After discovering his ASC experienced two infections in one quarter, Ralph Gambardella, MD, an orthopedic surgeon and president of Kerlan-Jobe Surgery Center in Los Angeles, quickly went to work with the governing board to discuss potential protocols that can be put in place to immediately eradicate the incidence of infections. Dr. Gambardella discusses five of the key best practices that were implemented.
1. Patients scrub before surgery. Dr. Gambardella says the ASC has since worked hard with physicians and physicians' offices to start a new program that calls for increased efforts for pre-operative disinfection. Now, all physicians are being asked to communicate better with patients and order them to scrub themselves in the days leading up to their surgery. "One of the things shown to definitely lower the risk of skin microbes is trying to have patients wash a day or two before their surgery with scrub," he says.
2. Surgeons scrub before surgery. In addition to ensuring patients scrub before the day of their surgery, added emphasis has been placed on Kerlan-Jobe physicians to also scrub before entering the operating room for skin prep. The pre-operative scrubbing acts as a second line of defense following the traditional skin prep that occurs in the operating room.
3. Limit and monitor traffic flow. Dr. Gambardella says the nurse manager is responsible for monitoring traffic flow in the surgery center, thereby limiting the number of personnel going in and out of patient and operating rooms. Even supply vendors who deliver packages of equipment must be closely followed to ensure infection doesn't spread as they travel through the facility, he says.
4. Go above and beyond in disinfecting the facility. It is much easier for ASCs to remember to disinfect equipment that is regularly used by staff members and physicians, such as surgical instruments, countertops and larger equipment. However, in order to reduce the potential for infection even more, ASCs should consider disinfecting beyond the traditional means and going as far as disinfecting air vents and lights. Dr. Gambardella says even the furniture in the waiting area is wiped down more regularly to reduce the incidence of infection.
5. Time antibiotic administration carefully. It is absolutely critical ASCs keep their physicians accountable for administration of antibiotics and physicians ensure administration falls within the one-hour time window of incisions. Dr. Gambardella says it is common knowledge that falling outside the one-hour time window may put patients at risk of being administered less effective antibiotics. Additionally, a new program has been introduced to physicians at Kerlan-Jobe. Now physicians must make sure patient are not cold before administering antibiotics, as hypothermia has been linked to decreased immune system, he says.
Learn more about Kerlan-Jobe Surgery Center.
1. Patients scrub before surgery. Dr. Gambardella says the ASC has since worked hard with physicians and physicians' offices to start a new program that calls for increased efforts for pre-operative disinfection. Now, all physicians are being asked to communicate better with patients and order them to scrub themselves in the days leading up to their surgery. "One of the things shown to definitely lower the risk of skin microbes is trying to have patients wash a day or two before their surgery with scrub," he says.
2. Surgeons scrub before surgery. In addition to ensuring patients scrub before the day of their surgery, added emphasis has been placed on Kerlan-Jobe physicians to also scrub before entering the operating room for skin prep. The pre-operative scrubbing acts as a second line of defense following the traditional skin prep that occurs in the operating room.
3. Limit and monitor traffic flow. Dr. Gambardella says the nurse manager is responsible for monitoring traffic flow in the surgery center, thereby limiting the number of personnel going in and out of patient and operating rooms. Even supply vendors who deliver packages of equipment must be closely followed to ensure infection doesn't spread as they travel through the facility, he says.
4. Go above and beyond in disinfecting the facility. It is much easier for ASCs to remember to disinfect equipment that is regularly used by staff members and physicians, such as surgical instruments, countertops and larger equipment. However, in order to reduce the potential for infection even more, ASCs should consider disinfecting beyond the traditional means and going as far as disinfecting air vents and lights. Dr. Gambardella says even the furniture in the waiting area is wiped down more regularly to reduce the incidence of infection.
5. Time antibiotic administration carefully. It is absolutely critical ASCs keep their physicians accountable for administration of antibiotics and physicians ensure administration falls within the one-hour time window of incisions. Dr. Gambardella says it is common knowledge that falling outside the one-hour time window may put patients at risk of being administered less effective antibiotics. Additionally, a new program has been introduced to physicians at Kerlan-Jobe. Now physicians must make sure patient are not cold before administering antibiotics, as hypothermia has been linked to decreased immune system, he says.
Learn more about Kerlan-Jobe Surgery Center.