What are the criteria for the surgical infection prevention project (SIP)
patients get antibiotics within 1 hr of incision
patients have antibiotic regimen consistent with guidelines
antibiotics are DC’d within 24 hr of surgery stop
What is the goal of SIP?
decrease morbidity and mortality of SSI
What is the surgical care improvement process? (SCIP)
Developed a few years later (2005)
aimed at reducing surgical complications by 25% by 2010
Who is involved in the decision-making of SCIP? Who is not?
CMS, CDC, American college of surgeons, society of anesthesiologists, association of perioperative nurses, joint commission
Not: CRNA’s
What are the 7 SCIP measures?
- antibiotics
- beta blockers
- hair removal
- foley documentation
- DVT measures
- glucose control
- temperature management
What are the three measures related to antibiotics in SCIP?
- administer abx within 1 hr of surgery (2hr for vancomycin and clindamycin)
- correct abx choice based on procedure
- DC abx within 24 hr of surgery end time (48 hr for cardiac surgery)
What are the 2 measures associated with beta blocker therapy in regards to SCIP?
beta blocker must be given within 24 hr of surgery start for ALL patients on beta blockers
beta blocker should be restarted after surgery
(best to take home dose and beta blocker)
What should be used for hair removal?
clippers (not razor - increased risk of infection)
What are the measures that need to be met with regards to SCIP and foley catheters?
Foley needs to be removed on or before POD 2 (unless an order exists to extend the catheter - reason to extend must be documented and may not be written on post-op admission orders)
What are the goals related to blood glucose in cardiac patients with regard to SCIP?
cardiac patients need to have controlled post-op blood sugar (</= 200) and must be 180 or less within 18-24 hours after anesthesia end
What measures need to be met with regards to DVT prophylaxis and SCIP?
- SCDs should be placed for surgery if >/= 1 hr
-Orders for appropriate DVT prophylaxis on the post-op admission orders
-RN administration of appropriate DVT prophylaxis within 24 hrs of surgery end
What are the temperature measures that need to be met with regards to SCIP?
normothermia or active warming must be documented in the OR
1st temp in PACU must be >/= 96.8F within 15 min of leaving the OR
What are the 5 SCIP measures that need to be met pre-operatively?
- administer abx within 1 hr of incision
- correct abx used based on the procedure
- beta blocker taken within 24 of surgery
- documented appropriate hair removal
- placement of SCDs
What are the 6 SCIP measures that need to be met post-operatively?
- DC abx within 24hr (48hr for cardiac cases)
- beta blockers restarted after surgery (RN administration on POD 1)
- Foley removal prior to or on POD 2
- blood sugar </=180 within 18-24hr for cardiac patients
- post-op admission orders with DVT prophylaxis
- RN administration of DVT prophylaxis within 24hr of surgery end
