Clinical/Organizational
Problem

            The
organizational problem is an increase in the number of surgical site infections
(SSI).  According to Loyola University
(2017), SSI affect as many as 300,000 patients a year in the United States.  Over the past few months, the organization
has had an increase in SSI. 

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Rationale for Change, Quality
Improvement, or Innovation

            With the establishment of
value-based purchasing, the Center for Medicare and Medicaid (CMS) will no
longer reimburse for hospital acquired infections which could have been
prevented. SSI make up 20 percent of all hospital-acquired infections with an
annual incidence of 160,000 to 300,000 and an estimated annual cost ranging
from $3.5billion to 10 billion (Loyola University, 2017).

            With surgical service departments
being the financial pillar for most hospitals, it is essential they concentrate
on decreasing the number of SSI to increase reimbursement from CMS.

            Hospitals need to change their
practices to stay current with evidence-based practice (EBP).  Following the current guidelines and creating
a bundle approach to combat surgical site infections have been shown to
decrease the number of SSI.      

 

 

Causes
of the Problem

            The cause of SSI is numerous, in the organization a lack of
proper orientation of new staff ranging from pre-op nurses, sterile processing
technicians, operating room staff to post-op nurses.  Many of these employees come from no
background in the surgical services area. 

Another
problem is not following current guidelines. 
Facilities have a responsibility to keep patients safe. By adhering to new
guidelines and following an evidence-based approach, the number of SSI will
decrease.

Not
holding staff accountable for follow policy is another reason for the increase
in SSI.  Staff threaten to leave when
they are reprimanded for any wrong doings or not following policy, so a blind
eye is turned so that staff doesn’t leave.

Patients
play a part in the cause as well, by proper education prior to surgery some of
the factors on the patient’s side can be decreased.  These can include: smoking, a high basal
metabolic index, poor nutrition and blood glucose monitoring.