Reducing Surgical

Site Infections
Wendy Keil
Andrea Suan
Burden on U.S. Healthcare System1

Annual cost related SSI are the most

Estimated cost per
to Surgical Site costly type of 2-5% of inpatient
infection $11,000-
Infections (SSI) Hospital Acquired surgeries
$35,000
$3.5-$10 billion Infections (HAI)

2-11 patients have 7-11 additional

Increased length of
a greater chance of post-operative
stay
death days inpatient
 Staphylococcus aureus 50.4%

Escherichia coli 23.2%

Common
Organisms2 Pseudomonas aeruginosa 7.9%

Citrobacter 7.9%
Plan: Objectives3

• Reduce the rate of SSI

• Decrease the incidence of SSI by 20%
• Education
• Compliance
• Evaluation
 • Perform preoperative skin care
Plan: SSI • Postoperative skin care
Prevention • Glucose control
• Hair Removal
Bundle4 • Hand hygiene
 • Implement plan
Do5 • Identify nurse
leaders
• Educate staff,
patients and family
• Allocate appropriate
recourses
• Pilot CDC approved
antimicrobial agent
(alcohol based with
CHG)
• Assign team to
gather SSI data
• Adherence
Study
• During the 3 month pilot program:

• Identify how many patients developed

SSI
• Assess compliance of prevention bundle
• Patient rounding
• Analyze and compare data with baseline
data
• Improvement?
Act

• Assess effectiveness of interventions

• Areas identified need for improvement
• Develop a plan for next cycle
• Establish permanent practice change based
on results
• Utilize best antiseptic skin preparation
• Assign compliance team to monitor
quarterly data
References
1. Anderson, D. J., Podgorny, K., Berríos-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L.,
Nyquist, A. C., Saiman, L., Yokoe, D. S., Maragakis, L. L., … Kaye, K. S. (2014). Strategies to prevent
surgical site infections in acute care hospitals: 2014 update. Infection Control and Hospital
Epidemiology, 35(6), 605-27.
2. Negi, V., Pal, S., Juyal, D., Sharma, M. K., & Sharma, N. (2015). Bacteriological Profile of Surgical
Site Infections and Their Antibiogram: A Study From Resource Constrained Rural Setting of
Uttarakhand State, India. Journal of clinical and diagnostic research : JCDR, 9(10), DC17-20.
3. Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. (2017)Centers for Disease Control and
prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg, 152(8):784–791.
doi:10.1001/jamasurg.2017.0904
4. Allegranzi, B. B. (2016). New WHO recommendations on preoperative measures for surgical site
infection prevention: an evidence-based global perspective. The Lancet Infectious Diseases, 276-
287.
5. Podgrony, K. K. (2013). The Joint Commission’s implementation guide for NPSG 07.05.01 on
surgical site infections: The SSI change project. The Joint Commission.