Surgical Services Nurse Educator Methodist Hospitals Gary/Merrillville, Indiana, United States
Disclosure(s):
Megan Gengo, BSN, RN: No financial relationships to disclose
Lori McBride, MPA, RN, CNOR: No financial relationships to disclose
Description: Problem Statement: Higher than predicted numbers of SSIs Data Collection: 26 SSIs reported in 2023 Goal Statement: Decrease SSI by 30% from 2023 to 2024 Action Plan for 2024: Implement a PDSA (Plan Do Study Act) cycle for SSI Quality Improvement Project Description of team: Multidisciplinary collaboration including teams from Nursing Professional Development, OR Leadership, Infection Control, Pharmacy, Anesthesia, Physicians, and Quality Improvement Departments
Plan - Implementation of Interventions: Developed evidence based, best practice surgical checklist. Transitioned checklist from paper to electronic medical record. Revised checklists and continued to educate staff and providers on utilization. Developed report in EMR to monitor checklist compliance. Addressed checklist deviations. Utilized multiple formats for education surrounding SSI prevention (normothermia, glucose control, antibiotic prophylaxis, sterile technique) including in-person and zoom presentations, online e-learning, and AORN in-person seminars and webinars. Trialed new warming equipment with a focus on pre-warming. Observed cases in real time. Encouraged active engagement with physicians. Reviewed any SSI with a multidisciplinary team and shared information with staff in a lesson's learned newsletter. Completed staff competencies with emphasis on Infection Control. Do - Cycle was carried out as planned. Study - Monitored SSI events, SIR, and numbers predicted for 2024 Act - Improve the changes and continue testing the plan
Outcome: 16 SSIs reported in 2024 Measure of Success: 38% reduction in SSIs from 2023-2024. Performed 50% better in colorectal surgeries from 2023-2024 and met the value based purchasing threshold for 2024. Perioperative Nursing Implications: Excellence in OR leadership and importance of multidisciplinary teamwork. Alignment of goals to increase quality and patient safety, patient experience, and financial performance. AORN Guidelines referenced: Team Communication, Information Management, Patient Temperature Management, Sterile Technique, Patient Skin Asepsis
