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Surgical Site Infection Prevention

APIC Guide to the Elimination of Orthopedic Surgical Site Infections, 2010
This guide has many valuable resources even if your ASC does not perform orthopedic surgery. These include: infection prevention measures for preoperative, operative and postoperative care; epidemiology, risk factors, and pathogenesis of orthopedic surgical site infections; a sample SSI risk assessment tool, a SSI infection worksheet, an observation checklist for infection prevention measures and instructions on how to calculate a Standard Infection Ratio (SIR). Also included is chapter on the Surgical Care Improvement Project (SCIP) and CMS Value-based Purchasing. Staphylococcus aureus decolonization is discussed on pages 39-40 and pages 70-72.
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SHEA / IDSA Practice Recommendation - Strategies to Prevent Surgical Site Infections in Acute Care Hospitals, 2008
This compilation of practice recommendations is a must have for every ASC and includes an introduction describing the burden of surgical site infections (SSIs). There is also a helpful illustration of SSI classifications as superficial incisional, deep incisional, or organ/space. Methods of surveillance for identifying SSIs and providing feedback to personnel, surgeons and leadership are described. Other topics include: hair removal, antimicrobial prophylaxis, blood glucose control, perioperative normothermia, preoperative bathing with chlorhexidine and routine screening for MRSA. The 1999 HICPAC Guideline for Prevention of Surgical Site Infection is frequently referenced in this document.
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CDC / HICPAC Guideline for the Prevention of Surgical Site Infection, 1999
This is the CDC’s last comprehensive SSI prevention guideline. The content includes SSI risks, preoperative, operative and postoperative patient care; hand and forearm antisepsis of the surgical team; surgical attire and drapes and operating room cleaning and disinfection.
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NHSN Surveillance Definitions of Health Care-Associated Infection, 2008
In this document from the CDC and the National Safety Healthcare Network (NHSN) you will find the official definitions of SSIs as well as bloodstream infections, pneumonia and other lower respiratory tract infections, bone and joint infections, central nervous system infections, cardiovascular system infections, eye, ear, nose, throat and mouth infections, gastrointestinal system infections, reproductive tract infections and skin and soft tissue infections.
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NHSN Surgical Site Infection Rates
Use this official CDC/National Safety and Healthcare Network (NHSN) data and statistics site to find pooled means for surgical site infection rates by operative procedure and risk index categories. This is a must have resource for benchmarking your procedure-specific infection rates.
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Joint Commission National Patient Safety Goals (NPSGs) for Ambulatory Care
Ambulatory Care NPSG.07.05.01 requires implementing evidence-based practices for preventing surgical site infections (SSIs). Elements of performance include: educating staff, patients and families about preventing SSIs; following best practices for SSI prevention, using science-based methods to remove hair, administering appropriate antimicrobial prophylaxis, measuring SSI rates, monitoring compliance with SSI prevention measures and providing process and outcome monitor results to stakeholders.
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WHO Safe Surgery Tools and Resources
Through this site you can access the WHO Guidelines for Safe Surgery 2009 including Ten Essential Objectives for Safe Surgery and the Surgical Safety Checklist which addresses preoperative, intraoperative and postoperative care.
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Surgical Care Improvement Project (SCIP), 2010
Established by the Centers for Medicare and Medicaid Services (CMS), QualityNet provides healthcare quality improvement news and resources. Use this site to find up-to-date information about antibiotic prophylaxis printed on a convenient pocket card. You’ll also find a link to the SCIP measures and other helpful tools.
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Patient Education Tools for SSI Prevention
SHEA / IDSA Frequently Asked Questions about Surgical Site Infections
This handout can help you educate patients about what they can do to help prevent a surgical site infection.
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IHI What You Need to Know about Infections after Surgery: A Fact Sheet for Patients and Their Family Members
This fact sheet advises patients about what they can do to lower the risk of infection after surgery.
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Did You Know

Skin irritation caused by hand hygiene agents is a substantial barrier to compliance.1

Hand hygiene compliance is still less than 60%.2

1. Larson, E. Girard, R. et al (2006). Skin reactions related to hand hygiene and selection of hand hygiene products. American Journal of Infection Control. 34(10) 627-35.

2. Boyce, JM & Pittet, D. (2002). Guideline for hand hygiene in health-care settings. Morbidity and Mortality Weekly Review 51(RR 16).

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