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Surgical Site Infections Persist, But Why?
Johns Hopkins physician-researcher Nauder Faraday, MD, this week said out loud what I bet many quality chiefs have been saying about surgical site infections, perhaps in between muttered curses, for quite some time.
He said there's little chance hospitals can consistently drive down infection rates to that elusive zerono matter how hard they try—and many are trying very, very hard. That's because, he says, there are other factors in play beyond a hospital's control, and scientists and doctors are so far clueless as to what those might be.
Some patients get infected, and some patients don't.
Therefore, he says, it's inappropriate for the Centers for Medicare & Medicaid Services to impose financial penalties, as it now does, by refusing to pay for additional care required when certain surgical procedures transmit a bug into a surgical cavity.
I don't agree with Faraday that the penalty, which has been in effect since October 1, is misguided. On the contrary, it has succeeded in putting fire under the feet of hospital teams and the surgeons who work there to take a hard look at their surgical processes, and even at how the patient is cared for at home.
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Comments are moderated. Please be patient.
Paula Forte (5/31/2012 at 3:51 PM)
Your author asks, if we found vulnerable DNA, "Would we do more prep work than we do now? Keep these patients in the hospital longer? Not allow them to have surgery?" We don't have the DNA test to prove vulnerability to SSIs but we do know when our patients are poor surgical risks. For them we DO delay surgery and work with them and their faimilies in a specialty clinc (sometimes for up to a year) to build protein stores, pulmonary function, etc. in order to enhance their outcomes (and ours) when surgery is performed. We are not to zero yet, but for our population which is already high risk, thanks to incredible vigilance on many clinician's part, we beat the NHSN benchmark most quarters.