Evidenced Based Practice And Applied Nursing Research
A. significance/background of healthcare problem (Surgical Site infections) Describe healthcare problem, significance of problem, how problem impacts patient/organization
headings needed:A1 Describe a Healthcare Problem, A2. Significance of Problem, A3. Current Practice, A4. Impact on Background
B.This is PICO table I created: P (patient/problem) For the surgical patient
I (Intervention/indicator) Will the use of Chlorhexidine gluconate skin preparation preoperatively
C (comparison) Compared with the current practice antibacterial soap or povidone-iodine
O (outcome)Reduce surgical site infections
PICO question This is question I formulated:For the surgical patient, will the use of chlorhexidine gluconate (CHG) preoperative skin preparation prevent surgical site infections (SSIs) after total knee arthroplasty?
E. Recommended Practice Change
F1. Key Stakeholders
F2. Barriers
F3. Strategies
F4. Indicators to Measure outcome
References: Please only use the references I attached no additional references
Kapadia, B. H., Zhou, P. L., Jauregui, J. J., & Mont, M. A. (2016). Does Preadmission Cutaneous Chlorhexidine Preparation Reduce Surgical Site Infections After Total Knee Arthroplasty?. Clinical Orthopaedics And Related Research, 474(7), 1592-1598. doi:10.1007/s11999-016-4767-6
Young, H. L., Reese, S., Knepper, B., Miller, A., Mauffrey, C., & Price, C. S. (2014). The Effect of Preoperative Skin Preparation Products on Surgical Site Infection. Infection Control & Hospital Epidemiology, 35(12), 1535-1538. doi:10.1086/678601
PART A
Description of Surgical Site Infections
Surgical site infections are one of the most frequently reported cases of hospital-acquired infections and it constitutes 19. 6% of all the hospital-acquired infections. According to the Centre for Disease Control and Prevention (CDC), surgical site infections can be defined as a post-operative infection that occurs within 30 days after a surgical procedure or even within a period of one year in the case of permanent implants. In some cases the surgical site infections can be superficial in that they will be affecting the skin of the patient only but in some cases, they may become serious and affect the skin, body organs, and implants that have been given to a patient CITATION You14 \l 1033 (Young, Reese, Knepper, Miller A, & CS., 2014). CDC is one of the bodies that has provided guidelines and tools to the healthcare community so that they can be used in ending surgical site infections by helping the members of the public to gain an understanding of all the infections so that they can take up the necessary prevention measures to safeguard their health.
Surgical site infections can be caused by endogenous and exogenous micro-organisms that are present in the skin when surgical incisions are made to the skin of the patient. Most of the common causative bacteria are Staphylococcus aureus that contains micro-organism that dwells on the skin of the infected individual when the body of the patient becomes exposed after they have undergone a surgery.
Significance of Surgical Site Infections
Surgical site infections are associated with the increase in the cases of mortality and morbidity. The development of surgical site infections is associated with the substantial increase in the clinical and economic cost that is associated with the surgery. There are other extra costs that are incurred and they are caused by the increased period that the [patient stays in the hospital. There are also other tests which are carried out to diagnose their cause and appropriate treatment procedures. In some of the cases, the patient may require re-operation after they have contracted the infection and such can increase the additional costs that are involved in the treatment of the patient.
Given the higher costs that are associated with SSIs, it is important to come up with proper treatment procedures that will lower the cost of treatment and be effective at the same time.
Current Practice
The current practice involves the use of iodine preparations such as povidone iodine and anti-bacterial soap in the prevention of surgical site infections. The iodine-based antiseptics are effective and they can prevent a wide range of micro-organisms such as fungi, virus, and tubercle bacillus from getting into the body of the patient. They penetrate into the cell wall and work through the process of oxidation of the micro-organisms. There are also other iodophors which are simply iodine formulations that are prepared by a stabilizing agent that plays a big role in liberating free iodine and it can be prepared in form of an alcohol preparation in aqueous. When povidone-iodine ids in the aqueous form it requires a two-step application by the use of scrub and paint technique. One of the limitations povidone iodine ad other iodine solutions that are used in the prevention of surgical site infections is that their activity is limited by the amount of time that they are in contact with the skin of the patient.
The use of anti-bacterial sops is also one of the means of preventing the infection of surgical site infections. Anti-bacterial sop is used by the patient to bathe or shower before prior to the surgery to ensure that...