Surgical Site Infections: The Impact of Culture, Teamwork, and Communication.
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Surgical Site Infections: The Impact of Culture, Teamwork, and Communication
Transcript of Surgical Site Infections: The Impact of Culture, Teamwork, and Communication.
Surgical Site Infections:The Impact of Culture, Teamwork, and
Communication
Our Last Call Together• Purpose of This Portion of the Call Series• History of Infection Prevention Techniques• Prophylactic Antibiotic Administration• Weight-Based Dosing• Re-Dosing• Discontinuing Antibiotics
Todays Topics• Three problems that sit at the core of
surgical site infections• The South Carolina Surgical Safety
Checklist as a Drug
Three Problems
Doing reliably what we know needs to be
done
Always being vigilant about keeping the patient safe
Teamwork and
Communication
The Checklist As A Drug:Doing Reliably What We Know Needs
To Be Done
Make sure that appropriate warming precautions are taken
when necessary
Risk of hypothermia – operation > 1h Warmer in place
• Anesthesia professional discusses if antibiotics are completely infused
• If needed, plan for re-dosing is discussed
Has antibiotic prophylaxis been given within the last 60 minutes?
Plan for re-dosing discussed
Practical Tip For Re-Dosing:Use a timer to help remind the team to
re-dose antibiotics
Confirmation that all of the instruments are sterile
Sterility, including indicator results
The Checklist As A Drug:Teamwork and Communication
Communication and Teamwork
Better Communication and Pre-Operative Briefings Can Reduce OR Traffic
The Checklist As A Drug:Vigilance
Surgical Conscience
When individuals . . . – promote patient safety all of the time– hold themselves accountable for making sure
the patient is safe and don’t hesitate to admit when the patient may be at risk
– do not take shortcuts when it may put the patient at risk
Surgical Conscience in Everyday Life in the OR
• Scrubbing• Gowning• Gloving• Instrument Sterility
Defending the Sterile Field
The Majority of Us Go Into the OR With the Intention of
Doing What is Best For Our Patients
The reality of the OR:– Pressure to move quickly– Individuals have to feel comfortable and safe
to voice concerns
Realities of Speaking Up• “I’m afraid”• “I’m embarrassed”• “I’m stupid”• “They might yell at me”• “I might be wrong”• “The surgeon is mean”• “They won’t listen anyway”• “It is not that important”
Please state your name and role
• Activates team members• If someone says
something at the beginning of the case they are more likely to speak up if they see something that may not be right
• Sets the tone that anybody can say something during the case if they see something
• Invites people to speak up
Surgeon says:“Does anybody have any concerns? If you see something that
concerns you during this case, please speak up.”
Take Home Messages• Preventing SSI’s is technical and cultural• A well used checklist can help:
– us reliably do what we know needs to be done for every patient
– improve teamwork and communication, which sit at the core of surgical site infections and complications
– us create a culture where everyone feels empowered to speak up if they feel that something isn’t right
??Questions
Upcoming Calls
Thursday, May 30th 2:00-2:45 Preventing SSI’s When Preparing Our
Patients for Surgery
Thursday, June 13th 2:00-2:45Other Ways of Preventing Venous
Thromboembolism
Office Hours:Wednesday 2:00-3:00
