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Surgical site infections cut nearly in half

YIMC - Wendy Alain

Patient Wendy Alain has had several surgeries over the past 10 years and she’s noticed many improvements at The Ottawa Hospital, including patient warming blankets, caring bedside manners, meeting with the anesthesiologist beforehand, and surgical team members introducing themselves and explaining their part in the surgery. “I was very impressed.”

Uncontrollable shivering. That’s what Wendy Alain experienced just before previous surgeries, but not last May before her colorectal surgery.

“This time I had the patient warming blanket,” she explained. “It made a huge difference. It’s so cozy and it also relaxes you as well.”

Patients under an anesthetic can’t regulate their body temperature. It drops rapidly, increasing the risk for hypothermia, which increases the risk of infection. But warm bodies can better fight infections. Nearly all patients having surgery of an hour or longer now receive a warming blanket.

The special blankets are one of about 60 changes made to reduce surgical site infections – and the changes are clearly having an effect. The Ottawa Hospital’s average infection rate has been cut nearly in half – from 4.8 percent in 2013 to 2.8 percent in July.

“This means about 285 fewer patients per year are getting infections due to their surgery,” said Dr. Husein Moloo, Alain’s surgeon. “Treating patients with infections costs an average of $7,786 extra, so these changes are saving the hospital about $2.2 million a year, conservatively. And, we’re improving the quality of care for our patients.”

“Even though this was the most complicated and longest surgery I’ve had, it was the best experience,” said Alain. “I healed the quickest and it probably had a lot to do with the new things they’re trying.”

Not all changes are necessarily visible to patients, but they still benefit.

During Alain’s seven-hour surgery, an automatic timer on the anesthesiologist’s computer went off at the 3.5-hour mark, signalling the surgical team that it was time to redose with antibiotics, to further help fight infection.

After her surgery, Alain had the new antimicrobial dressings that are changed for the first time 72 hours after surgery, instead of 24 hours after.

Better communications among all health-care providers – in the Operating Room and on units – also leads to better patient outcomes, including reduced infections. “All the surgeons, the anesthesiologist, the nurses – they all introduced themselves and explained their part in the surgery,” said Alain. “It was a whole team and I was very impressed. I could ask questions. You felt like you were in control.”

“Two years of steadily working to reduce TOH’s rate of surgical site infections is paying off,” said Dr. David Schramm, who leads the committee overseeing the changes.


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