Surgical Care Improvement Project Process of Care Measures Hospitals can reduce the risk of infection after surgery by making sure they provide care that’s known to get the best results for most patients. Here are some examples: Giving the recommended antibiotics at the right time before surgery Stopping the antibiotics within the right timeframe after surgery Maintaining the patient’s temperature and blood glucose (sugar) at normal levels Removing catheters that are used to drain the bladder in a timely manner after surgery. Hospitals can also reduce the risk of cardiac problems associated with surgery by: Making sure that certain prescription drugs are continued in the time before, during, and just after the surgery. This includes drugs used to control heart rhythms and blood pressure. Giving drugs that prevent blood clots and using other methods such as special stockings that increase circulation in the legs. Surgery Patients Who Were Taking Heart Drugs Called Beta Blockers Before Coming To The Hospital, Who Were Kept On The Beta Blockers During the Period Just Before And After Their Surgery April 2010 through March 2011 It is often standard procedure to stop patients’ usual medications for a while before and after their surgery. But if patients who have been taking beta blockers suddenly stop taking them, they can have heart problems such as a fast heart beat. For these patients, staying on beta blockers before and after surgery makes it less likely that they will have heart problems. Higher percentages are better. Surgery Patients Who Were Given An Antibiotic At The Right Time (Within One Hour Before Surgery) To Help Prevent Infection April 2010 through March 2011 Hospitals can prevent surgical wound infections. Medical research shows that surgery patients who get antibiotics within the hour before their surgery are less likely to get wound infections. The timing is important: getting an antibiotic earlier, or after surgery begins, is not as effective. Hospital staff should make sure patients get antibiotics at the right time. Higher percentages are better. Surgery Patients Who Were Given The Right Kind Of Antibiotic To Help Prevent Infection April 2010 through March 2011 Surgical wound infections can be prevented. Medical research has shown that certain antibiotics work better to prevent wound infections for certain types of surgery. Hospital staff should make sure patients get the antibiotic that works best for their type of surgery. Higher percentages are better. Surgery Patients Whose Preventive Antibiotics Were Stopped At The Right Time (Within 24 Hours After Surgery) April 2010 through March 2011 Antibiotics are often given to patients before surgery to prevent infection. Taking these antibiotics for more than 24 hours after routine surgery is usually not necessary. Continuing the medication longer than necessary can increase the risk of side effects such as stomach aches and serious types of diarrhea. Also, when antibiotics are used for too long, patients can develop resistance to them and the antibiotics won’t work as well. Higher percentages are better. Heart Surgery Patients Whose Blood Sugar (Blood Glucose) Is Kept Under Good Control In The Day Right After Surgery April 2010 through March 2011 Even if heart surgery patients do not have diabetes, keeping their blood sugar under good control after surgery lowers the risk of infection and other problems. “Under good control” means their blood sugar should be 200 mg/dL or less when checked first thing in the morning. Higher percentages are better. Surgery Patients Needing Hair Removed From The Surgical Area Before Surgery, Who Had Hair Removed Using A Safer Method (Electric Clippers Or Hair Removal Cream – Not A Razor) April 2010 through March 2011 Preparing a patient for surgery may include removing body hair from skin in the area where the surgery will be done. Medical research has shown that shaving with a razor can increase the risk of infection. It is safer to use electric clippers or hair removal cream. Higher percentages are better. Surgery Patients Whose Doctors Ordered Treatments To Prevent Blood Clots After Certain Types Of Surgeries April 2010 through March 2011 Certain surgeries increase the risk that the patient will develop a blood clot (venous thromboembolism). When patients stay still for a long time after some types of surgery, they are more likely to develop a blood clot in the veins of the legs, thighs, or pelvis. A blood clot slows down the flow of blood, causing swelling, redness, and pain. A blood clot can also break off and travel to other parts of the body. If the blood clot gets into the lung, it is a serious problem that can cause death. To help prevent blood clots from forming after surgery, doctors can order treatments to be used just before or after the surgery. These include blood-thinning medications, elastic support stockings, or mechanical air stockings that help with blood flow in the legs. Higher percentages are better. Patients Who Got Treatment At The Right Time (Within 24 Hours Before Or After Their Surgery) To Help Prevent Blood Clots After Certain Types Of Surgery April 2010 through March 2011 Many factors influence a surgery patient’s risk of developing a blood clot, including the type of surgery. When patients stay still for a long time after some types of surgery, they are more likely to develop a blood clot in the veins of the legs, thighs, or pelvis. A blood clot slows down the flow of blood, causing swelling, redness, and pain. A blood clot can also break off and travel to other parts of the body. If the blood clot gets into the lung, it is a serious problem that can sometimes cause death. Treatments to help prevent blood clots from forming after surgery include blood-thinning medications, elastic support stockings, or mechanical air stockings that help with blood flow in the legs. These treatments need to be started at the right time, which is typically during the period that begins 24 hours before surgery and ends 24 hours after surgery. Higher percentages are better.