Page 14 - Hoag Orthopedic Institute 2012 Outcomes Report

INFECTION PREVENTION
Nationally, the cost of a hospital stay for a person without an infection acquired in the hospital is, on average, $9,377, but treating an infection acquired in the hospital costs about $43,000 more than
the original treatment cost. At HOI, a collaborative team aggressively pursues low infection rates through adherence to Centers for Disease
Control (CDC) guidelines regarding hand hygiene, antibiotic stewardship and standard precautions that are instrumental in preventing infection and improving patients outcomes.
HOI INFECTION PREVENTION MEASURES
HOI is committed to pursuing excellence in utilizing best practices and the most up-to-date evidence-based standards to prevent surgical site infections and other surgical complications. Some of the best practices utilized for surgical patients at HOI include:
• Educating patients on bathing preoperatively
with chlorhexidine products that reduce bacterial colonization of the skin and have demonstrated decreasing surgical site infection risk
• Conducting preoperative screening of surgical patients for Methicillin-Resistant Staphylococcus Aureus (MRSA). MRSA carriers are identified by swabbing the nares (nostrils), providing options to the surgeon to decrease the risk of infection from MRSA. This may include adjusting the choice of antibiotics before surgery to prevent
infection, isolation protocols to decrease the opportunity for transmission, and treatment to decolonize the patient before surgery when appropriate.
• Testing urine preoperatively to identify potential kidney complications or early infections
• Tailoring choice and time of antibiotics to each patient’s surgery and needs to prevent infection
• Warming patients throughout the operative process to maintain normal temperature
as studies have shown this is a significant contributor to decreasing surgical site infections
Best practices were developed based on guidelines from medical organizations such as CDC, Society of Healthcare Epidemiologists Association, Association of Professionals in Infection Control & Epidemiology, Association of Perioperative Registered Nurses, Infectious Diseases Society of America and American Hospital Association.
METHICILLIN-RESISTANT
STAPHYLOCOCCUS AUREUS (MRSA)
All patients undergoing elective inpatient knee and hip arthroplasties and spinal surgery are screened for MRSA colonization, which portends an increased risk for Surgical Site Infections (SSIs). To prevent the transmission of MRSA among hospital patients, the following screening and treatment algorithm guides clinicians in the care of all patients scheduled for joint replacement or spinal surgery
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