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October 27, 2021

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Surgical Site Infection (SSI) Prevention in Anesthesia

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Surgical site infection (SSI) is a persistent concern for perioperative teams. When caring for patients with diabetes, the concern is even greater. In some cases, diabetic patients are 50% more likely to experience SSI than non-diabetic patients. This risk affects not only patient welfare but also the health of surgical programs, making SSI prevention vital.

Infection Control in Anesthesia

SSI prevention begins before surgery. Ubiquitous patient safety and risk protocols – such as sterile clothing, clean air, wound care and more – all work to prevent infection. However, teams should not ignore the impact of morning-of-surgery blood sugar levels on infection potential. While some perioperative teams may have blood sugar levels above which surgery will be postponed, many may not adequately capture high-risk individuals, particularly diabetics, whose chance of superficial, deep incision or organ SSI is increased. Evidence suggests that for diabetic patients, subsequent case postponements for those with elevated blood sugar levels do prevent infection.

Solutions for SSI Prevention

In my facility at Kettering Health – a network based in Cincinnati, Ohio – we took a collaborative approach to prevent SSIs. By implementing a morning-of-surgery blood sugar limit, we have seen a drastic decrease in SSIs. From February 1 to June 30, 2021, only three superficial wound infections were reported (secondary to improper post-op wound care) and no deep wound infections—which was a marked improvement over what had been the average prior to February 1, 2021.

From February 1 to June 30, 2021, only three superficial wounds were noted with no deep wound infections.” – Dr. Robert Melashenko

To implement this tested, strategic program, we actively collaborated with other departments. There were fears of increased same-day cancellations that could have economic impacts on the facility. Combatting that valid fear was our first step in the cooperative process. To do so, we brought surgeons and the diabetes center on board to counsel patients prior to surgery. Patients received education and information about how their blood sugar levels would impact their surgery status.

By enacting this preoperative education, we saw no significant impact on same-day cancellations, while at the same time we were able to diminish  the very sizable  economic impact of high SSI rates.

TeamHealth’s Anesthesia Program

The SSI prevention program continues to succeed at Kettering Health, as we’ve expanded to more facilities both in the network and across the country. The program’s success is attributable to the alliance of multi-disciplinary teams. As an individual clinician, it can be difficult to implement change. But as a team, we can all improve healthcare quality. The vast resources available to TeamHealth clinicians also made this program possible. Our national footprint allows us to share best practices and medical literature easily among the more than 15,000 clinicians in our network.

TeamHealth strives for excellence and performs at a higher level.” – Dr. Melashenko

TeamHealth’s anesthesiology services support our clients’ successes to improve clinical and patient experiences. Our culture of collaboration and excellence allows our clinicians to provide a higher level of care while utilizing evidence-based best practices cultivated by harnessing our national network of resources.

To learn more about our SSI prevention program or how our anesthesiology services can support your facility, get in touch with us.