Paper
Wednesday, July 11, 2007
SIPP and Beyond - Perioperative Strategies
Callie Sue Craig, RN, BSN, CNOR1, Janet A. Lewis, RN, MA, CNOR1, and Stacey Decker, RN, BSN2. (1) Surgical Services, INTEGRIS Baptist Medical Center, Oklahoma City, OK, USA, (2) Surgery, Anesthesia, PACU, Surgical Admission Unit, INTEGRIS Baptist Medical Center, Oklahoma City, OK, USA
| Learning Objective #1: Discuss the importance of compliance with the SIPP recommendations. |
| Learning Objective #2: Describe the relationship for perioperative nurses to promote compliance to the SIPP recommendations. |
The Surgical Infection Prevention Project (SIPP) coordinated by CDC advocated specific guidelines for the administration of antibiotics. Through a large metropolitan hospital’s participation in this collaborative activity, other new medical and nursing practice guidelines were developed and resulted in significant improvement. In the perioperative settings, several measures were developed with the focus on reducing the factors that predispose patients to poor wound healing and surgical site infection.
A review of over 100 research studies was conducted that resulted in instituting best practice measures to avoid perioperative hypothermia. A preoperative glucose monitoring study was conducted on total joint replacement patients with subsequent implementation of a postoperative hyperglycemia management protocol. Following a review of current medical antibiotic ordering practices, a protocol was developed for a recommended antibiotic prophylaxis for colon surgical procedures. The processes and interactions between the medical staff and nursing presented many challenges.
Education, communication and physician champions were vital components for success in addressing change in practice for both nurses and physicians. The SIPP has been a catalyst for many other quality initiatives that continue to evolve. JCAHO has included reduction of hospital acquired infections in the National Patient Safety Goals. Additionally hospitals are now being benchmarked on the level of compliance to the quality measurements for safe patient care which includes proper antibiotic administration and reduction of surgical site infection. Continued monitoring is necessary to assure compliance as well as reporting for quality benchmarks. The ultimate goal is to provide a safer environment for the surgical patient.