Introduction
There are over thirty million surgeries performed every year in the United States. Despite advances in surgical and anesthesia technique, as well as enhancements in preoperative care, surgical site infections (SSIs) are associated with about half a million of the annual surgical procedures. Steinberg, Braun, Hellinger, & Kusek (2009), claim that the probability of postoperative complications increases significantly from 6% to 30% for patients undergoing non-cardiac surgery and those undergoing high-risk surgery respectively. The implications of SSIs include prolonged hospital length of stay, hospital costs from $1,400 for infectious complications to $50,000 for respiratory complications, and mortality (Hammond, et al., 2011). The Surgical Care Improvement Project (SCIP) was established by the Centers for Medicare and Medicaid Services. Its key role was to decrease surgical morbidity by up to 25% by 2010. The target areas for SCIP are a decrease of postoperative complications, such as SSI, venous thromboembolism, postoperative pneumonia, and cardiac complications through the establishment of surgical practice guidelines using evidence-based medicine (Stulberg, Delaney, & Neuhauser, 2010).
Most of the complications associated with surgery, including SSIs, cardiovascular complications, respiratory complications, and thromboembolic complications, have stipulated guidelines for their prevention based on numerous years of evidence-based research. However, there are still numerous instances of failure to apply standards of care known to inhibit unfavorable outcomes, which causes harm to large numbers of patients (Pastor, Artinyan, Varma, Kim, Gibbs, & Garcia-Aguilar, 2010). This project involves the analysis of various evidence-based practice journal articles in order to assess the impact of various processes of care performance measures including prevention of infection, prevention of venous thromboembolism (VTE), prevention of cardiac events, and prevention of respiratory complications. The project is vital due to the increasing interest in the quality of surgical care by multiple parties including purchasers, payers and consumers of health care. Due to the unpredictable nature of outcomes from surgeries, these parties continue to seek transparency and accountability in the surgical process (Berenguer, Ochsner, Lord, & Senkowski, 2010). Additionally, there is increased pressure to reduce the high costs and healthcare expenditures associated with surgical complications. As such, this project seeks to examine multiple performance measures govern the quality of surgery.
Identification of relevant scholarly resources
Since the establishment of SCIP in 2006, there have been numerous efforts by various hospitals to minimize surgical site infections. In addition, the Senate Bill 739 required all general acute care hospitals to implement and report annually on their implementation of infection surveillance and infection prevention process measures that were recommended by the Centers for Disease Control and Prevention (CDC) Healthcare Infection Control Practices Advisory Committee. As a result, scholars have had access to data on which to conduct their studies and draw conclusions on the state of surgical complications. Consequently, there are numerous scholarly articles available on Internet databases reporting on the nature of surgical complications. This project is based on five journal articles, containing research conducted from the 2006.
Learning objectives
The Surgical Care improvement Project (SCIP) poster project aims at achieving three primary objectives. These are:
- To identify primary and modifiable risk factors for surgical site infections (SSIs)
- To identify and describe evidence-based infection prevention strategies and interventions that minimizes the risk of SSIs in hospitalized patients
- To review the results from clinical trials that have assessed the efficacy of various pre and post surgical preparations.
Proposed project calendar
Personal and professional goals in the capstone project
The creation of a SCIP poster has numerous benefits at both the personal and professional level. The entire poster project involves intensive interaction with a variety of studies conducted on the impact of various performance measures in curbing surgery complications. In the process, it is possible to identify the merits and challenges of the surgical care improvement project. The availability of relevant scholarly material to prepare the poster is an indication of the willingness of various hospitals to take an active role in implementing the SCIP measures.
One of the key goals of assessing scholarly resources pertaining to SCIP measures and preparing a poster is to increase the knowledge of the RN with regard to antibiotic registration, as well as both non-pharmacologic and pharmacologic interventions. Some of the knowledge acquired involves cardiac care, prevention of venous thromboembolism (VTE), and prevention of infections through proper administration of antibiotics, careful observation of blood sugar levels, correct hair removal operations, preoperative temperature management, and removal of urinary catheters. Another goal in the capsone project is to fully comprehend the implications of surgical complications to all entities concerned, especially the health care facility. For instance, it is vital for nurses to understand that the extra expenditure incurred by a hospital die to surgical implications is not covered by Medicare or Medicaid services (Hammond, et al., 2011). The third goal of the project is to fully comprehend the significance of protocols that help to standardize processes, and as a result increase patient safety and improve performance.
References
Berenguer, C. M., Ochsner, G., Lord, A., & Senkowski, C. K. (2010). Improving Surgical Site Infections: Using National Surgical Quality Improvement Program Data to Institute Surgical Care Improvement Project Protocols in Improving Surgical Outcomes. J Am Coll Surg, 210(5), 737-741.
Hammond, J., Kozma, C., Hart, J. C., Nigam, S., Daskiran, M., Paris, A., et al. (2011). Rates of Venous Thromboembolism Among Patients with Major Surgery for Cancer. Ann Surg Oncol, 18, 3240–3247.
Pastor, C., Artinyan, A., Varma, M. G., Kim, E., Gibbs, L., & Garcia-Aguilar, J. (2010). An Increase in Compliance With the Surgical Care Improvement Project Measures Does Not Prevent Surgical Site Infection in Colorectal Surgery. Diseases of the Colon & Rectum Volume, 53: 1, 24-29.
Steinberg, J. P., Braun, B. I., Hellinger, W. C., & Kusek, L. (2009). Timing of Antimicrobial Prophylaxis and the Risk of Surgical Site Infections. Annals of Surgery, 250(1), 10-16.
Stulberg, J. J., Delaney, C. P., & Neuhauser, D. V. (2010). Adherence to Surgical Care Improvement Project Measures and the Association With Postoperative Infections. JAMA, 303(24), 2479-2485.