informationPatient Preparation. Surgical Team
January 2019 www.nursingcenter.com Surgical Site Infection Prevention Surgical site infections (SSIs) are one of the most common and costly healthcare-associated infections in the United States (Smith
More informationResponders as percent of overall members in each category: Practice: Adult 490 (49% of 1009 members) 57 (54% of 106 members)
Infectious Diseases Society of America Emerging Infections Network 6/2/10 Report for Query: Perioperative Staphylococcus aureus Screening and Decolonization Overall response rate: 674/1339 (50.3%) physicians
More informationNHS Dumfries And Galloway. Surgical Prophylaxis Guidelines
NHS Dumfries And Galloway Surgical Prophylaxis Guidelines The aim of surgical prophylaxis is to reduce rates of surgical site and health-care associated infections and so reduce surgical morbidity and
More informationProphylactic antibiotic timing and dosage. Dr. Sanjeev Singh AIMS, Kochi
Prophylactic antibiotic timing and dosage Dr. Sanjeev Singh AIMS, Kochi Meaning - Webster Medical Definition of prophylaxis plural pro phy lax es \-ˈlak-ˌsēz\play : measures designed to preserve health
More informationDeveloped by Kathy Wonderly RN, MSEd,CPHQ Developed: October 2009 Most recently updated: December 2014
Developed by Kathy Wonderly RN, MSEd,CPHQ Developed: October 2009 Most recently updated: December 2014 The Center for Medicare and Medicaid (CMS) is moving away from collecting data on the process of care
More informationPreventing Surgical Site Infections. Edward L. Goodman, MD September 16, 2013
Preventing Surgical Site Infections Edward L. Goodman, MD September 16, 2013 Outline NHSN Reporting and Definitions Magnitude of the Problem Risk Factors Non Pharmacologic Interventions Pharmacologic Interventions
More informationSHC Surgical Antimicrobial Prophylaxis Guidelines
SHC Surgical Antimicrobial Prophylaxis Guidelines I. Purpose/Background This document is based upon the 2013 consensus guidelines from American Society of Health-System Pharmacists (ASHP), the Infectious
More informationVCH PHC SURGICAL PROPHYLAXIS RECOMMENDATIONS
VCH PHC SURGICAL PROPHYLAXIS RECOMMENDATIONS CARDIAC Staphylococcus aureus, S. epidermidis, except for For patients with known MRSA colonization, recommend decolonization with Antimicrobial Photodynamic
More informationIn an effort to help reduce surgical site infections, Surgical Services associates will be expected to observe the following guidelines:
To: Dept. of Surgery Associates From: Gloria Karr, Dir. Infection Prevention Date: May, 2012 Re: Guidelines for Infection Control in In an effort to help reduce surgical site infections, Surgical Services
More informationConflict of interest: We have no conflict of interest to report on this topic of SSI reduction for total knees.
Reducing SSI- Knees TIFFANY KENNERK MBA, MSN, RN, NE -BC, ONC CYNTHIA SEAMAN BSN, RN, ONC, CMSRN ~COMMUNITY HOSPITALS AND WELLNESS CENTERS~ Conflict of interest: We have no conflict of interest to report
More informationSURGICAL ANTIBIOTIC PROPHYLAXIS GUIDELINES WITHIN ORTHOPAEDIC SURGERY FOR ADULT PATIENTS
SURGICAL ANTIBIOTIC PROPHYLAXIS GUIDELINES WITHIN ORTHOPAEDIC SURGERY FOR ADULT PATIENTS Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if
More informationAntibiotic prophylaxis guideline for colorectal, hepatobiliary and vascular surgery for adult patients.
Antibiotic prophylaxis guideline for colorectal, hepatobiliary and vascular surgery for adult patients. Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience,
More informationCefuroxime 1.5gm IV and Metronidazole 500mg IV. Metronidazole 500mg IV/Ampicillin-sulbactam e 3g/Ceftriaxone 2gm. +Metronidazole 500mg/Ertapenem 1gm
SURGICAL ANTIBIOTIC PROPHYLAXIS GENERAL SURGERY* PROCEDURE RECOMMENDED AGENTS a,b Clean None None ALTERNATIVE AGENTS (If allergic to penicillin or colonized/infected with MRSA at any site) Clean with potential
More informationNeurosurgery Antibiotic Prophylaxis Guideline
Neurosurgery Antibiotic Prophylaxis Guideline Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if Trust wide): Review date (when this version
More informationThis is the use of antibiotics before, during and after a diagnostic, therapeutic or surgical procedure to prevent infectious complications.
Antibiotic prophylaxis in surgery CSu2 Policy Antimicrobial prophylaxis is used to reduce the incidence of post operative wound infection; patients undergoing procedures associated with high infection
More informationSurgical Site Infection (SSI) Prevention: The Latest, Greatest and Unanswered Questions
Surgical Site Infection (SSI) Prevention: The Latest, Greatest and Unanswered Questions Keith S. Kaye, MD, MPH Corporate Vice President of Quality and Patient Safety Corporate Medical Director, Infection
More informationBeyond SCIP: Leading the Way to SSI Reduction. House Keeping. House Keeping. Questions. Dianne Rawson, RN, MA Hugo, MN May 14, 2013
3M Learning Connection 5/7/2013 3M Infection Prevention Solutions Learning Connection Beyond SCIP: Leading the Way to SSI Reduction Dianne Rawson, RN, MA Hugo, MN May 14, 2013 2012. All Rights Reserved.
More informationPREVENTION OF SURGICAL SITE INFECTION
PREVENTION OF SURGICAL SITE INFECTION Montreal, March 29 2011 Chantal Bellerose P. Dt., BScHN, M.Sc. Adm Claude Laflamme MD, FRCPC, MHSC(c) Sandra Savery BScN, M.Sc.Adm Disclosure Financial disclosure:
More informationOverview of Infection Control and Prevention
Overview of Infection Control and Prevention Review of the Cesarean-section Antibiotic Prophylaxis Program in Jordan and Workshop on Rational Medicine Use and Infection Control Terry Green and Salah Gammouh
More informationAntimicrobial prophylaxis. Bs Lưu Hồ Thanh Lâm Bv Nhi Đồng 2
Antimicrobial prophylaxis Bs Lưu Hồ Thanh Lâm Bv Nhi Đồng 2 Definition The United States Centers for Disease Control and Prevention (CDC) has developed criteria that define surgical site infection (SSI)
More informationSurgical prophylaxis for Gram +ve & Gram ve infection
Surgical prophylaxis for Gram +ve & Gram ve infection Professor Mark Wilcox Clinical l Director of Microbiology & Pathology Leeds Teaching Hospitals & University of Leeds, UK Heath Protection Agency Surveillance
More informationPrevention of Surgical Site Infections
Prevention of Surgical Site Infections A Review of Recent Evidence and Guidelines Dale W. Bratzler, DO, MPH, MACOI, FIDSA Professor and Associate Dean, College of Public Health Professor, College of Medicine
More informationScottish Surveillance of Healthcare Infection Programme (SSHAIP) Health Protection Scotland SSI Surveillance Protocol 7th Edition 2017 Question &
Contents General... 4 Pre-op... 4 Peri-op... 5 Post-op... 8 Caesarean Section... 12 Orthopaedics... 14 Large Bowel:... 15 Vascular... 17 General Pre-op Q: If a patient is an emergency admission is the
More informationMeasure #20 (NQF 0270): Perioperative Care: Timing of Prophylactic Parenteral Antibiotic Ordering Physician
Measure #20 (NQF 0270): Perioperative Care: Timing of Prophylactic Parenteral Antibiotic Ordering Physician 2014 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage of surgical
More informationSurgical Site Infections (SSIs)
Surgical Site Infections (SSIs) Postoperative infections presenting at any level Incisional superficial (skin, subcutaneous tissue) Incisional deep (fascial plane and muscles) Organ/space related (anatomic
More informationTreatment of Surgical Site Infection Meeting Quality Statement 6. Prof Peter Wilson University College London Hospitals
Treatment of Surgical Site Infection Meeting Quality Statement 6 Prof Peter Wilson University College London Hospitals TEG Quality Standard 6 Treatment and effective antibiotic prescribing: People with
More informationReducing Infections in Surgical Practice. Fred A Sweet, MD Rockford Spine Center Illinois, USA
Reducing Infections in Surgical Practice Fred A Sweet, MD Rockford Spine Center Illinois, USA Introduction: How bacteria get in The Host The Surgeon The Procedure The STAFF Skin PREP Prophylactic Antibiotics
More informationThe surgical site infection risk in developing countries. Yves BUISSON Société de Pathologie Exotique
The surgical site infection risk in developing countries Yves BUISSON Société de Pathologie Exotique Surgical site infections Health-care-associated infections occurring within 30 days after surgery, or
More informationGynaecological Surgery in Adults Surgical Antibiotic Prophylaxis
Gynaecological Surgery in Adults Surgical Antibiotic Prophylaxis Full Title of Guideline: Author (include email and role): Division & Speciality: Scope (Target audience, state if Trust wide): Review date
More informationPrevention of Surgical Site Infection 2017 Guidelines & Antimicrobial Stewardship
Prevention of Surgical Site Infection 2017 Guidelines & Antimicrobial Stewardship Phenelle Segal RN, CIC, FAPIC President Infection Control Consulting Services www.iccs home.com 215 692 3485 info@iccs
More informationAntibiotic Prophylaxis Update
Antibiotic Prophylaxis Update Choosing Surgical Antimicrobial Prophylaxis Peri-Procedural Administration Surgical Prophylaxis and AMS at Epworth HealthCare Mr Glenn Valoppi Dr Trisha Peel Dr Joseph Doyle
More informationPrevention of Perioperative Surgical Infections
Prevention of Perioperative Surgical Infections Michael A. West, MD, PhD, FACS Department of Surgery University California San Francisco San Francisco, CA, USA Surgical Site Infections (SSI) 2-5% of operated
More informationInfection control in intensive care. Sandra Fairley Senior Nurse, Neurocritical Care
Infection control in intensive care Sandra Fairley Senior Nurse, Neurocritical Care sandra.fairley@uclh.nhs.uk Risks to the patient of health care acquired infection (HCAI) Patient admitted to hospital
More informationAntimicrobial Prophylaxis for Surgical and Non-surgical Procedures
Antimicrobial Prophylaxis for Surgical and Non-surgical Procedures Written by: Dr Linda Jewes, Consultant Microbiologist Date: April 2016 Approved by: Drugs & Therapeutics Committee Date: September 2016
More informationLearning Objectives:
Preventing Surgical Site Infections (SSI) Learning Objectives: Discuss risk factors for surgical site infections in healthcare settings. Review current strategies and emerging guidelines for SSI prevention.
More informationStandardization of Perioperative Antibiotic Prophylaxis through the Development of Procedure-specific Guidelines in the NICU
Standardization of Perioperative Antibiotic Prophylaxis through the Development of Procedure-specific Guidelines in the NICU Setting: Ann and Robert H. Lurie Children s Hospital of Chicago in Chicago,
More informationMeasure #21 (NQF 0268): Perioperative Care: Selection of Prophylactic Antibiotic First OR Second Generation Cephalosporin
Measure #21 (NQF 0268): Perioperative Care: Selection of Prophylactic Antibiotic First OR Second Generation Cephalosporin 2013 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage
More informationMeasure Information Form
Release Notes: Measure Information Form Version 2.4 **NQF-NORS VOLUNTARY CONSNSUS STANARS FOR HOSPITAL CAR** Measure Information Form Measure Set: Surgical Care Improvement Project (SCIP) Set Measure I
More informationSystemic Antimicrobial Prophylaxis Issues
Systemic Antimicrobial Prophylaxis Issues Pierre Moine Department of Anesthesiology University of Colorado Denver 3 rd International Conference on Surgery and Anesthesia OMICs Group Conference The Surgical
More informationTop Ten Articles Infection Prevention and Control
Top Ten Articles Infection Prevention and Control 2017-2018 John M Conly MD Chingiz Amirov Just wash em! May 2018 Objectives Research or evidence-based guidelines in IPC Critique strengths and weaknesses
More informationSurgical Site Infection Prevention
Surgical Site Infection Prevention A Clinical Practice Guideline developed by the University of Toronto s Best Practice in Surgery in collaboration with the Antimicrobial Stewardship Program P Bonnar,
More informationPreventing Surgical Site Infections Loretta Litz Fauerbach, Shands Hospital at the University of Florida Sponsored by 3M Canada
Preventing Surgical Site Infections Loretta Litz Fauerbach, MS, CIC Hosted by Paul Webber paul@webbertraining.com Sponsored by: 3M Canada www.3m.ca www.webbertraining.com Surgical Site Infections (SSIs)
More informationNeonatal Antibiotic Prophylaxis and Surgical Site Infection Adam C. Alder, MD MSCS Ryan Walk, MD UTSW and Children s Health Dallas, TX
Neonatal Antibiotic Prophylaxis and Surgical Site Infection Adam C. Alder, MD MSCS Ryan Walk, MD UTSW and Children s Health Dallas, TX Nothing to disclose Disclosures Objectives Review the current challenges
More informationThe Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection
THE IRAQI POSTGRADUATE MEDICAL JOURNAL PROPHYLACTIC ANTIBIOTICS ON SURGICAL WOUND INFECTION The Effect of Perioperative Use of Prophylactic Antibiotics on Surgical Wound Infection Ahmed Hamid Jasim*, Nabeel
More informationPrevention of surgical site infections (SSI) nosocomial infection * - Lead to prolonged hospital stay and increased coasts
Antibiotic Prophylaxis in Surgery Birgit Ross, MD Dep. of Hospital Hygiene University Hospital and Clinics, Essen Prevention of surgical site infections (SSI) - Surgical site infections account for approximately
More informationAntibiotic Prophylaxis in Adult Orthopaedic Surgery. Formulary/prescribing guideline
Document type: Antibiotic Prophylaxis in Adult Orthopaedic Surgery Version: 2.0 Author (name): Author (designation): Validated by Formulary/prescribing guideline Dr Celia Chu, Dr Katy Edwards, Dr Pradeep
More informationNQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE. Measure Information Form Collected For: CMS Voluntary Only
Last Updated: Version 4.4a NQF-ENORSE VOLUNTARY CONSENSUS STANARS FOR HOSPITAL CARE Measure Information Form Collected For: CMS Voluntary Only Measure Set: Surgical Care Improvement Project (SCIP) Set
More informationPrevention of Perioperative Surgical Infections
Prevention of Perioperative Surgical Infections Michael A. West, MD, PhD, FACS Department of Surgery University California San Francisco San Francisco, CA, USA Surgical Site Infections (SSI) 2-5% of operated
More informationSurgical Antibiotic Prophylaxis: What Happens When SCIP Skips the Evidence Base?
Surgical Antibiotic Prophylaxis: What Happens When SCIP Skips the Evidence Base? NOTIFICATIONS CHART Institute, LLC is an approved provider of continuing nursing education by the Pennsylvania State Nurses
More informationWho should read this document 2. Key practice points 2. Background/ Scope/ Definitions 2. What is new in this version 3. Policy/Procedure/Guideline 3
Antibiotic Prophylaxis in Cranial Neurosurgery Antibiotic Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): as above Authors Division: DCSS & Tertiary
More informationAntimicrobial utilization: Capital Health Region, Alberta
ANTIMICROBIAL STEWARDSHIP Antimicrobial utilization: Capital Health Region, Alberta Regionalization of health care services in Alberta began in 1994. In the Capital Health region, restructuring of seven
More informationPerioperative Infection. Surgical site infections: How to prevent them. Surgical site infections
Surgical site infections: How to prevent them Raghuvender Ganta MD, FRCA. Associate Professor, Anesthesiology Adjunct Associate Professor, OUMC Director Pain Management, VAMC Surgical site infections 17%
More informationPrescribers, trained nurses and pharmacists.
Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Author: Contact Name and Job Title Directorate & Speciality Date of submission June 2015 Explicit definition of
More informationAntimicrobial Surgical Prophylaxis
Antimicrobial Surgical Prophylaxis The antimicrobial surgical prophylaxis protocol establishes evidence-based standards for surgical prophylaxis at The Nebraska Medical Center. The protocol was adapted
More informationAntibiotic Prophylaxis in Spinal Surgery Antibiotic Guidelines. Contents
Antibiotic Prophylaxis in Spinal Antibiotic Guidelines Classification: Clinical Guideline Lead Author: Antibiotic Steering Committee Additional author(s): Authors Division: DCSS & Tertiary Medicine Unique
More informationPeri-operative Antibiotic Prophylaxis. 2 nd QI Cycle results Compiled by: Dr Stella Sasha
Peri-operative Antibiotic Prophylaxis 2 nd QI Cycle results Compiled by: Dr Stella Sasha 2 nd QI cycle 4 weeks (11 April 8 May) Elective MIS cases Hysterectomy +/- salpingo-oophorectomy Myomectomy Oophorectomy
More informationAntimicrobial Surgical Prophylaxis
Antimicrobial Surgical Prophylaxis The antimicrobial surgical prophylaxis protocol establishes evidence-based standards for surgical prophylaxis at Nebraska Medicine. The protocol was adapted from the
More informationUse And Misuse Of Antibiotics In Neurosurgery
Use And Misuse Of Antibiotics In Neurosurgery CSF infection in the United States after neurosurgery from 1992 to 2003 0.86% to 2.32% * *National Nosocomial Infections Surveillance System: National Nosocomial
More informationSurgical antibiotic prophylaxis: Are you doing it right?
Southern African Journal of Anaesthesia and Analgesia 2018; 24(3)(Supplement 1) Open Access article distributed under the terms of the Creative Commons License [CC BY-NC-ND 4.0] http://creativecommons.org/licenses/by-nc-nd/4.0
More information2017 SURVEILLANCE OF SURGICAL SITES INFECTIONS FOLLOWING TOTAL HIP AND KNEE ARTHROPLASTY
Canadian Nosocomial Infection Surveillance Program 2017 SURVEILLANCE OF SURGICAL SITES INFECTIONS FOLLOWING TOTAL HIP AND KNEE ARTHROPLASTY FINAL Working Group: E. Henderson, M. John, I. Davis, S. Dunford,
More informationPRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE
PRACTIC GUIDELINES for APPROPRIATE ANTIBIOTICS USE Global Alliance for Infection in Surgery World Society of Emergency Surgery (WSES) and not only!! Aims - 1 Rationalize the risk of antibiotics overuse
More informationIntra-Abdominal Infections. Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018
Intra-Abdominal Infections Jessica Thompson, PharmD, BCPS (AQ-ID) Infectious Diseases Pharmacy Clinical Specialist Renown Health April 19, 2018 Select guidelines Mazuski JE, et al. The Surgical Infection
More informationAntibiotic Usage Guidelines in Hospital
SUPPLEMENT TO JAPI december VOL. 58 51 Antibiotic Usage Guidelines in Hospital Camilla Rodrigues * Use of surveillance data information of Hospital antibiotic policy guidelines from Hinduja Hospital. The
More informationGUIDE TO INFECTION CONTROL IN THE HOSPITAL. Hand Hygiene CHAPTER 6: Authors A. J. Stewardson, MBBS, PhD D. Pittet, MD, MS
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 6: Hand Hygiene Authors A. J. Stewardson, MBBS, PhD D. Pittet, MD, MS Chapter Editor Shaheen Mehtar, MD, MBBS, FRC Path, FCPath (Micro) Topic Outline
More informationAntimicrobial Selection and Therapy for Equine Musculoskeletal Trauma
Antimicrobial Selection and Therapy for Equine Musculoskeletal Trauma Lucio Petrizzi DVM DECVS Università degli Studi di Teramo Surgical site infections (SSI) Microbial contamination unavoidable Infection
More informationGive the Right Antibiotics in Trauma Mitchell J Daley, PharmD, BCPS
Give the Right Antibiotics in Trauma Mitchell J Daley, PharmD, BCPS Clinical Pharmacy Specialist, Critical Care Dell Seton Medical Center at the University of Texas and Seton Healthcare Family Clinical
More informationProc. related Joseph Lister - antiseptic principles Zoutman et al Inf Contr Hosp Epi 1999
Dick Zoutman, MD, FRCPC Queen s University School of Medicine & Kingston General Hospital, Kingston, Ontario, Canada Hosted by Paul Webber paul@webbertraining.com www.webbertraining.com Practical Meaning
More informationApproach to Antibiotics in Obstetrics: Surgical Prophylaxis for Cesareans
Approach to Antibiotics in Obstetrics: Surgical Prophylaxis for Cesareans Amy Murtha, MD Associate Professor Vice Chair for Research Department of Ob/Gyn Objectives Review antibiotic prophylaxis for
More informationHow to get senior hospital and clinical engagement
How to get senior hospital and clinical engagement Professor Alison Holmes Professor of Infectious Diseases Director, NIHR Health Protection Research Unit: HCAI and AMR Engagement through Organisational
More informationASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery
426 ASHP Therapeutic Guidelines ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery The ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery, 1 which have provided practitioners
More informationUPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM
UPDATE ON ANTIMICROBIAL STEWARDSHIP REGULATIONS AND IMPLEMENTATION OF AN AMS PROGRAM Diane Rhee, Pharm.D. Associate Professor of Pharmacy Practice Roseman University of Health Sciences Chair, Valley Health
More informationClinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery
654 ASHP Therapeutic Guidelines Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery These guidelines were developed jointly by the American Society of Health-System Pharmacists (ASHP),
More informationSummary of major changes
1 Summary of major changes The first SSI surveillance protocol was produced in 2002. Changes have been applied, either based on the issue of Scottish Government directives or to align Scotland s SSI surveillance
More information2013 PQRS Measures Groups Specifications Manual PERIOPERATIVE CARE MEASURES GROUP OVERVIEW
PERIOPERATIVE CARE MEASURES GROUP OVERVIEW 2013 PQRS OPTIONS F MEASURES GROUPS: CLAIMS, REGISTRY 2013 PQRS MEASURES IN PERIOPERATIVE CARE MEASURES GROUP: #20. Perioperative Care: Timing of Prophylactic
More informationHyperlink to Guideline
Clinical Guideline Surgical Antibiotic Prophylaxis Sites where Clinical Guideline applies All facilities where surgery is carried out This Clinical Guideline applies to: 1. Adults Yes 2. Children up to
More informationThe CARI Guidelines Caring for Australians with Renal Impairment. 8. Prophylactic antibiotics for insertion of peritoneal dialysis catheter
8. Prophylactic antibiotics for insertion of peritoneal dialysis catheter Date written: February 2003 Final submission: May 2004 Guidelines (Include recommendations based on level I or II evidence) Antibiotic
More informationPOTENTIAL STRUCTURE INDICATORS FOR EVALUATING ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN EUROPEAN HOSPITALS
POTENTIAL STRUCTURE INDICATORS FOR EVALUATING ANTIMICROBIAL STEWARDSHIP PROGRAMMES IN EUROPEAN HOSPITALS Dirk VOGELAERS Department of General Internal Medicine, Infectious Diseases and Psychosomatic Medicine
More informationCore Elements of Antibiotic Stewardship for Nursing Homes
Core Elements of Antibiotic Stewardship for Nursing Homes Nimalie D. Stone, MD, MS Medical Epidemiologist for LTC Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Antimicrobial
More informationMeasure Information Form
Release Notes: Measure Information Form Version 2.0 **NQF-NDORSD VOLUNTRY CONSNSUS STNDRDS FOR HOSPITL CR** Measure Information Form Measure Set: Surgical Care Improvement Project (SCIP) Set Measure ID
More informationRxPress. May/Jun Vol 16 No 3. The White House Releases Plan to Combat Antibiotic-Resistant Bacteria
May/Jun 2015 Vol 16 No 3 RxPress TABLE OF CONTENTS The White House Releases Plan to Combat Antibiotic-Resistant Bacteria 1-2 FDA Requests New Data on Health Care Antiseptics 2-4 Penicillin Allergies and
More informationSurgical Antibiotic Prophylaxis: Adherence to hospital s guidelines
Surgical Antibiotic Prophylaxis: Adherence to hospital s guidelines Abstract Aim: This study was designed to assess the compliance to local hospital guidelines for antimicrobial prophylaxis in general
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Bennett-Guerrero E, Pappas TN, Koltun WA, et al. Gentamicin
More informationGetting Started Kit PREVENT SURGICAL SITE INFECTIONS. Reducing Harm Improving Healthcare Protecting Canadians. September 2010
Reducing Harm Improving Healthcare Protecting Canadians PREVENT SURGICAL SITE INFECTIONS Getting Started Kit September 2010 www.saferhealthcarenow.ca Safer Healthcare Now! We invite you to join Safer Healthcare
More informationAn Evidence Based Approach to Antibiotic Prophylaxis in Oral Surgery
An Evidence Based Approach to Antibiotic Prophylaxis in Oral Surgery Nicholas Makhoul DMD. MD. FRCD(C). Dip ABOMS. FACS. Director, Division of Oral and Maxillofacial Surgery Assistant Professor McGill
More informationThe Impact of Timing, Selection, and Dosage of Preoperative Prophylactic Antibiotics on Preventable Surgical Site Infections
Rhode Island College Digital Commons @ RIC Master's Theses, Dissertations, Graduate Research and Major Papers Overview Master's Theses, Dissertations, Graduate Research and Major Papers 1-1-2012 The Impact
More informationGUIDELINE FOR ANTIMICROBIAL USE IN THE ORTHOPAEDIC AND TRAUMA DEPARTMENT
GUIDELINE FOR ANTIMICROBIAL USE IN THE ORTHOPAEDIC AND TRAUMA DEPARTMENT Written by: Dr Ken. N. Agwuh, Consultant Microbiologist Mr Roger Helm, Consultant Orthopaedic Surgeon Mr T Kumar, Consultant Orthopaedic
More informationCanadian Nosocomial Infection Surveillance Program 2018 SURVEILLANCE OF SURGICAL SITES INFECTIONS FOLLOWING HIP AND KNEE ARTHROPLASTY
Canadian Nosocomial Infection Surveillance Program 2018 SURVEILLANCE OF SURGICAL SITES INFECTIONS FOLLOWING HIP AND KNEE ARTHROPLASTY FINAL Working Group: Dominik Mertz (Chair) Elizabeth Henderson, Johan
More informationObjectives. Review basic categories of intra-abdominal infection and their respective treatments. Community acquired intra-abdominal infection
Objectives Review basic categories of intra-abdominal infection and their respective treatments Community acquired intra-abdominal infection Mild/Moderate Severe Acute biliary tract infections Nosocomial
More informationPreventing Surgical Site Infections
Preventing Surgical Site Infections BC Hip & Knee Arthroplasty Collaborative February 7, 2006 Felicia Laing, BSc MSc CIC, Infection Control Anisha Lakhani, BScPharm Pharm D Fraser Health Authority It s
More informationJump Starting Antimicrobial Stewardship
Jump Starting Antimicrobial Stewardship Amanda C. Hansen, PharmD Pharmacy Operations Manager Carilion Roanoke Memorial Hospital Roanoke, Virginia March 16, 2011 Objectives Discuss guidelines for developing
More informationPopulation Decolonized and Decolonization Regimen
Appendix Table 1a Characteristics Studies Evaluating a Bundle Including Decolonization and Glycopeptide Prophylaxis as a Means of Preventing Gram-Positive Surgical Site Infections First Author, Year, Location
More informationMeasure Information Form
Release Notes: Measure Information Form Version 2.0 **NQF-ENDORSED VOUNTRY CONSENSUS STNDRDS FOR HOSPIT CRE** Measure Information Form Measure Set: Surgical Care Improvement Project (SCIP) Set Measure
More informationAntimicrobial Stewardship in the Hospital Setting
GUIDE TO INFECTION CONTROL IN THE HOSPITAL CHAPTER 12 Antimicrobial Stewardship in the Hospital Setting Authors Dan Markley, DO, MPH, Amy L. Pakyz, PharmD, PhD, Michael Stevens, MD, MPH Chapter Editor
More informationTrust Guideline for the Management of: Antibiotic Prophylaxis in adults undergoing procedures in Interventional Radiology
Antibiotic Prophylaxis in adults undergoing procedures in Interventional Radiology A Clinical Guideline For use in: By: For: Division responsible for document: Key words: Interventional Radiology Prescribers
More informationReceived 25 April 2011/Returned for modification 23 June 2011/Accepted 26 July 2011
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Oct. 2011, p. 4659 4663 Vol. 55, No. 10 0066-4804/11/$12.00 doi:10.1128/aac.00562-11 Copyright 2011, American Society for Microbiology. All Rights Reserved. Nonconcordance
More informationWhat can we learn from point prevalence surveys? Mark Gilchrist Consultant Pharmacist Infectious Diseases
What can we learn from point prevalence surveys? Mark Gilchrist Consultant Pharmacist Infectious Diseases Imperial College Healthcare NHS Trust mark.gilchrist@imperial.nhs.uk Outline Placing point prevalence
More information