抗生素PPT课件（英文精品）Surgical Infection Prevention In Washington State（50p）.pptVIP

Surgical Infection PreventionIn Washington StateWhere we started and where we’re going… Why focus on surgical quality? ~30 million major operations each year in the US Despite advances in surgical and anesthesia technique and improvements in perioperative care, variations in outcomes for patients having surgery are well known Consequences of Surgical Complications Dimick and colleagues demonstrated increased costs: infectious complications was $1,398 cardiovascular complications $7,789 respiratory complications $52,466 thromboembolic complications $18,310. Khuri and colleagues demonstrated that, independent of preoperative patient risk, the occurrence of a 30-day complication reduced median patient survival by 69%. Who Pays for Surgical Complications? Medicare Surgical Infection Prevention (SIP) Project Objective To decrease the morbidity and mortality associated with postoperative infection in the Medicare patient population Selected Surgical Procedures Cardiac Coronary Artery Bypass Graft (CABG) Colon Hip Knee Arthroplasty Abdominal Vaginal Hysterectomy Vascular Surgery: Aneurysm repair Thromboendarterectomy Vein Bypass Perioperative Prophylactic AntibioticsTiming of Administration Infection antibiotic IndicatorsNational Surgical Care Improvement Project SCIP INF – 1: Proportion of patients with antibiotic initiated within 1 hour before surgical incision SCIP INF – 2: Proportion of patients who receive prophylactic antibiotics consistent with current recommendations SCIP INF – 3: Proportion of patients whose prophylactic antibiotics were discontinued within 24 hours of surgery end time Surgical Care Improvement ProjectPerformance measures - Process Surgical infection prevention Antibiotics Administration within one hour before incision Use of antimicrobial recommended in guideline Discontinuation within 24 hours of surgery end Other Process Improvement Glucose control in cardiac surgery patients Proper hair removal Normothermia