Prepping a patient before surgery is important because multi-drug resistant organisms can live on a patient's skin.
For patients who will be intubated, administering comprehensive oral care before surgery can help minimize bacteria than can cause Ventilator-Associated Pneumonia (VAP).
The skin - source of bacteria that can cause SSIs
Most SSIs come from bacteria already found on a patient's skin. Multi-drug resistant organisms such as MRSA, VRE, and Acinetobacter are just some of the SSI-causing pathogens that can be found on a patient's skin.
The number one threat to surgical patients
Of the approximately 60 million inpatient and ambulatory surgical procedures performed in the U.S. every year,1,2 surgical site infections (SSIs) occur after 2.6% to 5% of them,1,3 translating to at least 1.5 million SSIs every year.4 SSIs can add 7 to 10 days to a patient's length of stay5 and increase costs by an average of $25,546.3 Patients who develop an SSI are also "twice as likely to die."6
A costly problem
- SSIs may account for as much as $10 billion annually in direct and indirect medical costs.7
- Cardiac surgery deep sternal and deep leg SSIs can add $55,000 to $85,000 to hospital cost per patient.3
- Orthopedic SSIs can increase costs by over 300%.8
Patients who develop SSIs are:6
- Twice as likely to die
- 60% more likely to spend time in an ICU
- Over 5 times more likely to be readmitted
The oral cavity is a proven source of hospital-acquired pneumonias (HAPs), including ventilator-associated pneumonia (VAP).9,10 Bacteria that cause nosocomial respiratory disease colonize the oropharyngeal area, including dental plaque.11,12,13 These pathogens can be aspirated into the lungs and cause infection.13
Consequences of VAP
- Mechanically ventilated patients have a 6 to 21 times greater risk of developing HAP than non-vent patients.10
- VAP is the most common infectious complication among ICU patients, accounting for up to 47% of all infections.15
- As a 9,080-patient study found, the average VAP patient spends 9.6 additional days on mechanical ventilation, 6.1 extra days in the ICU and 11.5 more days in the hospital.16
- In a 59-hospital study, VAP patients had a mortality rate of 29.3%, a mean length of stay of 23 days and mean hospital charges of $150,841.17
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CDC RECOMMENDATIONS FOR PREVENTION OF SURGICAL SITE INFECTION
7. Require patients to shower or bathe with an antiseptic agent on at least the night before the operative day.18 Category IB†
COMPENDIUM OF STRATEGIES TO PREVENT HEALTHCARE-ASSOCIATED INFECTION IN ACUTE CARE HOSPITALS21
"To gain the maximum antiseptic effect of chlorhexidine, it must be allowed to dry completely and not be washed off."
Association of Perioperative Registered Nurses (AORN) Guidelines for Preoperative Skin Antisepsis20
Recommended Practices for Preoperative Patient Skin Antisepsis: "Patients undergoing open class I surgical procedures below the chin should have two (2) preoperative showers with chlorhexidine gluconate (CHG) before surgery, when appropriate."
IHI FIVE MILLION LIVES CAMPAIGN
In its Five Million Lives Campaign, the Institute for Healthcare Improvement (IHI) includes a recommendation to fight MRSA infection.19
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