Surgical Care Improvement Project and the Perioperative Nurse's Role

Abstract

The Surgical Care Improvement Project (SCIP) was formed by a partnership of national organizations with the goal of reducing surgical complications by 25% by 2010. The focus of the SCIP initiative includes four key components that perioperative health care workers can address in reducing the morbidity and mortality of surgical patients. By implementing SCIP quality measures, hospitals could prevent an estimated 13,000 patient deaths and 271,000 surgical complications each year.

Postoperative Infection Rates in Foot and Ankle Surgery

“…Initiated in 2003 by the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention, the Surgical Care Improvement Project partnership is coordinated by a steering committee of ten national organizations including the Agency for Healthcare Research and Quality, the American College of Surgeons, the American Hospital Association, the American Society of Anesthesiologists, the Association of Perioperative Registered Nurses, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, the Department of Veterans Affairs, the Institute for Healthcare Improvement, and the Joint Commission on Accreditation of Healthcare Organizations. The Surgical Care Improvement Project states that several preexisting factors, including diabetes, obesity, tobacco use, malnutrition, and the use of immunosuppressive medications, increase a surgical patient's risk for postoperative infection 19,20 . The Surgical Care Improvement Project recommendations for modifiable risk factors that help to prevent surgical site infections include controlling hypothermia, monitoring elevated blood glucose levels, use of electric clippers to remove hair from the surgical site, and administering preoperative, procedure-specific antibiotics within an appropriate time frame 20 .…”

“…The Surgical Care Improvement Project states that several preexisting factors, including diabetes, obesity, tobacco use, malnutrition, and the use of immunosuppressive medications, increase a surgical patient's risk for postoperative infection 19,20 . The Surgical Care Improvement Project recommendations for modifiable risk factors that help to prevent surgical site infections include controlling hypothermia, monitoring elevated blood glucose levels, use of electric clippers to remove hair from the surgical site, and administering preoperative, procedure-specific antibiotics within an appropriate time frame 20 .…”

What are the Patterns of Prophylactic Postoperative Oral Antibiotic Use After Foot and Ankle Surgery?

“…Numerous studies have supported associations with increased wound complications and surgical site infections in patients with complicated diabetes, peripheral vascular disease, and wound compromising medications [8,16,23,36,43,44,59]. Other comorbidities associated with increased risk of postoperative infection include obesity, malnutrition, tobacco use, and immunosuppressive medication [11,21,43,45]. Another potential cause for greater concern for surgical site infections after foot and ankle surgery is the persistent colonization of the forefoot despite preoperative preparation [7,12,30,47,48,63,65].…”

Does Participation in Graduate Medical Education Contribute to Improved Patient Outcomes as Outlined by Surgical Care Improvement Project Guidelines?

“…[9][10][11][12] Although teaching institutions are necessary for resident training, it is not known whether GME has a positive or negative affect on patient outcomes. Currently, no literature addresses the impact of GME on SCIP compliance.…”