The surgical care improvement project and prevention of post-operative infection, including surgical site infection

Laura H. Rosenberger, Amani Politano, Robert G. Sawyer

Research output: Contribution to journalArticle

102 Citations (Scopus)

Abstract

Background: In response to inconsistent compliance with infection prevention measures, the Centers for Medicare & Medicaid Services collaborated with the U.S. Centers for Disease Control and Prevention on the Surgical Infection Prevention (SIP) project, introduced in 2002. Methods: Quality improvement measures were developed to standardize processes to increase compliance. In 2006, the Surgical Care Improvement Project (SCIP) developed out of the SIP project and its process measures. These initiatives, published in the Specifications Manual for National Inpatient Quality Measures, outline process and outcome measures. This continually evolving manual is intended to provide standard quality measures to unify documentation and track standards of care. Results: Seven of the SCIP initiatives apply to the peri-operative period: Prophylactic antibiotics should be received within 1 h prior to surgical incision (1), be selected for activity against the most probable antimicrobial contaminants (2), and be discontinued within 24 h after the surgery end-time (3); (4) euglycemia should be maintained, with well-controlled morning blood glucose concentrations on the first two post-operative days, especially in cardiac surgery patients; (6) hair at the surgical site should be removed with clippers or by depilatory methods, not with a blade; (9) urinary catheters are to be removed within the first two post-operative days; and (10) normothermia should be maintained peri-operatively. Conclusions: There is strong evidence that implementation of protocols that standardize practices reduce the risk of surgical infection. The SCIP initiative targets complications that account for a significant portion of preventable morbidity as well as cost. One of the goals of the SCIP guidelines was a 25% reduction in the incidence of surgical site infections from implementation through 2010. Process measures are becoming routine, and as we practice more evidence-based medicine, it falls to us, the surgeons and scientists, to be active, not only in the implementation and execution of these measures, but in the investigation of clinical questions and the writing of protocols. We are responsible for ensuring that out-of-date practices are removed from use and that new practices are appropriate, achievable, and effective.

Original languageEnglish (US)
Pages (from-to)163-168
Number of pages6
JournalSurgical Infections
Volume12
Issue number3
DOIs
StatePublished - Jun 1 2011
Externally publishedYes

Fingerprint

Surgical Wound Infection
Process Assessment (Health Care)
Infection
Urinary Catheters
Evidence-Based Medicine
Medicaid
Standard of Care
Centers for Disease Control and Prevention (U.S.)
Medicare
Quality Improvement
Documentation
Hair
Thoracic Surgery
Compliance
Blood Glucose
Inpatients
Outcome Assessment (Health Care)
Guidelines
Anti-Bacterial Agents
Morbidity

ASJC Scopus subject areas

  • Surgery
  • Infectious Diseases
  • Microbiology (medical)

Cite this

The surgical care improvement project and prevention of post-operative infection, including surgical site infection. / Rosenberger, Laura H.; Politano, Amani; Sawyer, Robert G.

In: Surgical Infections, Vol. 12, No. 3, 01.06.2011, p. 163-168.

Research output: Contribution to journalArticle

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