Clinical update
Surgical site infection Essential facts
Find out more
Surgical site infection happens when an incision becomes infected after a surgical procedure. According to the Health Protection Agency (HPA), these kinds of infections account for up to 16 per cent of all healthcare-associated infections. As well as resulting in substantial discomfort for patients, serious surgical site infections can lead to longer stays in hospital, life-threatening illnesses and long-term disabilities.
NICE Surgical site infection, quality standard 49 (2013) guidance.nice.org.uk/QS49 Surgical site infection, clinical guideline 74 (2008) tinyurl.com/nk33vco
Signs/symptoms A surgical site infection can range from a limited wound discharge within seven to ten days of an operation to a life-threatening post-operative complication, such as a sternal infection after open-heart surgery. Signs of infection include redness, delayed healing, fever, pain, tenderness, warmth and swelling.
Causes/risk factors Most surgical site infections are caused by the contamination of an incision with micro-organisms from the patient’s own body during surgery. The rate of surgical site infection varies depending on the type of procedure, says the HPA, with rates of more than 10 per cent for large bowel surgery and less than 1 per cent for orthopaedic procedures. The majority of surgical site infections are preventable.
Expert comment
Pauline Harrington is surgical site infection surveillance manager and infection control nurse at Public Health England
SPL
What’s new The National Institute for Health and Care Excellence (NICE) has issued new standards to help prevent and treat surgical site infection in adults, children and young people undergoing surgical incisions through the skin.
Treatment Most infections can be treated with antibiotic medications. Sometimes additional surgery or procedures may be required. People having surgery and their carers should receive information and advice on wound and dressing care, including how to recognise problems with the wound and who to contact if they are concerned. Appropriate wound and dressing care promotes healing and reduces the risk of infection.
How you can help your patient Ensure patients do not remove hair from the surgical site before surgery, as this can increase the risk of infection. If hair needs to be removed, healthcare staff should do it using electric clippers with a single-use head on the day of surgery. Patients should also be advised to have a shower, bath or bed bath the day before or on the day of surgery to reduce the number of micro-organisms on the skin surrounding the incision. ‘Preventing surgical site infections should be of concern to everyone involved in surgical patient care. The primary role of nursing is patient advocacy, and ensuring patients have the best outcome is central to that role. The surveillance programme run by Public Health England is an effective
Prevention and control of healthcare-associated infections, public health guidance 36 (2011) guidance.nice.org.uk/ ph36 Surgical Site Infection Surveillance Service tinyurl.com/pnvly78 HPA English National Point Prevalence Survey on Healthcare-associated Infections and Antimicrobial Use, 2011: preliminary data (2012) tinyurl.com/oxfasbs Article from Nursing Standard: Causes, prevention and management of surgical site infection (July 2012) dx.doi.org/10.7748/ ns2012.07.26.47.47.c9226
means for helping hospitals reduce infections by monitoring problems. ‘Nurses should be part of a team working towards implementation of the seven NICE quality standards on surgical site infection. These should be embedded in care plans and used to educate patients. Audits can then follow.’
NURSING december 18 No :: vol 28uses no 16-18 2013 23 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 14, 2015. For personal use only. other without:: permission. Copyright © 2015 RCNi Ltd. All rights reserved.
Surgical site infection Essential facts
Find out more
Surgical site infection happens when an incision becomes infected after a surgical procedure. According to the Health Protection Agency (HPA), these kinds of infections account for up to 16 per cent of all healthcare-associated infections. As well as resulting in substantial discomfort for patients, serious surgical site infections can lead to longer stays in hospital, life-threatening illnesses and long-term disabilities.
NICE Surgical site infection, quality standard 49 (2013) guidance.nice.org.uk/QS49 Surgical site infection, clinical guideline 74 (2008) tinyurl.com/nk33vco
Signs/symptoms A surgical site infection can range from a limited wound discharge within seven to ten days of an operation to a life-threatening post-operative complication, such as a sternal infection after open-heart surgery. Signs of infection include redness, delayed healing, fever, pain, tenderness, warmth and swelling.
Causes/risk factors Most surgical site infections are caused by the contamination of an incision with micro-organisms from the patient’s own body during surgery. The rate of surgical site infection varies depending on the type of procedure, says the HPA, with rates of more than 10 per cent for large bowel surgery and less than 1 per cent for orthopaedic procedures. The majority of surgical site infections are preventable.
Expert comment
Pauline Harrington is surgical site infection surveillance manager and infection control nurse at Public Health England
SPL
What’s new The National Institute for Health and Care Excellence (NICE) has issued new standards to help prevent and treat surgical site infection in adults, children and young people undergoing surgical incisions through the skin.
Treatment Most infections can be treated with antibiotic medications. Sometimes additional surgery or procedures may be required. People having surgery and their carers should receive information and advice on wound and dressing care, including how to recognise problems with the wound and who to contact if they are concerned. Appropriate wound and dressing care promotes healing and reduces the risk of infection.
How you can help your patient Ensure patients do not remove hair from the surgical site before surgery, as this can increase the risk of infection. If hair needs to be removed, healthcare staff should do it using electric clippers with a single-use head on the day of surgery. Patients should also be advised to have a shower, bath or bed bath the day before or on the day of surgery to reduce the number of micro-organisms on the skin surrounding the incision. ‘Preventing surgical site infections should be of concern to everyone involved in surgical patient care. The primary role of nursing is patient advocacy, and ensuring patients have the best outcome is central to that role. The surveillance programme run by Public Health England is an effective
Prevention and control of healthcare-associated infections, public health guidance 36 (2011) guidance.nice.org.uk/ ph36 Surgical Site Infection Surveillance Service tinyurl.com/pnvly78 HPA English National Point Prevalence Survey on Healthcare-associated Infections and Antimicrobial Use, 2011: preliminary data (2012) tinyurl.com/oxfasbs Article from Nursing Standard: Causes, prevention and management of surgical site infection (July 2012) dx.doi.org/10.7748/ ns2012.07.26.47.47.c9226
means for helping hospitals reduce infections by monitoring problems. ‘Nurses should be part of a team working towards implementation of the seven NICE quality standards on surgical site infection. These should be embedded in care plans and used to educate patients. Audits can then follow.’
NURSING december 18 No :: vol 28uses no 16-18 2013 23 DownloadedSTANDARD from RCNi.com by ${individualUser.displayName} on Nov 14, 2015. For personal use only. other without:: permission. Copyright © 2015 RCNi Ltd. All rights reserved.
