The facility should strive to bring the SSI rate down below the expected level for the types of patients and surgeries that the facility has. Plan of Action

In order to achieve better-than-average results in the SSI rates for our facility, there are a number of tactics that can be used. The first is that the culture of the organization needs to emphasize safety to a degree greater than the current degree. As of now, there is no particular focus on SSIs, and this contributes to a culture where there is little accountability with respect to the SSI rates, or to individual SSI cases. The organization must improve the accountability, so that staff members are specifically held accountable for the mistakes that they make that result in an SSI.

Beyond culture, there are specific things that the organization can do to promote an improved rate of SSI. The first is that the training program needs to be more extensive. The typical approach of the organization to this point is to generally assume that members of the staff are well-versed on basic SSI prevention procedures. While this might be true, the staff should be kept up-to-date on the most recent information on the subject. They should receive substantial training on the appropriate procedures. Such training can help reduce SSIs caused by procedural lapses.

One issue that contributes to the persistent high rates of SSI across the medical profession is the development of acquired microbial resistance. This occurs as the result of overuse of antibiotic prophylaxis. While antibiotics are a necessary part of managing potential SSIs, anything over 48 hours seems to contribute to acquired microbial resistance, while adding little benefit to the patient. Harbarth et al. (2000) prescribe under 48 hours of antibiotics to reduce acquired microbial resistance.

Mangram et al. (1999) also prescribe a number of tactics to reduce SSIs. These include tactics to reduce errors during transfusions, shaving the patient immediate prior to surgery, the use of preoperative antiseptic showering and specific skin preparation as well as cleanliness measures for the surgical personnel.

Conclusion

Surgical site infections are costly for hospitals, both in terms of patient outcomes and in terms of the bottom line....

While not all SSIs are preventable, most are. This means that the hospital often bears the cost of such errors, especially when the patient does not have the means to do so. It is imperative, therefore, that hospitals take steps to address the problem of SSIs both in the short-term and the long-term. In the short-term, the use of antimicrobials is essential, as is following basic best practices with regard to hygiene in the surgical suite. The institution should also take the long-run into consideration, however, and not use antimicrobials excessively, because antimicrobial resistance is one of the major reasons why SSI rates remain persistently high despite a century and a half of continuous improvement efforts.
With specific training and prescribed best practices, the organization can begin to reduce its SSI rates. It is also worth considering that the rates will also decline with a change in the types of patients taken on, or the types of surgeries offered. In addition, education is something that must be done with the staff as well. Ultimately, from a management perspective, most SSIs are preventable, and therefore should be prevented. Hospitals can prevent SSIs by having consistent procedures that are based on evidence. Doing the right thing every time is the best way to reduce SSIs in the future.

Works Cited:

Anderson, D. (2009). Surgical site infections. Division of Infectious Diseases, Duke University Medical Center. Retrieved September 29, 2012 from http://www.hapmd.com/home/hapmdcom/public_html/wp-content/uploads/2009/03/cirugia/bibliografica-cx/20110504_articulo_2.pdf

Barie, P. & Eachempati, S. (2005). Surgical site infections. The Surgical Clinics of North America. Vol. 85 (6) 1115-35.

Harbarth, S., Samore, M., Lichtenberg, D. & Carmeli, Y. (2000). Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance. Circulation. Vol. 101 (2000) 2916-2921.

Lauwers, S. & de Smet, F. (1998). Surgical site infections. Acta Clin Belg. Vol 53 (5) 303-310.

Mangram, a., Horan, T., Pearson, M., Silver, L., Jarvis, W. (1999). Guideline for prevention of surgical site infection, 1999. Infection Control and Hospital Epidemiology. Vol. 20 (4) 250-280.