The Not‐So‐Hidden Costs of Surgical Site Infections

Barnett, Todd E.

doi:10.1016/j.aorn.2007.03.012

Cited by 21 publications

(22 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the literature, clinicians suggested that reusable ECG-LWs might lead to cross-contamination of microorganisms, including resistant bacteria, and be a culprit in HAIs. 15,21,22 Our findings represent new knowledge and provide evidence that reusable ECG-LWs are not more likely to be a source of pathogens that lead to HAIs. Further, our cardiovascular surgery ICUs cleaned reusable ECG-LWs by ultrasound.…”

Section: Discussionmentioning

confidence: 70%

Infection Rates in Intensive Care Units by Electrocardiographic Lead Wire Type: Disposable vs Reusable

Albert

Slifcak²,

Roach³

et al. 2014

American Journal of Critical Care

View full text Add to dashboard Cite

A closed-book, multiple-choice examination following this article tests your under standing of the following objectives: Patients' characteristics and infections were collected from hospital databases. Event rates were described by using total counts and rates per 100 patient days and were compared between groups by using generalized linear mixedeffect models weighted by patients' ICU length of stay. Results Overall, 4056 patients from 6 ICUs received disposable and 3184 patients from 5 ICUs received reusable ECG-LWs. The characteristics of the 2 groups were similar, except patients receiving disposable ECG-LWs were less likely to be discharged home (P = .03) and had more comorbid conditions (P = .002).Overall infection rates did not differ between ECG-LW groups, between groups in matched ICUs, between groups by infection type, or when only patients with ICU stays longer than 48 hours were considered (2578 cases). In multivariate analyses, infection rates did not differ between all patients in ECG-LW groups or for patients with ICU stays beyond 48 hours (both P = .10).Conclusions No difference was observed in infection rates of ICU patients receiving disposable versus reusable ECG-LWs.

show abstract

Section: Discussionmentioning

confidence: 70%

Infection Rates in Intensive Care Units by Electrocardiographic Lead Wire Type: Disposable vs Reusable

Albert

Slifcak²,

Roach³

et al. 2014

American Journal of Critical Care

View full text Add to dashboard Cite

show abstract

“…Patients that develop a SSI are up to 60% more likely to spend time in the Intensive Care Unit (ICU), where care is costly for both the patient and hospital (Barnett, 2007). The patient with a SSI is five times more likely to be readmitted to the hospital (Fry & Fry, 2007), and 77% of deaths among patients with a SSI are directly attributable to the SSI.…”

Section: Ssi Definition and Impactmentioning

confidence: 99%

“…Most estimates are based on inpatient costs and do not account for the additional costs of rehospitalization, post-discharge outpatient expenses, and any long term disabilities (Barnett, 2007). SSis pose a substantial clinical burden (Owens & Stoessel, 2008 The mean extra hospital duration was 6.5 days, and in a SSI involving organs or body space, there was even a longer hospital duration and increased costs compared with a SSI that only involved the incision or was superficial in nature.…”

Section: Ssi Definition and Impactmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of Timing, Selection, and Dosage of Preoperative Prophylactic Antibiotics on Preventable Surgical Site Infections

Insana¹

2012

Preprint

View full text Add to dashboard Cite

<p>Surgical site infections (SSIs) are a subset of a larger group of infections that are known as hospital acquired infections (HAis). SSIs are a huge financial burden, costing billions of dollars in excess hospital charges every year. There is a considerable amount of evidence-based practice recommendations that can help reduce the incidence of SSIs. Research has supported the efficacy of preoperative antibiotic prophylaxis when appropriately selected and timed according to published guidelines. In addition to these measures, re-dosing of antibiotics must occur for those procedures that last more than four hours in order to continue to maintain tissue perfusion throughout the surgical procedure. The purpose of this study was to evaluate the timely administration, appropriate selection, and dosage of preoperative prophylactic antibiotics in surgical patients in one community hospital. A retrospective research design was used to obtain information on 100 randomly selected colon, hysterectomy, total hip and knee arthroplasty cases. Data were collected on those surgical procedures that occurred between October 1, 2010 and March 31 , 2011. During this time period, there were eight documented SSIs, three involving an organ space, and five that were superficial. In more than half of the colon and hysterectomy cases, the prophylactic antibiotic was administered less than 30 minutes before surgical incision, and in more than half of the total hip and total knee arthroplasty cases, antibiotic administration was between 30-60 minutes. All the procedures met the SCIP recommendations for timing and selection of prophylactic antibiotic. This study suggests that to ensure adequate tissue perfusion prior to surgical incision, the antibiotic should be administered in the preoperative holding unit, immediately prior to transfer to the operating room. This would assure that the antibiotic is given 30-60 minute timeframe, thus reducing the potential for the development of a SSI. Recommendations for further research and advanced nursing practice are discussed.</p>

show abstract

“…2 Contaminated ECG lead wires may be a contributing factor to the development of surgical site infections. 3,4 ECG lead wires that lie directly on the patient's skin are near open wounds on the chest and surgical incisions. The potential for cross-contamination from an unclean ECG lead wire to the surgical site is of great concern.…”

mentioning

confidence: 99%

Cleanliness of Disposable vs Nondisposable Electrocardiography Lead Wires in Children

Addison

Quatrara

Letzkus

et al. 2014

American Journal of Critical Care

View full text Add to dashboard Cite

Background Mediastinitis costs hospitals thousands of dollars a year and increases the incidence of patient morbidity and mortality. No studies have been done to evaluate adenosine triphosphate (ATP) counts on disposable and nondisposable electrocardiography (ECG) lead wires in pediatric patients. Objective To compare the cleanliness of disposable and nondisposable ECG lead wires in postoperative pediatric cardiac surgery patients by measuring the quantity of ATP (in relative luminescence units [RLUs]). ATP levels correlate with microbial cell counts and are used by institutions to assess hospital equipment and cleanliness. Methods A prospective, randomized trial was initiated with approval from the institutional review board. Verbal consent was obtained from the parents/guardians for each patient. Trained nurses performed ATP swabs on the right and left upper ECG cables on postoperative days 1, 2, and 3. Results This study enrolled 51 patients. The disposable ECG lead wire ATP count on postoperative day 1 (median, 157 RLUs) was significantly lower (P < .001) than the count for nondisposable ATP lead wires (median, 610 RLUs). On postoperative day 2, the ATP count for the disposable ECG lead wires (median, 200 RLUs) was also lower (P = .06) than the count for the nondisposable ECG lead wires (median, 453 RLUs). Conclusion Results of this study support the use of disposable ECG lead wires in postoperative pediatric cardiac surgery patients for at least the first 48 hours as a direct strategy to reduce the ATP counts on ECG lead wires.

show abstract

The Not‐So‐Hidden Costs of Surgical Site Infections

Cited by 21 publications

References 17 publications

Infection Rates in Intensive Care Units by Electrocardiographic Lead Wire Type: Disposable vs Reusable

Infection Rates in Intensive Care Units by Electrocardiographic Lead Wire Type: Disposable vs Reusable

The Impact of Timing, Selection, and Dosage of Preoperative Prophylactic Antibiotics on Preventable Surgical Site Infections

Cleanliness of Disposable vs Nondisposable Electrocardiography Lead Wires in Children

Contact Info

Product

Resources

About