Changing old habits is hard, but it’s easier when everyone understands the reasons. When Tallahassee Memorial Hospital in Tallahassee, Florida, wanted to reduce surgical site infections, education was essential. “We thought we were doing everything right already,” says Anne White, RN, BSN, CNOR, Nurse Manager, main operating room. “You couldn’t get buy-in until everyone saw that we could do better.”
When the evidence showed that changing some practices would improve outcomes, people got on board. “One of the surgeons said, ‘We want to do the right thing, tell us what to do differently,’” recalls Todd Schneider, BSIE, EIT, Performance Improvement Advisor, an engineer by training.
One of the components of ideal perioperative care is using clippers for hair removal, not razors, which can leave nicks that invite infection. This change required a practical approach — eliminating razors from the supply list — and a psychological one. “We told the surgeons they could still use razors if they really wanted, but they would have to bring them in from home and document that they shaved the patient themselves,” says White. That seemed to work, she adds.
Administering antibiotics to all surgical patients within 60 minutes of surgery is trickier, but with pre-op order sheets and carefully engineered processes, the hospital is meeting that standard for 95 percent of patients. “It’s encouraging to see how far you can go when you have everyone on the same page,” says White.
02/05/2007
