Reduction of Surgical Site Infections Through Education

Surgical site infections (SSIs) are a major health concern, recognized by the Centers for Disease Control and Prevention (CDC) as one of the leading causes of healthcare-associated infections (HAIs).¹ SSIs have significant direct and indirect impact on patients and the economy.² Direct impact includes prolonged hospital stays and re-admissions, as well as additional treatments, surgical procedures, testing, supplies, and labor. Indirect costs for the patients and family members include disability, decreased work productivity, and increased litigation. Finally, there are intangible costs associated with SSIs including psychological damage, pain and suffering, decreased social functioning, and impact on daily activities.³ It is estimated that approximately half of SSIs could be prevented with the implementation of evidence-based practice.⁴

Numerous strategies have been implemented for the reduction of SSIs. These tactics target patient-controlled factors such as smoking cessation, reduction in alcohol consumption, and maintenance of normal body mass index (BMI).⁵ Other practices are physician-driven such as administration of prophylactic antibiotics, glycemic control during surgery, and maintenance of normal body temperature during surgery.⁶ Finally, some elements of SSI reduction are influenced primarily by the practices of nursing staff within surgical services. These evidence-based practices include such actions as surgical hand antisepsis, patient skin antisepsis, and adherence to sterile technique.⁷ Recent updates to AORN (Association of periOperative Registered Nurses) guidelines for principles and practices for sterile technique include monitoring traffic in the operating room and covering the sterile field with a drape during delays or times of increased activity. In addition, practice recommendations have been made regarding nasal decolonization of patients prior to orthopedic and spinal procedures.⁸ The focus of this project is to provide education on new guidelines that have been recommended for nursing practice in the reduction of SSIs.

A pre/post test project has been developed in order to assess whether the level of knowledge and understanding among OR staff members is higher following the presentation of educational material, than what it had been prior to receiving the information. Following IRB approval, a pre-test will be administered to volunteer OR nurses and surgical technologists to assess their current knowledge regarding AORN recommendations. These recommendations include covering the sterile field with sterile drapes when there is a surgical delay or during periods of increased OR activity. In addition, the pre-test will contain questions pertaining to AORN recommendations for monitoring operating room traffic. Finally, knowledge of current practice guidelines for the use of povidone-iodine for nasal decolonization will be assessed. After the completion of the pre-test, an educational session will be provided to staff members. The educational session will include information on each of these three SSI reduction practices. Following the education session, staff members will be given a post-test in order to assess their level of knowledge on these three topics. The purpose of this project is to determine the effectiveness of the provided education in increasing OR staff knowledge of current recommended practices. The results of this pre/post test project will be displayed in this poster presentation.