Quality Improvement project for Surgical Site Infections Assignment

Quality Improvement project for Surgical Site Infections Assignment

You will be looking up articles that correlate an uncontrolled HA1C( WHICH IS A BLOOD TEST TO DETERMINE HOW CONTROLLED YOUR BLOOD SUGAR HAS BEEN FOR THE LAST THREE MONTHS) TO SURGICAL SITE INFECTIONS.

MY PROJECT IS THIS: IMPLENTING AN HA1C TEST IN THE PRE ADMISSION TESTING OR PRE OP VISIT FOR ELECTIVE SURGERY ON DIABETIC PATIENTS to reduce SSIs in elective surgical patients. If the HA1C is out of range above 7 for elective surgeries, the surgery should be cancelled until the HA1C levels are below 7 regardless of the sugar levels the day of surgery. Just because the patient has controlled their blood sugar a week or two before surgery does not reduce the risk of surgical site infections, Look for articles that prove there is a correlation between uncontrolled HA1C and Surgical site infections in patients with and without diabetes. I have a feeling that it won’t matter if they are not diabetic, but with diabetic patients there is a correlation between HA1c levels and surgical site infections. Quality Improvement project for Surgical Site Infections Assignment.

THE ARTICLES HAVE TO BE LESS THAN 5 YEARS OLD AND SCHOLARLY!!!!

BUY A PLAGIARISM-FREE PAPER HERE

For this Assignment, write 4-5 paragraphs that address the following:
Literature Review

o Summarize the purpose, methods, and findings from at least five peer-reviewed, evidence-based practice articles that support your practice problem.
§ Two main components of successful synthesis include evidence of the student\'s own ideas and a well-organized presentation of evidence.
o Include an explanation of the quality management measurement and data that were presented.
o Include a minimum of at least 5 peer-reviewed evidence-based practice articles that support your practice problem.
o I have included below examples of articles that can or may be used if you want to, if not that’s fine as well just need you to look for articles that show a correlation between high HA1C and surgical site infections, which will prove why we need to implement an HA1C preoperatively for elective surgeries.Quality Improvement project for Surgical Site Infections Assignment

Preoperative glycosylated hemoglobin and postoperative glucose together predict major complications after abdominal surgery
CJ Goodenough, MK Liang, MT Nguyen… - … College of Surgeons, 2015 – E
The Role of Chronic and Perioperative Glucose Management in High-Risk Surgical Closures: A Case for Tighter Glycemic Control
Endara, Matthew M.D.; Masden, Derek M.D.; Goldstein, Jesse M.D.; Gondek, Stephen M.D., M.P.H.; Steinberg, John D.P.M.; Attinger, Christopher M.D.
Here is the introduction to my project so you can base your five articles on what I have already written. Thanks

One of the most devastating and preventable incidents occurring in surgical patients is surgical site infections. Most of these infections are caused by opportunistic bacteria that affect the health status of patients. Surgical patients are already health vulnerable, due to the nature of surgery which renders them more susceptible to infections. As such, there is not just negative consequences to health outcomes, but these types of infections also take a toll on the healthcare system financially.
Surgical site infections remain a common cause of morbidity, mortality, and increased length of hospital stay. According to the CDC (2017)Quality Improvement project for Surgical Site Infections Assignment, “patients with a SSI (surgical site infection) are twice as likely to die, there is a 60% chance that these patients will spend time in an ICU setting and 5 times more likely to be readmitted to the hospital when compared with other patients undergoing surgery who did not have an SSI…Overall it is estimated that SSIs account for 3.5-10 billion dollars annually in health care expenditures for patients who have gotten an SSI” (para.2) Decreasing the chances of patients acquiring hospital infections before surgery is therefore an important construct of direct patient care.
The CDC has presented guidelines that operating room providers should follow to reduce surgical site infections. These guidelines consist of having patients shower or bathe with an antimicrobial soap the day before and the day of surgery. Antibiotic prophylaxis should be administered an hour before the incision into the skin, as this allows for the antibiotic to be absorbed and performing its magic before the surgeon invades the skin with the incision and introduces normal flora from the skin into the wound. Skin prepping solutions in the operating room should be performed using an alcohol-based agent unless contraindicated. During surgery, glycemic control should be implemented and maintained throughout the perioperative period, and maintaining body temperature should be maintained in all patients (CDC 2017)Quality Improvement project for Surgical Site Infections Assignment.
Although advances have been made in infection control practices, including improved operating room ventilation, temperature control of the OR, sterilization methods, skin preparation solutions, surgical technique, making sure patients maintain a normal body, and selecting the right type of antimicrobial prophylaxis for specific procedures, SSIs remain a substantial cause of morbidity, prolonged hospitalization, and poor patient outcomes, and new interventions need to be explored to reduce the rate of SSI’s.Quality Improvement project for Surgical Site Infections Assignment
In the facility I work, our SSI’s are discussed in monthly meetings to compare and contrast previous numbers to determine if our interventions in preventing surgical site infections is working, or do we need to address the issue and examine why infections are increasing and look for interventions that can reduce the number of SSI’s.
After interviewing the director of the OR, Doug Robinson, to talk about quality indicators and how we compare to the national standard he informed me that although we below the national standard for SSIs, in the last three months, the number of SSI’s have been increasing; although all the guidelines that the CDC recommends are being followed. Since the effects of SSIs are so detrimental to our patients and no longer being paid for by insurance companies, a group of nurses, doctors, and upper management was formed to investigate why our SSIs are increasing. Upon investigating the reasons behind the SSI increase, it was discovered that every SSI that occurred in our facility in the last three months were with patients who were diabetic and had elevated HA1C levels prior to surgery. Quality Improvement project for Surgical Site Infections Assignment
On the day of surgery, there glucose was normal throughout the perioperative period and all recommended guidelines had been followed, but the committee identified a correlation between poor HA1C numbers preoperatively and SSIs postoperatively, and could be the culprit for the increased infections.
Due to the findings from this committee, I think that adding an HA1C test which gives the doctor a snapshot of how the patient has been controlling their blood sugars for the last three months should be implemented into the CDCs guidelines and become part of the preoperative guidelines to prevent surgical site infections. This notion of performing an HA1C before surgery was tested in a study performed by Hikata, T., Iwanami, A., Hosogane, N., Watanbe, K., Ishii, K., Nakamura, et al. (2014), and in the conclusion of their study it was noted that, “DM patients whose blood glucose levels were poorly controlled before surgery were at high risk for SSI. To prevent SSI in DM patients, we recommend lowering the HbA1c to <7.0 % before performing surgery” (pg. 224).
Every patient who is going to have elective surgery goes through a pre admission testing process whether that is done at a doctor’s office, or at the hospital where they are having surgery, it is always part of the pre procedure process so the patient can be cleared for surgery. This is the perfect time to add an HA1C blood test to the CBC and BMP blood tests that are already a prerequisite before elective surgery and is the basis of my capstone project. The HA1C test would only be implemented in diabetic patients or patients with pre surgical blood glucose levels that are elevated.Quality Improvement project for Surgical Site Infections Assignment

Please use the attached template for the paper. Read the Instructions I have uploaded as they are clearer than the ones above in the order so follow the attachment of the instructions, please.

Please follow the attached instructions to a T this is how the paper will be graded.

Please look at the revised instructions as it had to be revised based on feedback from my instruction. Please look at all the attachments but note that the last attachment is what the articles are supposed to be used. My project is the same I just had to tweak what the project was not narrow it down to a group of patients. Quality Improvement project for Surgical Site Infections Assignment

oYou will be looking up articles that correlate an uncontrolled HA1C( WHICH IS A BLOOD TEST TO DETERMINE HOW CONTROLLED YOUR BLOOD SUGAR HAS BEEN FOR THE LAST THREE MONTHS) TO SURGICAL SITE INFECTIONS.

 BUY A PLAGIARISM-FREE PAPER HERE

MY PROJECT IS THIS: IMPLENTING AN HA1C TEST IN THE PRE ADMISSION TESTING OR PRE OP VISIT FOR ELECTIVE SURGERY ON DIABETIC PATIENTS to reduce SSIs in elective surgical patients. If the HA1C is out of range above 7 for elective surgeries, the surgery should be cancelled until the HA1C levels are below 7 regardless of the sugar levels the day of surgery. Just because the patient has controlled their blood sugar a week or two before surgery does not reduce the risk of surgical site infections, Look for articles that prove there is a correlation between uncontrolled HA1C and Surgical site infections in patients with and without diabetes. I have a feeling that it won’t matter if they are not diabetic, but with diabetic patients there is a correlation between HA1c levels and surgical site infections. Quality Improvement project for Surgical Site Infections Assignment

 THE ARTICLES HAVE TO BE LESS THAN 5 YEARS OLD AND SCHOLARLY!!!!

  

For this Assignment, write 4-5 paragraphs that address the following:

Literature Review

  • Summarize the purpose, methods, and findings from at least five peer-reviewed, evidence-based practice articles that support your practice problem.
    • Two main components of successful synthesis include evidence of the student's own ideas and a well-organized presentation of evidence.
  • Include an explanation of the quality management measurement and data that were presented.
  • Include a minimum of at least 5 peer-reviewed evidence-based practice articles that support your practice problem.
  • I have included below examples of articles that can or may be used if you want to, if not that’s fine as well just need you to look for articles that show a correlation between high HA1C and surgical site infections, which will prove why we need to implement an HA1C preoperatively for elective surgeries.Quality Improvement project for Surgical Site Infections Assignment

Preoperative glycosylated hemoglobin and postoperative glucose together predict major complications after abdominal surgery

CJ Goodenough, MK Liang, MT Nguyen… - … College of Surgeons, 2015 – E

The Role of Chronic and Perioperative Glucose Management in High-Risk Surgical Closures: A Case for Tighter Glycemic Control

Endara, Matthew M.D.; Masden, Derek M.D.; Goldstein, Jesse M.D.; Gondek, Stephen M.D., M.P.H.; Steinberg, John D.P.M.; Attinger, Christopher M.D.

Here is the introduction to my project so you can base your five articles on what I have already written. Thanks

 

One of the most devastating and preventable incidents occurring in surgical patients is surgical site infections. Most of these infections are caused by opportunistic bacteria that affect the health status of patients. Surgical patients are already health vulnerable, due to the nature of surgery which renders them more susceptible to infections. As such, there is not just negative consequences to health outcomes, but these types of infections also take a toll on the healthcare system financially.Quality Improvement project for Surgical Site Infections Assignment

Surgical site infections remain a common cause of morbidity, mortality, and increased length of hospital stay. According to the CDC (2017), “patients with a SSI (surgical site infection) are twice as likely to die, there is a 60% chance that these patients will spend time in an ICU setting and 5 times more likely to be readmitted to the hospital when compared with other patients undergoing surgery who did not have an SSI…Overall it is estimated that SSIs account for 3.5-10 billion dollars annually in health care expenditures for patients who have gotten an SSI” (para.2)   Decreasing the chances of patients acquiring hospital infections before surgery is therefore an important construct of direct patient care.Quality Improvement project for Surgical Site Infections Assignment

The CDC has presented guidelines that operating room providers should follow to reduce surgical site infections. These guidelines consist of having patients shower or bathe with an antimicrobial soap the day before and the day of surgery. Antibiotic prophylaxis should be administered an hour before the incision into the skin, as this allows for the antibiotic to be absorbed and performing its magic before the surgeon invades the skin with the incision and introduces normal flora from the skin into the wound. Skin prepping solutions in the operating room should be performed using an alcohol-based agent unless contraindicated. During surgery, glycemic control should be implemented and maintained throughout the perioperative period, and maintaining body temperature should be maintained in all patients (CDC 2017)Quality Improvement project for Surgical Site Infections Assignment.

Although advances have been made in infection control practices, including improved operating room ventilation, temperature control of the OR, sterilization methods, skin preparation solutions, surgical technique, making sure patients maintain a normal body, and selecting the right type of antimicrobial prophylaxis for specific procedures, SSIs remain a substantial cause of morbidity, prolonged hospitalization, and poor patient outcomes, and new interventions need to be explored to reduce the rate of SSI’s.

In the facility I work, our SSI’s are discussed in monthly meetings to compare and contrast previous  numbers to determine if our interventions in preventing surgical site infections is working, or do we need to address the issue and examine why infections are increasing and look for interventions that can reduce the number of SSI’s.

After interviewing the director of the OR, Doug Robinson, to talk about quality indicators and how we compare to the national standard he informed me that although we below the national standard for SSIs, in the last three months, the number of SSI’s have been increasing; although all the guidelines that the CDC recommends are being followed. Since the effects of SSIs are so detrimental to our patients and no longer being paid for by insurance companies, a group of nurses, doctors, and upper management was formed to investigate why our SSIs are increasing. Upon investigating the reasons behind the SSI increase, it was discovered that every SSI that occurred in our facility in the last three months were with patients who were diabetic and had elevated HA1C levels prior to surgery.Quality Improvement project for Surgical Site Infections Assignment

On the day of surgery, there glucose was normal throughout the perioperative period and all recommended guidelines had been followed, but the committee identified a correlation between poor HA1C numbers preoperatively and SSIs postoperatively, and could be the culprit for the increased infections.

Due to the findings from this committee, I think that adding an HA1C test which gives the doctor a snapshot of how the patient has been controlling their blood sugars for the last three months should be implemented into the CDCs guidelines and become part of the preoperative guidelines to prevent surgical site infections. This notion of performing an HA1C before surgery was tested in a study performed  by Hikata, T., Iwanami, A., Hosogane, N., Watanbe, K., Ishii, K., Nakamura, et al. (2014), and in the conclusion of their study it was noted that, “DM patients whose blood glucose levels were poorly controlled before surgery were at high risk for SSI. To prevent SSI in DM patients, we recommend lowering the HbA1c to <7.0 % before performing surgery” (pg. 224)Quality Improvement project for Surgical Site Infections Assignment.

Every patient who is going to have elective surgery goes through a pre admission testing process whether that is done at a doctor’s office, or at the hospital where they are having surgery, it is always part of the pre procedure process so the patient can be cleared for surgery. This is the perfect time to add an HA1C blood test to the CBC and BMP blood tests that are already a prerequisite before elective surgery and is the basis of my capstone project. The HA1C test would only be implemented in diabetic patients or patients with pre surgical blood glucose levels that are elevated.  Quality Improvement project for Surgical Site Infections Assignment