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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).
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CDC GUIDELINES for Preventing Healthcare-Associated Pneumonia10
"…Develop and implement a comprehensive oral-hygiene program.…"
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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. |
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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 |
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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
The human cost
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
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THE ORAL CAVITY — proven source of HAPs, including VAP
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.11-13 These pathogens can be aspirated into the lungs and cause infection.13 |
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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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| 1. DeFrances CJ, Hall MJ, Podgornik MN, 2003 National hospital discharge survey. CDC, National Center for Health Statistics, Advance Data from Vital and Health Statistics. No. 359;8 July 2005:14. 2. Hall MJ, Lawrence L, Ambulatory surgery in the United States, 1996. CDC, National Center for Health Statistics, Advance Data from Vital and Health Statistics. No. 300;12 Aug1998:7. 3. Stone PW, et al., Am J Infect Control. Nov 2005;33(9):501-9. 4. Figure calculated by multiplying SSI rate from ref. #5 by surgical procedure numbers from ref. #1 and #2. 5. Mangram AJ, et al., Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention, Hospital Infection Control Practices Advisory Committee, Atlanta GA. 6. Kirkland KB, et al., Infect Control Hosp Epidemiol. Nov 1999;20(11):722-4. 7. Urban JA, Surg Infect. 2006 Jun;7 Suppl 1:S19-22. 8. Whitehouse JD, et al., Infect Control Hosp Epidemiol. 2002 Apr;23(4):183-9. 9. Schleder B, et al., J Advocate Health Care. 2002 Spr/Sum;4(1):27-30. 10. Tablan OC, et al., Guidelines for preventing health-care—associated pneumonia, 2003, Recommendations of CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC), 2003. 11. Scannapieco FA, J Periodontology. 1999 Jul;70(7):793-802. 12. Scannapieco FA, et al., Crit Care Med. 1992 Jun;20(6):740-5. 13. Fourrier F, et al., Crit Care Med. 1998;26:301-8. 14. Munro CL, Grap MJ, Am J Crit Care. 2004 Jan;13(1):25-33. 15. Cason CL, et al., Am J Crit Care. 2007 Jan;16(1)28-38. 16. Rello J, et al., Chest. 2002 Dec;122(6):2115-21. 17. Kollef MH, et al., Chest. 2005;126(6):3854-62. 18. Vollman K, Garcia R, Miler L, AACN News. 2005 Aug;22(8):12-6. 19. Campbell DL, Ecklund MM. Development of a research-based oral care procedure for patients with artificial airways. NTI News (a publication of AACN's National Teaching Institute). 7 May 2002. |
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