Background: Surgical site infections (SSI’s) are a major concern for patients, providers, and healthcare organizations worldwide. SSI’s remain the costliest and most common of all hospital-acquired infections (HAI’s) (Septimus, 2019). It is estimated that SSI’s occur in 2 percent to 5 percent of all patients undergoing surgery, translating to 160,000 to 300,000 people annually at a cost of $3.5 to $10 billion (Ban et al., 2017). An SSI substantially increases morbidity and mortality as patients are twice as likely to die, are 60% more likely to be admitted to the intensive care unit (ICU), and the readmission rate is five times higher than patients who do not have a hospital-acquired SSI (Darouiche, 2019).
Research Question: Did the intervention of preoperative nasal decolonization using the Profend Nasal Decolonization Kit, 10% povidone-iodine (PVP-I), reduce surgical site infections in patients undergoing an orthopedic surgery with implantation, to include total joint arthroplasty (TJA) and an orthopedic fracture repair, in a 12-month period preintervention compared to a 12-month period post-intervention?
Objective: The objective of this DNP project was to evaluate the effectiveness of using a 10% PVP-I Nasal Decolonization Kits in the prevention of SSI’s in patients undergoing an orthopedic surgery for a TJA or fracture repair at the medical center.
Methods: This DNP project used a retrospective data review from data points previously collected as part of standard work performed in the EMR. All patient information was blinded when the information was displayed. A standard report from the EMR was run to collect all data.
Results: The preintervention group was composed of 431 patients and the postintervention group contained 365 patients. The preintervention group had eight postoperative infections for an infection rate of 1.86%. The postintervention group had an infection rate of 0.27%. This resulted in a p-value of 0.0367 using a two proportions z-score, showing a statistical improvement in SSI’s.
Conclusion: The facility successfully implemented a nasal decolonization program with 10% PVP-I that decreased the number of infections, had a higher compliance rate for PVP-I nasal swab over the national average for mupirocin, and showed potential cost savings for the medical center., Copyrights are retained by Earl V. Laih.
subject
Nursing Nasal manifestations of general disease Surgical Wound Infection Risk Factors Povidone-Iodine
9 X 12 cm portrait photograph, of Ritchie Blaine Skelton. Written on the reverse of the tri-fold is "Ritchie Blaine Skelton, Age 8 1/2 months." Image is in sepia.
In nursing, two major socialization/resocialization processes have been described by researchers: first, the initial adult socialization period in which lay people are socialized into the nursing profession through a formal education process, and, secondly, the resocialization process that occurs as graduate nurses leave their formal educational programs and enter the work setting for the first time., Copyrights are retained by the author. Please contact Mary Ann Lubiejewski for further use of this material.
