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SURGICAL CARE IMPROVEMENT PROJECT SCIP

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Bunny Isgett-Lynn BSN, RN. Clinical Applications Coordinator ... We were below the benchmark for two mission critical measures. ... – PowerPoint PPT presentation

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Title: SURGICAL CARE IMPROVEMENT PROJECT SCIP


1
SURGICAL CARE IMPROVEMENT PROJECT (SCIP)
  • Antibiotic Surgical Prophylaxis
  • Bunny Isgett-Lynn BSN, RN
  • Clinical Applications Coordinator
  • VA Gulf Coast Veterans Health Care System,
    Biloxi, MS

2
Antibiotic Surgical Prophylaxis
  • PROBLEMS
  • We were below the benchmark for two mission
    critical measures.
  • Mc1d1a (sip 1a) Surgical Care Improvement
    Project (SCIP) Inpatient Prophylactic antibiotic
    received within one hour prior to surgical
    incision (started timely).
  • MC1d2a (sip10a) SCIP Inpatient Prophylactic
    antibiotic correct selection.

3
Antibiotic Surgical Prophylaxis
  • ISSUES
  • We have a large turnover of residents rotating
    through on Surgical Rotation, which further
    complicates insuring compliance.
  • Once the patient was in the OR, the antibiotic
    was ordered, but delayed the case or arrived too
    late to be given within the time frame.
  • Failure to document that the drug was given.
    Nurse thought was not her responsibility because
    Anesthesia gave the medication. Anesthesia
    thought nurse should document.

4
Antibiotic Surgical Prophylaxis
  • OBJECTIVES
  • Establish a multidisciplinary team to develop a
    process that would not only bring us to the
    benchmark, but would allow us to exceed the
    benchmark, thus giving our veterans the ultimate
    in patient care, reducing length of stay, and
    improving post surgical infections!

5
Antibiotic Surgical Prophylaxis
  • IMPLEMENTATION
  • Streamlined and organized the surgery order menu.
  • Created new surgery menus with new quick orders
    and grouped and categorized them. (This is to
    insure the correct prophylactic antibiotic is
    selected for the correct surgery.)
  • This gave the provider, by surgery type, which
    antibiotic to use, the recommended doses, along
    with alternatives for patients with Beta Lactam
    allergies.

6
Antibiotic Surgical Prophylaxis
  • IMPLEMENTATION
  • Developed process that was made mandatory by the
    Chief of Surgery to have all residents/ providers
    review all surgery cases the night prior to
    surgery and order the correct antibiotic that
    evening.
  • The orders would print directly to pharmacy.
    Evening pharmacist would prepare the antibiotics
    and deliver them to the OR at 5am day of surgery.
  • Anesthesia would give and document the proper
    antibiotic with the proper time frame.

7
Antibiotic Surgical Prophylaxis
  • OUTCOME
  • Since implementation, we are very proud to say
    we have been one hundred percent compliant!
    Pharmacy, Surgery, QM, and patients are all very
    pleased with the process. We also involved
    goal-sharing with this project and won the GOLD,
    with bonus bucks!

8
Antibiotic Surgical Prophylaxis
9
Antibiotic Surgical Prophylaxis
  • SURGERY ORDER MENU

10
Antibiotic Surgical Prophylaxis
  • RESIDENT/PROVIDER GUIDELINES

11
Antibiotic Surgical Prophylaxis
  • Prophylactic Antibiotics Menu
  • Given in the OR
  • BEFORE THE CUT!

12
Antibiotic Surgical Prophylaxis
  • QUICK ORDER

13
Antibiotic Surgical Prophylaxis
  • Thank you!
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