2.50
Hdl Handle:
http://hdl.handle.net/10755/157070
Category:
Abstract
Type:
Presentation
Title:
Hygiene and health: Can Baths and Oral Care Reduce Cardiac Surgery Infections?
Author(s):
Armstrong, Kathy; Hessels, Amanda; Janasie, Margaret
Author Details:
Kathy Armstrong, Jersey Shore University Medical Center, Neptune, NJ, USA, email: Klapanda@optonline.net; Amanda Hessels; and Margaret Janasie
Abstract:
PURPOSE: The purpose of improving cardiac surgery sternal wound infections was identified as a post operative complication that has impacted morbidity, length of stay and associated cost of care. One important component of patient preparation was identified as the pre- op compliance of patient bath and oral care the night and morning before the surgery. Infection Prevention and Control reviews a random sample of 25% of cardiac surgery cases that are inpatients prior to surgery. BACKGROUND: Jersey Shore University Medical Center (JSUMC) performs an average of 800 cardiac surgery cases annually. A goal of the cardiac surgery program is to decrease the incidence of sternal wound infections and the impact on overall patient outcomes. Surveillance data shows that the rate of deep surgical site infections after cardio-thoracic surgery (CTS) has not decreased. A review of the literature was performed to identify best practices in the CTS patients. METHODS: An institutional assessment was performed. The relative importance and feasibility of interventions were evaluated. One practice is the pre-operative bath and oral care preparation with Chlorhexidine. The CTS cases were reviewed by data for the first time and that association with sternal wound infections and bathing preparation practice. Identified were omissions in either the actual bathing or lacking nursing documentation that the patients were prepared with Chlorhexidine prep. The Evidenced Based Practice question was identified as "Will administration of Chlorhexidine baths and oral care pre-operatively play a role in reducing the incidence of post-operative sternal infections?" RESULTS: Based on the evidence in existing literature, product safety information, consultation with other hospital cardiac surgery programs and JSUMC's ability to develop a standard of care. The standard of care for preparing CST patients were defined that every inpatient will receive one bath and one oral rinse with Chlorhexidine products at 2100 the night before surgery and at 0500 the day of surgery. The Infection Control team met with individual nursing units to identify barriers and solutions for the nurses providing the pre-operative preps. CONCLUSIONS: After several solutions were implemented, revision of standing order set; identification of the best times and dose of bath and oral care for patients; nurse education; development of a nursing care plan; and the creation of a patient education handout; an educational campaign was developed with scripting, poster board and handouts to ensure consistency of the message. Five months after the plan to improve compliance with the pre-op prep, compliance has improved from 21% to 100%.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleHygiene and health: Can Baths and Oral Care Reduce Cardiac Surgery Infections?en_GB
dc.contributor.authorArmstrong, Kathyen_GB
dc.contributor.authorHessels, Amandaen_GB
dc.contributor.authorJanasie, Margareten_GB
dc.author.detailsKathy Armstrong, Jersey Shore University Medical Center, Neptune, NJ, USA, email: Klapanda@optonline.net; Amanda Hessels; and Margaret Janasieen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157070-
dc.description.abstractPURPOSE: The purpose of improving cardiac surgery sternal wound infections was identified as a post operative complication that has impacted morbidity, length of stay and associated cost of care. One important component of patient preparation was identified as the pre- op compliance of patient bath and oral care the night and morning before the surgery. Infection Prevention and Control reviews a random sample of 25% of cardiac surgery cases that are inpatients prior to surgery. BACKGROUND: Jersey Shore University Medical Center (JSUMC) performs an average of 800 cardiac surgery cases annually. A goal of the cardiac surgery program is to decrease the incidence of sternal wound infections and the impact on overall patient outcomes. Surveillance data shows that the rate of deep surgical site infections after cardio-thoracic surgery (CTS) has not decreased. A review of the literature was performed to identify best practices in the CTS patients. METHODS: An institutional assessment was performed. The relative importance and feasibility of interventions were evaluated. One practice is the pre-operative bath and oral care preparation with Chlorhexidine. The CTS cases were reviewed by data for the first time and that association with sternal wound infections and bathing preparation practice. Identified were omissions in either the actual bathing or lacking nursing documentation that the patients were prepared with Chlorhexidine prep. The Evidenced Based Practice question was identified as "Will administration of Chlorhexidine baths and oral care pre-operatively play a role in reducing the incidence of post-operative sternal infections?" RESULTS: Based on the evidence in existing literature, product safety information, consultation with other hospital cardiac surgery programs and JSUMC's ability to develop a standard of care. The standard of care for preparing CST patients were defined that every inpatient will receive one bath and one oral rinse with Chlorhexidine products at 2100 the night before surgery and at 0500 the day of surgery. The Infection Control team met with individual nursing units to identify barriers and solutions for the nurses providing the pre-operative preps. CONCLUSIONS: After several solutions were implemented, revision of standing order set; identification of the best times and dose of bath and oral care for patients; nurse education; development of a nursing care plan; and the creation of a patient education handout; an educational campaign was developed with scripting, poster board and handouts to ensure consistency of the message. Five months after the plan to improve compliance with the pre-op prep, compliance has improved from 21% to 100%.en_GB
dc.date.available2011-10-26T19:23:39Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:23:39Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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