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THE IMPORTANCE OF BEING NURSE: A KEY-ROLE IN PERIOPERATIVE CARE AND A MISSION OF RESPONSIBILITY

THE IMPORTANCE OF BEING NURSE: A KEY-ROLE IN PERIOPERATIVE CARE AND A MISSION OF RESPONSIBILITY. SALVATORE GIAMPICCOLO. P.O. “Michele Chiello ” Piazza Armerina (EN) ITALY. THE IMPORTANCE OF BEING NURSE: A KEY-ROLE IN PERIOPERATIVE CARE AND A MISSION OF RESPONSIBILITY. quality of results

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THE IMPORTANCE OF BEING NURSE: A KEY-ROLE IN PERIOPERATIVE CARE AND A MISSION OF RESPONSIBILITY

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  1. THE IMPORTANCE OF BEING NURSE: A KEY-ROLE IN PERIOPERATIVE CARE AND A MISSION OF RESPONSIBILITY SALVATORE GIAMPICCOLO P.O. “Michele Chiello” Piazza Armerina (EN) ITALY

  2. THE IMPORTANCE OF BEING NURSE: A KEY-ROLE IN PERIOPERATIVE CARE AND A MISSION OF RESPONSIBILITY qualityofresults evaluates qualityof performance and then QUALITY of CARE

  3. salvatoregiampiccolo@msn.com

  4. salvatoregiampiccolo@msn.com

  5. salvatoregiampiccolo@msn.com

  6. KEY-ROLE OF THE NURSE REGULATIONS salvatoregiampiccolo@msn.com

  7. Thisis the question salvatoregiampiccolo@msn.com

  8. KEY-ROLE IN THE PERIOPERATIVE CARE PREVENTION OF THE SURGICAL SITE INFECTIONS salvatoregiampiccolo@msn.com

  9. SOMETHING ABOUT SSI* 90% of SSI are contracted in the operating theatre Staff behaviour Importance of prevention *Surgical Site Infection salvatoregiampiccolo@msn.com

  10. MEASURES OF DEMONSTRATED EFFECTIVENESS • Sterilization • Hand washing • Closed-circuit vesical catheterization • Correct management of cardiovascular catheter s • Sterile clothing in the operating theatre • Correct management of assisted respiration salvatoregiampiccolo@msn.com

  11. NURSING RESEARCH IN OPERATING THEATRE* • Senic* Project *Study on the Efficacy of Nosocomial Infection Control • Predictability of SSI – Importance of Behaviour • Guidelines Guideline for Prevention of Surgical Site Infection, 1999 Linee Guida sulla Profilassi Antimicrobica Perioperatoria nell’Adulto salvatoregiampiccolo@msn.com

  12. salvatoregiampiccolo@msn.com

  13. Foreword: dr.ssa Maria Luisa Moro Studio sulla diffusione ed adozione delle Linee Guida per la Prevenzione delle ISC* Obiettivo Qualità Salvatore Giampiccolo P.O. “Michele Chiello” Piazza Armerina AUSL 4 Enna *Infezioni del Sito Chirurgico

  14. salvatoregiampiccolo@msn.com

  15. Doors in the operating theatre are: Right answer: always closed The global national value is 44%, with a fluctuation from a minimun of 22,22% to a maximum of 65,63% salvatoregiampiccolo@msn.com

  16. Is the area ofsurgical cut washedbefore the disinfectionof the operatingfield? Right answer: always The global national value is 49%, with a fluctuation from a minimum of 20,59% to a maximum of 72,73% salvatoregiampiccolo@msn.com

  17. Is the antibioticprophylaxispractised before the induction? Right answer: always The global national value is 57%, with a fluctuation from a minimum of 27,27% To a maximum of 76,92% salvatoregiampiccolo@msn.com

  18. Are the carpets, shoecovers and nebulizers, usedtopreventinfections? Right answer: never The global national value is 40%, with a fluctuation from a minimun of 5% to maximum of 71,25% salvatoregiampiccolo@msn.com

  19. Aftercontaminated or dirtyoperations, is the operationtheatreclosed or subjectedtospecial cleaning? Right answer: never The global national value is 17%, with a fluctuation from a minimum of 0% toa minimum of 30,19% salvatoregiampiccolo@msn.com

  20. Do youusuallycarry out the microbiological samplingof the air and surfacesof the operatingtheatre? Right answer: never The global national value is 21%, with a fluctuation from a minimun of 0% to a minimum of 44,34% salvatoregiampiccolo@msn.com

  21. The valueofguidelines • To spread the guidelines • To check their application • To assess the performance of the individual • To acquire results salvatoregiampiccolo@msn.com

  22. EBN SKILLS TO KNOW TO BE ABLE TO DO DAILY BEHAVIOUR PREFERENCES OF PATIENTS AVAILABLE RESOURCES AUTONOMY RESPONSIBILITY TO PLAN– TO ASSESS = RESULTS SATISFACTION OF PATIENTS salvatoregiampiccolo@msn.com

  23. CONCLUSION GUIDELINES PROTOCOLS PROCEDURES STANDARD TOOLS CONSOLIDATED HABITS NEVER SUBJECTED TO VERIFICATION OF SCIENTIFIC VALIDITY BECAUSE THEY WERE NEVER MEASURED WITH INDICATORS STANDARD RESULTS? BEHAVIOURAL VARIABLE (Tool that can’t be standardized) VALIDATION OF DEI BEHAVIOUR (to warrant the same quality of performance) salvatoregiampiccolo@msn.com

  24. salvatoregiampiccolo@msn.com

  25. CAN WE DO BETTER? Clinical experience, a large literature identifying risk factors for infection, and surgeons with higher than average infection rates ALL TELL US THAT WE CAN quoted in Richard Platt, MD, Msc, Progress in Surgical-Site Infection Surveillance salvatoregiampiccolo@msn.com

  26. THANKS FOR YOUR ATTENTION salvatoregiampiccolo@msn.com

  27. BIBLIOGRAPHY Essential • PNLG, Antibioticoprofilassi perioperatoria nell’adulto, 2008,, sta su internet www.pnlg.it • Salvatore Giampiccolo, Le Infezioni in chirurgia: teoria e prassi. Studio sulla diffusione ed adozione delle Linee Guida per la Prevenzione delle Infezioni del Sito Chirurgico, IV Corso per Infermieri di Sala Operatoria , Roma Settembre 2007 • Salvatore Giampiccolo, Protocolli di sala operatoria per prevenire le ISC*, III Corso per Infermieri di Sala Operatoria , Roma Maggio 2006 • S. Giampiccolo, Studio sulla diffusione e l’Adozione delle Linee Guida per la Prevenzione delle Infezioni del Sito Chirurgico, AICO vol 17 n° 4, 2005 • Salvatore Giampiccolo, Ricerca infermieristica in sala operatoria: teoria e prassi, sta in AICO Organo Ufficiale dell’Associazione Infermieri di Camera Operatoria Vol. 17 2005 – Fascicolo 2. • Salvatore Giampiccolo, Linee Guida sulla Prevenzione delle Infezioni del Sito Chirurgico ( Surgical Site Infection ), sta in Atti del IX Congresso Nazionale AICO, Rimini 25/27 marzo 2004. • Richard Platt, MD, MSc, Progress In Surgical-Site Infection Surveillance, Infection Control and Hospital Epidemiology, Volume 23 (7) * July 2002, sta su internet • Gazzetta Ufficiale della Regione Sicilia n° 18 del 20 aprile 2001, CIRCOLARE 27 marzo 2001, n. 1047. Lotta contro le infezioni ospedaliere salvatoregiampiccolo@msn.com

  28. BIBLIOGRAPHY Essential • Legge 10 agosto 2000 n° 251 - Disciplina delle professioni sanitarie infermieristiche, tecniche, della riabilitazione, della prevenzione, nonché della professione ostetrica. • Alicia J. Mangram, MD; Teresa C. Horan, MPH, CIC; Michele L. Pearson, MD; Leah Christine Silver, BS; William R. Jarvis, MD; The Hospital Infection Control Practices Advisory Committee, Guideline for Prevention of Surgical Site Infection, 1999 • Regione Piemonte - Assessorato Sanità, Linee Guida Per La Prevenzione Delle Infezioni del Sito Chirurgico, 1999 • Federazione Nazionale Collegi IPASVI - Codice Deontologico, I doveri degli infermieri sono i diritti dei cittadini, maggio 1999. • Nicolas Troillet (Sion), Sorveglianza Epidemiologica delle Infezioni del Sito Chirurgico: dai Principi alla Pratica, cit. in SWISS NOSO Volume 6, numero 1, Marzo 1999 • Legge 26.02.1999 n° 42 – Disposizioni in materia di professioni sanitarie. • D.M. 14.09.1994 n° 739 – Regolamento concernente l’individuazione della figura e del relativo profilo professionale dell’infermiere. • Maria Luisa Moro, Epidemiologia, sta in LE INFEZIONI OSPEDALIERE di Antonio Pagano e Gaetano Privitera, Intramed Comunications, Milano-Roma 1993. salvatoregiampiccolo@msn.com

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