For 50 years, SSI has provided high-quality training in Recreational Scuba, Extended Range, Rebreather Diving, Freediving, Swim, and Lifeguard programs, from beginner to Instructor Trainer levels, and is accredited by a Global ISO certification. The principles of safe design apply to BOTH technical tasks and teamwork. This tool will identify lapses in infection prevention processes that may have contributed to SSIs and will identify inconsistencies in practice patterns. CDC GUIDELINE FOR THE PREVENTION OF SSI, 2017 Current Bundle: A strategy to address the recommendation is currently incorporated into the SSI Bundle for that service. Tapping into the wisdom of the frontline staff is powerful on a number of levels. Other ideas involve posts in the break room, posts in the restrooms, and treats to celebrate successes. Consider the revised “Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals,” published in 2014 by the Society for Hospital Epidemiologists for America (SHEA) and the Infectious Disease Society of America (IDSA). Following columns provide space to record Barriers and Potential Actions. Clinical settings provide complicated services that require a sometimes herculean effort from multiple disciplines and departments. Different preoperative skin preparation products have different procedures. Share stories about how SSIs affected the patient’s life, his or her children, family, and their job. A variety of process measures are available. Step One—Form a subset of your CUSP or SSI prevention team. The first column reads: Guideline, Data collection mode (check one): The next columns provide space to record the Investigator and the Shift. Appropriate hair removal 3. Aim for frontline staff to own this effort. Learn how to conduct SSI surveillance in ASCs. Agency for Healthcare Research and Quality, Rockville, MD. The BIM tool walks through a series of questions focused on three categories. Does each provider know why a protocol has changed? 3 Preoperative components were used for elective procedures; peri- and postoperative components were recommended for all procedures (). Outcome of a Strategy To Reduce Surgical Site Infection in a Tertiary-Care Hospital Liau, Aung, Chua, et al Surgical infections 2010 :11, 2: 151-159 84 % reduction in SSI in 2 years (from 3.1% to 0.5%) (p<0.001) Bundle of interventions can reduce SSI rates Teach your team(s) about your intervention. The primary purpose of this safety bundle is to provide rec-ommendations that can be implemented into any surgi-cal environment in an effort to reduce the incidence of surgical site infection. The driving force behind the TRiP methodology is the core belief that clinicians want to do the right thing. Does the nurse know the correct way to use ChloraPrep®*? Once a barrier is identified, your team can begin to mitigate it. Forge new partnerships with other clinicians. Following columns provide space to record Barriers and Potential Actions. As an emerging area of science, this can be challenging. This next point cannot be stressed enough. The general surgeon champion and Infection Prevention collaborated on the development of the colon SSI prevention bundle by utilizing many of the pre-, intra- and postoperative bundle components in the model proposed by Keenan et al. Anti-staphylococcal bundle to reduce SSIs in orthopaedic and cardiac surgery – Discussion paper page 8 5. Image: Stacked arrows labeled Engage, Educate, Execute, and Evaluate. Identify local barriers to successful implementation. How do you think the next patient will develop a surgical site infection. Surfacing safety hazards using standardized operating room briefings and debriefings at a large regional medical center. Share a story about a patient who acquired a surgical site infection. Why isn’t each patient receiving the correct antibiotic, the correct dosage, and the correct redosage at the correct time (or therapy A, B, C, D, and E?). Ask them about the obstacles that impede compliance with the intervention. Recognize and exploit the opportunities you have by tapping into other means of motivation. Many hospitals grant privileges to visiting surgeons, making it difficult to provide consistent education on emerging evidence. How can the BIM process empower and motivate staff? First, consider assembling a BIM team, perhaps a subset of your surgical quality team. We talked about identifying and addressing local barriers that hinder the implementation of your bundle. Conflict with colorectal surgical instrument set. Henrickson SE, Wadhera RK, Elbardissi AW, et al. Pronovost PJ, Goeschel CA, Marsteller JA, et al. The last step of the TriP methodology is to ensure that all patients are receiving the evidence-based therapy. First column reads Factors. How will you know when progress is made on each effort? These tools will reveal the evidence-based therapies–therapies that could have prevented SSIs–not provided to the patients with SSIs. The need to focus on SSI surveillance and prevention is primarily due to the following evidence ( 1-3). Have the frontline staff walk the targeted process to identify defects. One successful strategy is to talk to the frontline staff. Intervention bundles were developed in the mid-1990s to improve the care of mechanically ventilated patients. Consider next translating that bundle into practice. Highlight staff members that ensure patients receive the evidence-based therapies. Briefings and debriefings standardize care, reduce complexity and create redundancy. While This allowed the safety team to record defects that impacted the current case. Financial incentives are not necessary. It is essential to adapt tools to the local environment. Perhaps these SSIs were not preventable, but these patients did not receive the evidence-based therapies. Nurse educators, physician assistants, infection preventionists, and department leaders can all offer valuable insight in implementing quality improvement initiatives. Design Prospective quasi experimental cohort study. Briefings and debriefings have been linked to reductions in communication breakdowns, operating room delays, communication-related disruptions, nursing time spent away from the patient’s bedside, operating room traffic, and SSIs. Facilitator Notes (Word, 6.71 MB), Internet Citation: Implementing Your Surgical Site Infection Prevention Bundle: Slide Presentation. Crolla RM, van der Laan L, Veen EJ, et al. Wick EC, Hobson DB, Bennett JL, et al. Under the heading Factors is a subheading for Work Environment and several categories and questions: Who is responsible for the following guideline? Framework for patient safety research and improvement. Development and pilot evaluation of a preoperative briefing protocol for cardiovascular surgery. Content last reviewed October 2020. 1 A number of specific bundles are available that can be implemented at health care facilities in resource-limited settings. Close the loop to solve defects at the system level. Social science literature teaches that by asking staff what their concerns are and then acting to remedy the concerns, staff members feel that they have been heard and their opinions valued. Efficacy of protocol implementation on incidence of wound infection in colorectal operations. Staff members need to know if their efforts are making a difference. …Ask: Do you have an SSI prevention bundle? 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