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Adoption of Surgical Site Infection Prevention Policies in California Hospitals
E56
American Journal of Infection Control June 2011
confirmed diagnosis of VAP. Material collection for microbiological analysis was done within the first 24 hours after beginning treatment or after changing antibiotics. Microbiological specimens included suction catheter aspirate of tracheal secretions and FOB-guided BAL fluid (BALF) in a distal airway. All patients included in our study had been empirically treated with antibiotics according to a standard protocol. Results: Gram-negative rods were the most frequent microorganisms in the cultures. Pseudomonas aeruginosa (68,6%) and Klebsiella pneumonia espessialy MDR (31,4%) were the most common species. Unexpectedly a low prevalence of Staphylococcus aureus has been detected. Conclusion: Pseudomonas aeruginosa and Klebsiella pneumonia were established as a predominant causative agents of VAP in stroke patients in our ICU. The knowledge of local epidemiological data is important and should be taken into consideration in choice of initial empiric antibiotic therapy. Presentation Number 13-170
Adoption of Surgical Site Infection Prevention Policies in California Hospitals Laurie Conway, RN, MS, CIC, PhD student, Columbia University School of Nursing, New York, NY Background/Objectives: Surgical site infections (SSI) are a significant cause of morbidity and mortality in the United States; however, little is known of the extent to which hospitals have adopted SSI prevention policies. The objective of this study was to describe the presence of and adherence to SSI prevention policies in California hospitals. Methods: A survey of 331 acute care California hospitals was conducted in Spring 2010 as part of a large study examining the changing role of infection preventionists. Policies for preoperative hair removal, prophylactic antibiotic selection and discontinuation, postoperative glucose control, and postoperative normothermia were assessed, as was the presence of a system to provide feedback to surgeons of SSI events. Descriptive statistics including frequencies and percentages were computed. Results: 180 hospitals provided data on SSI policies (54.4% response rate). For all 5 practices, a majority of respondents had written policies in place: appropriate hair removal (86.1%, n5155), selecting appropriate prophylactic antibiotics (76.1%, n5137), discontinuing prophylactic antibiotics within 24 hours after surgery (83.3%, n5150), postoperative glucose control (61.8%, n5110), and maintenance of normothermia after colorectal surgery (63.2%, n5110). The consistency with which these policies were adhered to varied. Policies for appropriate hair removal and selection of antibiotics were reported to be correctly implemented .95% of the time in 74.2% and 56.3% of hospitals respectively. Policies for discontinuing prophylactic antibiotics within 24 hours of surgery end time, postoperative glucose control, and normothermia in colorectal surgery patients were reported to be correctly implemented .95% of the time in less than half of hospitals (41.8%, 35.6%, and 48.3%, respectively). Most hospitals had a system in place to feedback SSI events to surgeons (78.9%, n5142); a majority did so in meetings rather than via individual communication (51.1%, n571). Conclusions: A majority of California hospitals has written policies in place for SSI prevention. However, with the exception of preoperative hair removal, .95% adherence to any single policy is infrequently reported. Efforts to improve the adoption of SSI prevention policies are indicated. Research into the adoption of SSI prevention policies in surgical outpatient settings is needed. Presentation Number 13-171
Beyond Critical Care: Reducing CABSI on Medical-Surgical and Long Term Care Units Kisha N. Wilkinson-Houston, BSN, MSPH, Infection Prevention and Control; Turena Reeves, RN, Quality Coordinator; Jerry Zuckerman, MD, Director of Infection Prevention and Control; Albert Einstein Medical Center, Philadelphia, PA
American Journal of Infection Control June 2011
confirmed diagnosis of VAP. Material collection for microbiological analysis was done within the first 24 hours after beginning treatment or after changing antibiotics. Microbiological specimens included suction catheter aspirate of tracheal secretions and FOB-guided BAL fluid (BALF) in a distal airway. All patients included in our study had been empirically treated with antibiotics according to a standard protocol. Results: Gram-negative rods were the most frequent microorganisms in the cultures. Pseudomonas aeruginosa (68,6%) and Klebsiella pneumonia espessialy MDR (31,4%) were the most common species. Unexpectedly a low prevalence of Staphylococcus aureus has been detected. Conclusion: Pseudomonas aeruginosa and Klebsiella pneumonia were established as a predominant causative agents of VAP in stroke patients in our ICU. The knowledge of local epidemiological data is important and should be taken into consideration in choice of initial empiric antibiotic therapy. Presentation Number 13-170
Adoption of Surgical Site Infection Prevention Policies in California Hospitals Laurie Conway, RN, MS, CIC, PhD student, Columbia University School of Nursing, New York, NY Background/Objectives: Surgical site infections (SSI) are a significant cause of morbidity and mortality in the United States; however, little is known of the extent to which hospitals have adopted SSI prevention policies. The objective of this study was to describe the presence of and adherence to SSI prevention policies in California hospitals. Methods: A survey of 331 acute care California hospitals was conducted in Spring 2010 as part of a large study examining the changing role of infection preventionists. Policies for preoperative hair removal, prophylactic antibiotic selection and discontinuation, postoperative glucose control, and postoperative normothermia were assessed, as was the presence of a system to provide feedback to surgeons of SSI events. Descriptive statistics including frequencies and percentages were computed. Results: 180 hospitals provided data on SSI policies (54.4% response rate). For all 5 practices, a majority of respondents had written policies in place: appropriate hair removal (86.1%, n5155), selecting appropriate prophylactic antibiotics (76.1%, n5137), discontinuing prophylactic antibiotics within 24 hours after surgery (83.3%, n5150), postoperative glucose control (61.8%, n5110), and maintenance of normothermia after colorectal surgery (63.2%, n5110). The consistency with which these policies were adhered to varied. Policies for appropriate hair removal and selection of antibiotics were reported to be correctly implemented .95% of the time in 74.2% and 56.3% of hospitals respectively. Policies for discontinuing prophylactic antibiotics within 24 hours of surgery end time, postoperative glucose control, and normothermia in colorectal surgery patients were reported to be correctly implemented .95% of the time in less than half of hospitals (41.8%, 35.6%, and 48.3%, respectively). Most hospitals had a system in place to feedback SSI events to surgeons (78.9%, n5142); a majority did so in meetings rather than via individual communication (51.1%, n571). Conclusions: A majority of California hospitals has written policies in place for SSI prevention. However, with the exception of preoperative hair removal, .95% adherence to any single policy is infrequently reported. Efforts to improve the adoption of SSI prevention policies are indicated. Research into the adoption of SSI prevention policies in surgical outpatient settings is needed. Presentation Number 13-171
Beyond Critical Care: Reducing CABSI on Medical-Surgical and Long Term Care Units Kisha N. Wilkinson-Houston, BSN, MSPH, Infection Prevention and Control; Turena Reeves, RN, Quality Coordinator; Jerry Zuckerman, MD, Director of Infection Prevention and Control; Albert Einstein Medical Center, Philadelphia, PA