al SCIP program focuses on adopting standard processes of care for
surgical site infections (SSIs), cardiac complications, deep vein
thromboembolism (DVT), and ventilator-associated pneumonia.
Surgical Infections–Research shows that delivering
antibiotics to a patient within one hour prior to beginning surgery
can dramatically cut surgical site infection rates. The national net-
work of Medicare quality improvement organizations (QIOs),
working under contract to CMS, recently conducted a surgical
infection prevention collaborative that effectively reduced SSIs by
27 percent at 56 centers across the country. In addition, current
medical literature recommends clipping hair before surgery instead
of shaving to avoid tiny cuts on the skin that create easy access for
germs and can lead to infection. Significant education was neces-
sary to overcome initial resistance from some physicians unfamiliar
with new guidance.
Cardiac Complications–Adverse cardiac events as a com-
plication of surgery, such as heart attacks, occur in 2 to 5 percent of
patients undergoing noncardiac surgery, and in as many as 34 per-
cent undergoing vascular surgery.
Deep Vein Thrombosis Concerns–DVT, a blood clot that
develops in a deep vein, usually the leg, occurs after approximate-
ly 25 percent of all major surgical procedures performed without
prophylaxis, and pulmonary embolism (PE) in 7 percent of surger-
ies done with prophylaxis. Despite well-established efficacy and
safety of preventative measures, studies show that prophylaxis is
often underused or used inappropriately.
Pneumonia Incidents–Ventilator-associated pneumonia
has been linked with high mortality rates, according to the Centers
for Disease Control and Prevention. Postoperative pneumonia
occurs in 9 to 40 percent of patients and has an associated mortali-
ty rate of 30 to 46 percent.
These areas were targeted by CMS because they are
among those with the highest incidence of postoperative complica-
tions and have the highest potential for improvement. By imple-
menting projects to reduce SSIs, hospitals could recognize a sav-
ings of $3,152 and a seven day reduction in extended length of stay
for each patient developing an infection, according to CMS.
For more information about the ongoing efforts to fight
hospital-acquired infections, go to www.lhcr.org or www.lhaon-
line.org, or contact Kenneth Alexander, Vice President of
Regulatory Activities for Louisiana Hospital Association, or Scott
Flowers, Director of Quality Improvement, Louisiana Health Care
Review.
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healthcarejournalbr.com | September / October 2008 Issue |
Healthcare Journal of Baton Rouge
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