AHRQ Safety Program for Surgery
Introduction
Problem Statement
Surgical site infection (SSI) prevention remains a global public health priority. Patients in acute care hospitals underwent more than 16 million surgical procedures in the United States in 2010.1 Using National Healthcare Safety Network (NHSN) definitions and surveillance methods, the overall national SSI rate is approximately 1.9 percent. A recent meta-analysis showed that SSIs are the third most costly healthcare-associated infection (HAI) per event, accounting for more annual health care costs than any other major infection.2 SSIs are common HAIs: A recently published point-prevalence survey of HAIs across 10 States showed that 4 percent of patients had 1 or more HAIs by NHSN definitions, and SSIs accounted for approximately 20 percent of all HAI cases.3 SSIs continue to impart an enormous burden on patients, their families, employers, and society.
Purpose of This Tool
This tool will help your safety program team reduce or eliminate the potential for an SSI.
Please Adapt This Tool
A team of clinicians designed this tool for a specific clinical setting. Please modify this tool to best fit your team’s needs.
How To Use This Tool
Follow the instructions in each table included in this tool. Start with “Before Induction of Anesthesia.” Then, go to “Before Skin Incision.” Then, follow the checklist outlined in “Before Patient Leaves Operating Room.” If the procedure is considered minor, complete the checklist presented in the “Minor Procedures” table, and provide the information adjacent to that table. This checklist is for your internal use only. How you modify or follow this checklist is up to you. Only your team knows the approach that will work best in your perioperative area. To help guide your team through the quality improvement intervention design process, you can use the Learning From Defects Through Collective Sensemaking Tool in the AHRQ Toolkit to Promote Safe Surgery
Before Induction of Anesthesia
SIGN IN |
___ Identity (name and date of birth) ___ Site (along with marking) ___ Procedure ___ Consent
___ Known allergy? ____________________________________________________________________________
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Before Skin Incision
TIMEOUT |
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Before Patient Leaves Operating Room
SIGN OUT |
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Items to be addressed:
Please provide your comments and your contact information, and we will follow up personally with you on any issue you address:
- If no comments, indicate not applicable (N/A):___________
- Attending surgeon: ________________________________
- Anesthesia personnel: _____________________________
- Circulating nurse: _________________________________
Issues or comments:
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
Contact information for response and/or followup:
____________________________________________________________
Minor Procedures |
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References
1. Centers for Disease Control and Prevention. Surgical Site Infection (SSI) Event. April 2015. http://www.cdc.gov/nhsn/PDFs/pscManual/9pscSSIcurrent.pdf.
2. Zimlichman E, Henderson D, Tamir O, et al. Health Care–Associated Infections. JAMA Intern Med 2013;173(22):2039. PMID: 23999949.
3. Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014;370(13):1198-1208. PMID: 2467016.