Iatrogenic Inftections
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In January, 2003, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) issued a Sentinel Event Alert regarding acquired infections (Beyea). The report presented distressing news regarding iatrogenic infections: the Centers for Disease Control and Prevention (CDC) estimated more than two million hospitalized patients contract iatrogenic infections in the United States every year and as many as 90,000 of them die from these infections. Surgical site infections (SSIs) are the second most common cause of nosocomial infections, and up to two percent to five percent of patients undergoing clean extraabdominal surgery and up to 20 percent of those undergoing intraabdominal surgery will develop SSIs (Bratzler and Houck 706). The CDC estimates as many as 50,000 SSIs occur each year in the United States, and patients who develop SSIs are up to 60 percent more likely to spend time in an intensive care unit, are five times more likely to be readmitted to hospital, and twice as likely to die than patients without SSIs. Health care costs are increased substantially for patients who develop an SSI. Nurses have always played a crucial role in preventing infections, and with the development today of new infections and of antibiotic resistant strains of bacteria emerging, the role of nurses in preventing infections is even more critical to the patients' well-being (Beyea). Perioperative nurses need to review their roles in infection prevention, and
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r and Houck cite a study going as far back as 1969 which showed that antimicrobial prophylaxis reduced the incidence of wound and intraabdominal sepsis significantly (707).
The AORN believes that prophylactic antibiotics should be given before the initial incision is made to ensure that adequate serum and tissue concentrations of the antibiotic are achieved by the skin is opened (Petersen). Since the reason for administering antibiotics prophylactically is to reduce the microbial burden of intraoperative contamination to a level that does not overwhelm the patient's own defenses, the antibiotic should be given before the tissues are invaded, and depending on the type of medication used, the American Society of Health-System Pharmacists' guidelines recommend prophylactic antibiotic administration between 30 and 60 minutes before surgery. The protocol for administering prophylactic antibiotics varies from one institution to another, but should include: procedures for ordering the prophylactic antibiotics; identification of staff members responsible for procuring and preparing the medication; delineation of staff members responsible for administering the medication; and development of communication methods regarding surgical dela
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Approximate Word count = 1759
Approximate Pages = 7 (250 words per page)
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