Postoperative SSIs

2. Postoperative SSIs Magnitude of Problem Despite advances in infection control practices, “SSIs remain a substantial cause of morbidity and mortality among hospitalized patients. This may partially be explained by the emergence of antimicrobial-resistant pathogens and the increased numbers of surgical patients who are elderly and/or have a wide variety of chronic, debilitating, or immunocompromising underlying diseases.” Mangram AJ, et al., Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention, Hospital Infection Control Practices Advisory Committee, Atlanta GA

3. Postoperative SSIs Magnitude of Problem • Approximately 60 million surgical procedures performed per year in the U.S.1,2 • 2.6% to 5% of surgical procedures result in surgical site infections (SSIs) 3,4 • At least 1.5 million SSIs per year in the U.S.5 • 1. DeFrances CJ, Hall MJ, Podgornik MN, 2003 National hospital discharge survey. CDC, National Center for Health Statistics, Advance Data from Vital and Health Statistics. No. 359;8 July 2005:14. • 2. Hall MJ, Lawrence L, Ambulatory surgery in the United States, 1996. CDC, National Center for Health Statistics, Advance Data from Vital and Health Statistics. No. 300;12 Aug 1998:7. • 3. Mangram AJ, et al., Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention, Hospital Infection Control Practices Advisory Committee, Atlanta GA. • 4. Institute for Healthcare Improvement (IHI), Topics: patient safety: surgical site infections: case for improvement. (accessed 16 Jan 2006 at http://www.ihi.org). • 5. Figure calculated by multiplying SSI rate from ref. #3 by surgical procedure numbers from ref. #1 and #2.

4. Surgical Site Infections • The leading hospital-acquired infection for surgicalpatients (38%)1 • The third most common hospital-acquiredinfection overall 1 • Patients who develop are twice as likely to die and 60% more likely to spend time in the ICU 2 • Increase hospital length of stay by 7 to 10 days 1 • Account for more than $25,000 increase inhospital costs 3 • One of the two most expensive infectionsto healthcare3 • 1. Mangram AJ, et al., Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention, Hospital Infection Control Practices Advisory Committee, Atlanta GA. • 2. Kirkland KB, et al., Infect Control Hosp Epidemiol. Nov 1999;20(11):722-4. • 3. Stone PW, et al., Am J Infect Control. Nov 2005;33(9):501-9

5. Goal: Address a Known Risk Factor for SSIs Reduce themicroorganismson the patient’s skin. We should initiate acomprehensive approachfor skin antisepsis.

6. Current Practice • Our current practice … • We have a protocol? • The protocol is aligned with CDC guidelines for preventing SSIs? • Compliance to protocol is? • Hospital / surgeon compliance level? • Patient compliance level?

7. Where we want to be • Establish multidisciplinary SSI prevention team • Increased awareness • Standardized pre-op prep protocol aligned with CDC guidelines for preventing SSIs • High compliance to protocol • Hospital / surgeon compliance >90% • Patient compliance >80%

8. Solution Pre-op skin prepping with CHG • CHG is persistent, active for up to 6 hours • Literature suggests that repeat applications maximize antimicrobial effect • Rapid bactericidal action • The only pre-op skin prep agent that the CDC recognizes as having “excellent” activity against gram-positive bacteria (i.e., MRSA) as well as “excellent” residual activity

9. Solution Pre-op skin prepping with Sage 2% CHG • Only FDA-Approved cloth delivery of CHG • Unique 2% CHG formulation• Fast-acting and broad spectrum• Persistent• Free of alcohol and harsh detergents • Unique one-step applicator cloth• Delivers a uniform dose of CHG• No drips, runs or pooling• Large cloth allows easy prepping of body contours

10. Implementation

11. Awareness Announcement Letter Posters

12. How Sage 2% CHG Works

13. Thank Youfor your time!