The National Call, Cuts like a Knife, held on Thursday, June 27, 2013 provided an overview of the cutting edge evidence in preventing surgical site infections (SSI). Over 150 attendees were online to learn more about new protocols, the benefits of a reliability culture to improve safety in the operating room and the surgical checklist.
Dr. Claude Laflamme, Medical Director at the Sunnybrook Health Sciences Centre provided an overview of the updated literature for SSI prevention, focusing on three new practice guidelines; skin decontamination, appropriate surgical prophylaxis and core temperature.
The in-depth presentation also covered the multiple factors that play a role in surgical site infections and a checklist of the current and emerging evidence was provided, including reducing contamination in the operating room environment, hair removal, incise drapes, suture composition, the use of electrocautery, oxygen therapy, glucose control, transfusions and many others.
Marlies van Dijk, Director of Clinical Improvement, BC Patient Safety & Quality Council talked about the National Surgical Quality Improvement Program (NSQIP), a robust measurement system that helps guide the surgical team’s efforts to reduce surgical site infections. As most infections appear post-discharge, the cornerstone of the program is a 30-day post-operative chart review and follow-up with surgical patients. The NSQIP analysis of 19 out of 24 hospital sites in British Columbia identified areas for improvement and indicated there was a potential for saving between 7,700 to 31,000 patient days per year across the province.
The BC Patient Safety & Quality Council is building a reliability culture to reduce SSI. The essential components of a reliability culture are focus, proaction and priority. The successful strategies focus on frontline and clinical ownership. Shifting ownership and decision-making to the frontline is key to improving results.
“By looking at the adaptive side of clinical care we can bring our SSI rates under control,” says Marlies. We need to talk about safe surgical care differently and focus on culture, leadership and engagement. We have an obligation to our patients to ensure that best practices are being provided and this approach is very doable.”
Dr. Giuseppe Papia, a Vascular and Endovascular Surgeon at Sunnybrook Health Sciences Centre, highlighted the evolution and importance of the surgical checklist. He reinforced how the surgical checklist is a critical safety tool for surgical patients.
The new evidence and best practices will be reviewed by the Safer Healthcare Now! SSI Faculty and incorporated into an updated SSI Getting Started Kit, which is expected to be available in early 2014.
To access the archived video recording of the National Call, or to download the presentation, visit www.saferhealthcarenow.ca. Further information discussed during the call can be accessed from the SSI Community of Practice - Register or log-in at tools.patientsafety.ca