How to get rid of post-operative infections
Getting an infection after surgery is nothing to be sneezed at. It takes a hospital to save a patient, and doctors increasingly are taking a team approach to stamping out infections.
When people have major surgery, they have a 2 to 5 percent chance of developing an infection at the site of the incision. Such infections are no small matter: Those people are two to three times more likely to die, five to six times more likely to be readmitted to the hospital, and likely to stay in the hospital twice as long as patients without infections. The cost for all that can exceed $50,000. "It's a major public health problem," says Dale Bratzler, principal clinical coordinator at the Oklahoma Foundation for Medical Quality.
Doctors have known since the 1960s that giving antibiotics an hour before surgery can reduce the risk of infection. Discontinuing the antibiotic within 24 hours also helps, as does choosing the right antibiotic. But the odds of having a hospital do all of those things are relatively low. That's not because doctor's aren't trying to do the right thing; 99 percent, for instance, order the pre-incision antibiotic. But in the pre-surgery rush, proper antibiotic treatment often slips through the cracks.
In an effort to reduce those infections, 56 hospitals around the country collaborated in coming up with ways to improve their systems. Over the course of a year, multidisciplinary teams from the hospitals met in person, and also reported in to each other via E-mail to discuss their successes and failures. As a result, they reduced infections by 27 percent, from 2.3 percent to 1.7 percent. In the course of the project, which was sponsored by Centers for Medicare & Medicaid Services, an average of 92 percent of patients received antibiotics within one hour of surgery, compared with 72 percent before the project started. They also made progress in other actions thought to reduce risk of infection, including not shaving the surgical site, giving the patient lots of oxygen, and maintaining blood sugar levels. The results were published in the June American Journal of Surgery.
"This allows hospitals to share information, and to steal information shamelessly from others if it's information that helps improve patient care," says Jonathan Sugarman, president of the American Health Quality Association, an organization of Medicare-sponsored Quality Improvement Organizations. Over the past three years, QIOs have trained hospital employees to adopt the most successful techniques , which can be as simple as having the entire surgical team discuss whether the antibiotic has been administered or delegating one team member to deliver the drug.