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HCA375 Surgical Site Infections






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Surgical Site Infections
HCA375 Continuous Quality Monitoring & Accreditation
Surgical Site Infection

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A surgical site infection or SSI is an infection that occurs after surgery and is located on the
incision part of the body where the surgery took place. The severity of the SSI can be anywhere
from moderate, being only of the skin tissue, to severe, involving the tissue under the skin, the
internal organs, or the implanted material in the body. SSI is a serious health care associated
infection can cause either morbidity or mortality. This can cause the patient a much longer stay in
the hospital, an increase in costs, and a possibility of jeopardizing accreditation.
In the last decade there has been in increase in reports of patients losing their lives to
avoidable hospital incidents, commonly known as hospital acquired illness or HAI, the most
common reported HAI is either wrong site surgery or surgical site infection. Unfortunately, ssi’s,
effect 500,000 patients annually out of 27 million surgeries performed, and highly contribute to
the patient morbidity and/or mortality rate. (Barnett, 2007).
According to the John Hopkins website, a person’s skin is the natural barrier against infection,
so any surgery where the skin is opened, there is a 1 to 3% chance a ssi will develop within the
first 30 days postoperative. There are 3 types of ssi’s:
“Superficial incisional
SSI. This infection occurs just in the area of the skin where the surgical incision was made.
Deep incisional SSI. This
infection occurs beneath the incision area in muscle tissue and in fascia, the tissue
surrounding the muscles.

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Organ or space SSI. This
type of infection can be in any area of the body other than skin, muscle, and fascia that was
involved in the surgery, such as a body organ or a space between organs. “ (medicine, 2013)
The infection is caused by microorganism’s the most common being
Staphylococcus, Streptococcus, and Pseudomonas, all three passed via contact from human
to patient, or contaminated equipment to patient and even through the air. All three infections
will require antibiotics. One must also take into account there are other risk factors for ssi’s,
that range anywhere from a patient being elderly to overweight, to cancer and other diseases,
that already exist in the patient, even smoking. The infection is also evident in the first 30 to
90 days post-operative, therefore the CDC has implemented changes to monitor surgical site
infections for no more than 90 days if the surgery was for an implant, then the prior
recommendation of 1 year .
Hospitals pay a huge price for any patient with an HAI most especially the one’s with an SSI.
An additional $50,000 can be accrued per patient due to an HAI, and most times hospitals will
not be reimbursed the full cost. For example, Medicare and Medicaid now require hospitals to
submit a form called a Present on Admission (POA) form, this form indicates if the patient had
any condition similar to health care acquired condition upon admission or prior to surgery. Upon
submission of a Medicare claim does not indicate an HAC on the POA, then Medicare will not
reimburse the hospital the cost of the HAC, and since surgical site infections are at the top of the
list, the Center for Disease Control has stepped in to help combat this problem.
The Center for Disease Control has come up with it’s top recommendations to help hospitals
prevent them, before, during and after surgery:

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