From the GIC Winter 2004 Newsletter
Postoperative infection is a major cause of patient injury, mortality and health care costs. Of the nearly 30 million surgical operations performed annually, infection rates run from 2.6% to 11%, depending on the operation. Overuse of antibiotics has made many strains of bacterial infection resistant to drugs that help fight these infections. As a result, these infections can become lethal with infected patients more likely to spend time in an intensive care unit and twice as likely to die as patients who are not infected. Patients having a knee replacement who get an infection are more likely to require amputation. It is estimated that each infection, on average, increases a hospital stay by seven days and adds over $3,000 in charges.
In August of 2002, the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control (CDC) began a health care quality improvement project to prevent postoperative infection. An expert panel, comprised of members of the medical community, provides input and advice. The goal of the project is to cut the number of surgical infections by 50% by 2005.
According to the project's participants, between 40% and 60% of surgical infections are preventable if doctors and hospitals follow the guidelines issued by the CDC in 1999. Unfortunately, in 25% to 50% of surgeries, doctors are not following these protocols:
- Use recommended antibiotics
- Start preventive antibiotics within one hour before making the surgical incision
- Discontinue the antibiotics within 24 hours of the end of surgery
Other guidelines include administering oxygen to patients after surgery, keeping patient body temperatures normal, and not shaving a surgical site before surgery. This last measure used to be a standard practice, but has been found to cause micro abrasions in the skin where bacteria can take over. Instead, the CDC recommends that the surgical site be sterilized and the hair not removed, or the hair shortened with clippers.
So what can you do as a patient? The best approach is vigilance. Although asking questions of your health care team can be uncomfortable, it is your life, or your loved one's life, that matters. The CDC recommends the following:
- Avoid elective surgery if you have an active infection
- Become informed about the recommended medications for your surgery by accessing the project's guidelines at the Medicare Quality Improvement Community's web site
- If hospital personnel do not wash their hands, ask that they do so
- Do not let someone shave the surgical site. Or, if hair must be removed, request that electric clippers be used right before the operation
- Make sure you have a preventive dose of antibiotics an hour before surgery and that they are discontinued within 24 hours after the operation
- Request an antiseptic bath or shower the night before surgery
- Ask that people in the operating room be restricted to necessary medical personnel only and that no one have artificial fingernails or current infections
- Follow post operative instructions and medication orders and alert your doctor if you have any fever, weight loss, pain, oozing or swelling at the incision site
This information provided by the Group Insurance Commission.