THE IMPORTANCE OF BEING NURSE: A KEY-ROLE IN PERIOPERATIVE CARE AND A MISSION OF RESPONSIBILITY

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THE IMPORTANCE OF BEING NURSE A KEY-ROLE IN
PERIOPERATIVE CARE AND A MISSION OF RESPONSIBILITY

• SALVATORE GIAMPICCOLO

P.O. Michele Chiello Piazza Armerina (EN) ITALY
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THE IMPORTANCE OF BEING NURSE A KEY-ROLE IN
PERIOPERATIVE CARE AND A MISSION OF RESPONSIBILITY

• quality of results
• evaluates
• quality of performance
• and then

QUALITY of CARE
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KEY-ROLE OF THE NURSE
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This is the question
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KEY-ROLE IN THE PERIOPERATIVE CARE
PREVENTION OF THE SURGICAL SITE INFECTIONS
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SOMETHING ABOUT SSI
90 of SSI are contracted in the operating
theatre
Staff behaviour
Importance of prevention
Surgical Site Infection
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MEASURES OF DEMONSTRATED EFFECTIVENESS

• Sterilization
• Hand washing
• Closed-circuit vesical catheterization
• Correct management of cardiovascular catheter s
• Sterile clothing in the operating theatre
• Correct management of assisted respiration

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NURSING RESEARCH IN OPERATING THEATRE

• Senic Project
  Study on the Efficacy of
  Nosocomial Infection Control
• Predictability of SSI Importance of Behaviour
• Guidelines

Guideline for Prevention of Surgical Site
Infection, 1999
Linee Guida sulla Profilassi Antimicrobica
Perioperatoria nellAdulto
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Studio sulla diffusione ed adozione delle Linee
Guida per la Prevenzione delle ISC
Foreword dr.ssa Maria Luisa Moro
Obiettivo Qualità

• Salvatore Giampiccolo
• P.O. Michele Chiello Piazza Armerina
• AUSL 4 Enna

Infezioni del Sito Chirurgico
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Doors in the operating theatre are
Right answer always closed
The global national value is 44, with a
fluctuation from a minimun of 22,22 to a
maximum of 65,63
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Is the area of surgical cut washed before
the disinfection of the operating field?
Right answer always
The global national value is 49, with a
fluctuation from a minimum of 20,59 to a maximum
of 72,73
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Is the antibiotic prophylaxis practised before
the induction?
Right answer always
The global national value is 57, with a
fluctuation from a minimum of 27,27 To a
maximum of 76,92
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Are the carpets, shoe covers and nebulizers,
used to prevent infections?
Right answer never
The global national value is 40, with a
fluctuation from a minimun of 5 to maximum of
71,25
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After contaminated or dirty operations, is the
operation theatre closed or subjected to
special cleaning?
Right answer never
The global national value is 17, with a
fluctuation from a minimum of 0 toa minimum of
30,19
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Do you usually carry out the microbiological
sampling of the air and surfaces of the
operating theatre?
Right answer never
The global national value is 21, with a
fluctuation from a minimun of 0 to a minimum
of 44,34
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The value of guidelines

• To spread the guidelines
• To check their application
• To assess the performance of the individual
• To acquire results

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EBN
SKILLS
TO KNOW TO BE ABLE TO DO
DAILY BEHAVIOUR
PREFERENCES OF PATIENTS AVAILABLE RESOURCES
AUTONOMY RESPONSIBILITY
TO PLAN TO ASSESS RESULTS
SATISFACTION OF PATIENTS
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CONCLUSION
GUIDELINES PROTOCOLS PROCEDURES
STANDARD TOOLS
CONSOLIDATED HABITS NEVER SUBJECTED TO
VERIFICATION OF SCIENTIFIC VALIDITY BECAUSE
THEY WERE NEVER MEASURED WITH INDICATORS
STANDARD RESULTS?
BEHAVIOURAL VARIABLE (Tool that cant be
standardized)
VALIDATION OF DEI BEHAVIOUR (to warrant the same
quality of performance)
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CAN WE DO BETTER?
Clinical experience, a large literature
identifying risk factors for infection, and
surgeons with higher than average infection rates
ALL TELL US THAT WE CAN
quoted in Richard Platt, MD, Msc, Progress in
Surgical-Site Infection Surveillance
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THANKS FOR YOUR ATTENTION
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BIBLIOGRAPHY Essential

• PNLG, Antibioticoprofilassi perioperatoria
  nelladulto, 2008,, sta su internet www.pnlg.it
• Salvatore Giampiccolo, Le Infezioni in chirurgia
  teoria e prassi. Studio sulla diffusione ed
  adozione delle Linee Guida per la Prevenzione
  delle Infezioni del Sito Chirurgico, IV Corso per
  Infermieri di Sala Operatoria , Roma Settembre
  2007
• Salvatore Giampiccolo, Protocolli di sala
  operatoria per prevenire le ISC, III Corso per
  Infermieri di Sala Operatoria , Roma Maggio 2006
• S. Giampiccolo, Studio sulla diffusione e
  lAdozione delle Linee Guida per la Prevenzione
  delle Infezioni del Sito Chirurgico, AICO vol 17
  n 4, 2005
• Salvatore Giampiccolo, Ricerca infermieristica in
  sala operatoria teoria e prassi, sta in AICO
  Organo Ufficiale dellAssociazione Infermieri di
  Camera Operatoria Vol. 17 2005 Fascicolo 2.
• Salvatore Giampiccolo, Linee Guida sulla
  Prevenzione delle Infezioni del Sito Chirurgico
  ( Surgical Site Infection ), sta in Atti del IX
  Congresso Nazionale AICO, Rimini 25/27 marzo
  2004.
• Richard Platt, MD, MSc, Progress In Surgical-Site
  Infection Surveillance, Infection Control and
  Hospital Epidemiology, Volume 23 (7) July 2002,
  sta su internet
• Gazzetta Ufficiale della Regione Sicilia n 18
  del 20 aprile 2001, CIRCOLARE 27 marzo 2001, n.
  1047. Lotta contro le infezioni ospedaliere

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BIBLIOGRAPHY Essential

• Legge 10 agosto 2000 n 251 - Disciplina delle
  professioni sanitarie infermieristiche, tecniche,
  della riabilitazione, della prevenzione, nonché
  della professione ostetrica.
• Alicia J. Mangram, MD Teresa C. Horan, MPH, CIC
  Michele L. Pearson, MD Leah Christine Silver,
  BS William R. Jarvis, MD The Hospital Infection
  Control Practices Advisory Committee, Guideline
  for Prevention of Surgical Site Infection, 1999
• Regione Piemonte - Assessorato Sanità, Linee
  Guida Per La Prevenzione Delle Infezioni del Sito
  Chirurgico, 1999
• Federazione Nazionale Collegi IPASVI - Codice
  Deontologico, I doveri degli infermieri sono i
  diritti dei cittadini, maggio 1999.
• Nicolas Troillet (Sion), Sorveglianza
  Epidemiologica delle Infezioni del Sito
  Chirurgico dai Principi alla Pratica, cit. in
  SWISS NOSO Volume 6, numero 1, Marzo 1999
• Legge 26.02.1999 n 42 Disposizioni in materia
  di professioni sanitarie.
• D.M. 14.09.1994 n 739 Regolamento concernente
  lindividuazione della figura e del relativo
  profilo professionale dellinfermiere.
• Maria Luisa Moro, Epidemiologia, sta in LE
  INFEZIONI OSPEDALIERE di Antonio Pagano e Gaetano
  Privitera, Intramed Comunications, Milano-Roma
  1993.