Burger, Terry Lynn, MBA, BSN, RN, NE-BC, CIC

DiGiovanni, Stephanie, RN, BSN, CNOR

Fry, Deborah A, MT(ASCP), MBA, CIC

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of MedicineHave You Been to the Operating Room Lately?Terry Lynn Burger MBA, BSN, RN, NE-BC, CICLehigh Valley Health Network, Terry_Lynn.Burger@lvhn.orgDeborah A. Fry MT(ASCP), MBA, CICLehigh Valley Health Network, Deborah.Fry@lvhn.orgStephanie DiGiovanni RN, BSN, CNORLehigh Valley Health NetworkFollow this and additional works at: http://scholarlyworks.lvhn.org/medicinePart of the Medical Sciences CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtBurger, T. L., Fry, D. A., & DiGiovanni, S. (2011). Have You Been to the Operating Room Lately?. LVHN Scholarly Works. Retrievedfrom http://scholarlyworks.lvhn.org/medicine/27Have You Been to the Operating Room Lately?Terry Burger, MBA, BSN, RN, NE-BC, CIC; Deborah A. Fry, MT(ASCP), MBA, CIC; Stephanie DiGiovanni, RN, BSN, CNOR; Lehigh Valley Health Network, Allentown, PennsylvaniaIssue•  Surgical site infection (SSI) represent 1/4 of  all health care associated infections (HAIs)  that occur each year. The operating room is  generally not on the path of daily surveillance activities. Many Infection Preventionists (IPs) are uncomfortable entering the protective  environment of the operating room and  interacting in the unique culture of the  surgical team. •  The Infection Control and Prevention  Department identified a need to increase  transparency and enhance collaboration  with the operating room to improve surgical site infection pre vention practices.Project•  An operating room nurse was hired that  demonstrated an interest in infection pre­vention, was self motivated, and possessed the interpersonal skills to interact with  operating room personnel and facilitate  projects. The new IP’s responsibilities were  focused principally on improvements in the perioperative division. ResultsWithin 12 months the new IP was able to  identify, standardize, coordinate and facilitate the adoption of new products, procedures and  practices that improved infection prevention  and quality outcomes including:•  Terminal cleaning schedule of operating  rooms with UVC disinfection•  Environmental rounds and measurement of cleaning efficacy of anesthesia equipment•  Reduction of flash sterilization•  Implementation of a medical device  reprocessing program•  Transition to chlorhexidine as the preferred surgical skin prep•  Posted SCIP measures, SSI rates, and  Catheter Associated Urinary Tract Infection rates on  Visibility Walls•  Reduction in the weight of instrument  carriersUVC DisinfectionReduction of Flash Sterilization Chlorhexidine  Surgical Skin Prep UsageImprovement  Efforts in Progressn Decrease red bag waste	 •  Implement Isolysern  Reduce potential exposure to blood and  body fluid	 •  Enforce sharps managementn Improve environmental sanitation	 •  Establish routine environmental rounds	 •  Employ the luminometer 	 •  Install disinfectant wipes in every ORn Improve hand hygiene compliance	 •  Install alcohol hand sanitizers in  every ORLessons Learned•  Rapid cycle improvement in the operating room can be accomplished with the expertise of an “insider” in this case a former operating room nurse hired as an IP. •  Assigning an IP to work exclusively on  perioperative initiatives accelerated the identifi cation and execution of infection  prevention projects.•  Dissemination of performance outcomes to the end users is paramount to engage staff  in performance improvement and to function as change agents.Flash Rate 2010–201101020304050 Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb ’10            ’11 MonthsPercentageCC 17th MHC050010001500200025003000LocationLuminometer Readings 03/16/201112/17/2010> 200 Considered ContaminatedPatient Monitor Touch ScreenComputer KeyboardPulse OximeterSupply Cart KeypadChairCart Tilt-out Bins HandleVaporizer Control KnowTransport MonitorO2/N2O/Air Flow  Control KnobsPhone SurfacesSink HandlesLaryngoscope HandleTEE ProbeNarcotics BoxCode BoxNerve StimulatorDoor KeypadEnflow Heating Element SurfaceBair HuggerIV PoleBar Code ScannerAnesthesia EquipmentDevice Savings Oct  2010Nov  2010Dec  2010Jan  2011Feb  2011Mar  2011Apr  2011May  2011Total SavingsBurrs / Bits / Blades $0 $0 $0 $0 $2,289 $154 $0 $0 $2,443 Compression Device ­ Pairs $134 $538 $672 $672 $672 $538 $672 $656 $4,554 Diagnostic Ultrasound Catheter $0 $1,528 $16,806 $7,639 $16,439 $21,389 $7,639 $12,553 $83,993 EP Catheters & Cables $0 $6,367 $14,288 $1,000 $9,744 $11,849 $8,001 $4,804 $56,053 External Fixation $0 $0 $0 $0 $0 $44,478 $0 $12,176 $56,654 Soft Tissue Ablators ­ Arthro $0 $0 $0 $2,155 $1,796 $1,796 $0 $2,906 $8,653 Tourniquet Cuffs $0 $1,223 $3,667 $2,200 $3,666 $4,522 $1,956 $3,178 $20,412 Ultrasonic Scalpels $0 $0 $2,769 $11,880 $14,435 $0 $0 $0 $29,084 $134 $9,656 $38,202 $25,546 $49,041 $84,726 $18,268 $36,273 $261,846 Waste Savings Oct  2010Nov  2010Dec  2010Jan  2011Feb  2011Mar  2011Apr  2011May  2011Savings  TotalsWaste Savings $0 $110 $358 $563 $483 $719 $573 $540 $3,346Total Weight (lbs) 0 366 1,194 1,876 1,608 2,396 1,907 1,802 11,149Total Savings = $265,192ASCENT Medical Device Reprocessing0 2,000 4,000 6,000 8,000 10,000 12,000UnitsYear10,0194,497125% Increase20102008Medical Device ReprocessingWaste Savings,  $3,346Burrs/Bits/Blades, $2,443Compressions Device Pairs, $4,554Diagnostic Ultrasound Catheter, $83,993EP Catheter and Cables, $56,053External Fixation,  $56,654Soft Tissue Ablators Artho, $8,653Tourniquet Cuffs, $20,412Ultrasonic Scalpels, $29,084

Have You Been to the Operating Room Lately?

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Have You Been to the Operating Room Lately?

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Lehigh Valley Health Network: LVHN Scholarly Works