116 - Protect the Joint: The Power of Pre-Op Clipping and Interdepartmental Collaboration

Description: AdventHealth Celebration, a DNV Advanced Center of Excellence for Hip, Knee, Shoulder and Spine Surgery, faced multiple joint infections in 2024 and a near miss in 2025, prompting a cross-disciplinary effort to review and enhance pre-operative and intra-operative practices. Initial improvements began in 2020 with dressing protocols and glucose monitoring additions to prevent an uptick in infections within the joint population. Infections decreased until early 2024 when three joint infections happened within three months. Environmental monitoring in 2024 exposed over 80 intraoperative pressure drops during one case — highlighting the need for traffic control and prompting the installation of magnetic door chains and doorbells. After the MOCK survey (in preparation for the DNV recertification of the program), opportunities were found in relation to the skin prepping, draping, and clipping of these joint arthroplasty patients. Infection Prevention Specialist, Charles Vickery, supported evidence-based interventions like pre-op clipping and vacuum clipper use.
Pre-op ANM Teegan Smith led the shift of hair clipping to the pre-op unit, creating visual guides and training modules. OR Manager Nicholas DeStefano coordinated implementation of dressing, tracking, and traffic protocols. Cara Merchant, orthopedic clinical coordinator, standardized orthopedic practices and helped to shift the process across multiple service lines. The result: zero orthopedic infections post-implementation and reduced overall OR-acquired infections.