Perioperative Measures to Enhance Infection Control Report

This report examines effective perioperative measures to enhance infection control, focusing on reducing surgical site infections (SSIs) and improving patient outcomes. It highlights the importance of perioperative assessment in identifying and mitigating infection risks, emphasizing the role of ...Read More

Effective perioperative measures to enhance infection control.
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Introduction
Deaths out of surgical site infections (SSIs) during the perioperative process still remain
to be a major source of co morbidity and mortality rates in the world, (Allegranzi et al 2016).
According to the World Health Organization, up to 100 000 people die each year due to surgical
site related infections, (Nygren et al 2013). Infections can either be caused by endogenous
substances on the skin of the patient or they can be caused by exogenous factors such as
improperly sterilized surgical tools. Infection control in the perioperative setting involves the
procedural setting up of surgical instruments and the actions and methods that will ensure a
proper assessment of possible risks and the proper evaluation of the infection risks throughout
the perioperative process (Lassen et al 2013). The purpose of this study is to investigate patient
infections in the perioperative care and the nursing interventions in reducing the infections.
Avoidance of carefully related contaminations can be acknowledged by various ways, which
incorporate entirely following the perioperative evaluation conventions, legitimate
administration of the task room and adherence to the universally perceived nursing mediations in
the perioperative setting. A legitimate nursing administration program, combined with a
powerful administration of the activity room strategies, can help to effectively bring down
patient contaminations that are gained in the healing center particularly amid the perioperative
procedure.
Risk factors in the perioperative setting
Patient infection risks in the perioperative processes are majorly associated with
contamination of the surgical site, which leads to surgical site infections (SSIs). The infection
risk factor may vary depending on the number of harmful flora in the surgical site or the surgical
technique used. A study that has been done recently indicates that most surgical related
infections are of a patient related nature rather than treatment related nature (Gustafsson et al
2013). Risk factors can be classified into two: patient related factors and procedure related
factors. The patient related risk factors that play a role in surgical site infections majorly include
co morbidities such as diabetes, coronary diseases, cancer and smoking addiction. Pre-existing
infections and deficiencies in the body immunity may also increase patient related risk factors.
Risk factors that are procedure-related in nature include the duration of the surgery, poor

sterilization of the surgical tools, improper skin preparation, and tissue trauma (Jammer et al
2015).
Prevention and Control Measures
The role of perioperative assessment in reducing patient infection
The major objective of perioperative assessment is to assess the infection risk factors that
are associated with surgical procedures and which may lead to perioperative complications.
However, due to improved novel surgical techniques and effective safety procedures, the past 30
years have witnessed a general reduction of surgical complications. (Anderson et al 2014).
However, complications resulting from surgical procedures are still common. A study carried out
recently demonstrates that risk of patients dying from patient infection in cardiac surgery can be
reduced up to 0.8 % down from 1.5% by adopting the use of surgical safety checklists, (Tillman,
Wehbe-Janek, Hodges, Smythe & Papaconstantinou, 2013). Surgical safety checklists are meant
to instill a culture that promotes effectiveness in managing patient risks.
Perioperative Nursing interventions that enhance infection control
Nursing interventions involves all the actions that are carried out by nurses in order to
help reduce patient infection cases, (Go et al 2014. The processes involved during the
perioperative process are numerous, and each process requires critical attention. The role of the
nurse in perioperative care of patients is to identify the needs of the patient and analyze any risk
factors that may arise out of the surgical procedure. In the recent years, the perioperative
environment has become complicated, and it requires more effective measures in the operation
room to reduce the risk of infection, (Keenan et al 2014).
In the process of operational rooms, nurses are tasked with the mandate of ensuring the
safety of the patients and work to minimize damage to patients in the process of carrying out an
invasive procedure. Furthermore, nurses have a responsibility to ensure that the surgical team
work together in an efficient manner, and that coordination amongst them is good, (Garrett
2016). These interventions have been evidenced to reduce postoperative complications and lower
mortality and morbidity rates that come as a result of infections, and improve the quality and
efficiency of surgery processes, (Schweizer et al 2013).

Nurses also play a very important role in offering educative services to patients during
the pre-perioperative phase. For example, nurses provide counselling services to patients in their
initial visit to hospital, prior to their scheduled surgical operation. They also encourage patients
to report any strange reactions with the progress of their health. For example, AORN
(Association of perioperative Registered Nurses) recommends that patients should shower with
antiseptics before undergoing any surgery, so as to reduce the risk of infection.
Interventions for infection control before, during and after Surgery
The perioperative process involves the preoperative, intraoperative and postoperative
phases. To reduce the risk of surgical side infections require intensive care is needed in each of
these phases. Following are the infection control interventions that can reduce risk of infection
transmission to patients during the perioperative process.
i. Preoperative interventions
The nurses have to validate and ensure that the patients are in the required state.
The role of the nurse is to ensure that the patient maintains a constant body temperature,
since a low body temperature tends to encourage risk of an infection through
vasoconstriction. AORN ((Association of perioperative Registered Nurses) recommends
that patients should go through warming (hypothermia) for 15 minutes before they are
subjected to anesthesia.
ii. Intraoperative interventions
The operating room (OR) nurse is tasked to ensure that all hairs are removed
before surgery process begins and to ensure that the skin antisepsis factors are met. A
recent study has shown that the highest risk in surgical site infections is when a patient’s
hair is shaved using razors (Illingworth et al 2013). The study further indicates that the
risk is low when the hair is shaved immediately before an operation begins. Increasing

oxygen delivery has also been found to condition an infection in the wound simply by
augmenting the supply of oxygen to it.
Before incision, prophylaxis antibiotic has to be administered together with
anesthesia before a surgical process begins. Additionally, the operating room nurse has to
ensure that guidelines that are related to prophylaxis and are recorded in the safety
checklist. Furthermore, the doors of the operating room must be closed and human traffic
should be minimized completely.
iii. Postoperative interventions
Postoperative phase is the process that is used in the management of patient after
the aftermath of a surgical process. The postoperative wounds on patients should be
carefully managed in the post anesthesia care unit, whereby all dressings should be
carefully managed. The nurse has to make sure that hand hygiene standards are kept high
and asepsis in dressing changes are kept critical. For covering the surgical wounds,
research has presented evidence that use of structures that have been coated with anti-
microbes tend to lower the risk of surgical site infections, (Merollini, Crawford,
Whitehouse & Graves 2013).
Evidence further shows that using material coated with Triclosan-coated structure
can greatly provide protection against deep and superficial surgical wound infections,
(Merollini, Crawford, Whitehouse & Graves 2013). It is normally recommended that
incision sites be covered with sterile dressings for a period of 24 hours to 48 hours so as
to allow a scab to form between the edges of the skin. Another study shows that use of
tissue adhesives could further reduce surgical site infections, (Edmiston et al 2013).
Additionally, the nurses in the post anesthesia care unit have to monitor the temperatures
of the patient in order to enhance warming techniques.
Conduct in the operational room
The operating room environment (OR) is a special facility within a hospital where
surgical operations are carried out in an environment that has been sterilized, (Vetter et al 2013).
This facility is one of the health care facilities that is most commonly associated with patient

infections. A number of deaths are reported each year from uncontrolled infections in the
operation room, (Matatov, Reddy, Doucet, Zhao & Zhang 2013). The procedures required amid
the perioperative procedure are various, and each procedure requires basic consideration. The job
of the medical attendant in perioperative consideration of patients is to distinguish the
requirements of the patient and break down any hazard factors that may emerge out of the
surgery. In the ongoing years, the perioperative condition has turned out to be muddled, and it
requires more successful measures in the activity space to lessen the danger of contamination.
In order to reduce the possible risks of infection, the members of the theatre are required
to conduct a safety check before starting a surgical procedure. The operational process involves
several teams that work together which includes: anesthetists, nurses and surgeons. Each one of
these teams have their specific roles which they do in order for the operational procedure to run
in a seamless manner, and above all, to reduce the risk of patient infection.
In order for the operation procedure to be successful and free of infection risk, the
members have a shared responsibility to ensure that rules and safety protocols pertaining to the
operational room are followed. For example, human traffic should be reduced around the
operating table, and each of the members should have their surgical suits on. This is to ensure
that person to person infections are prevented, either from the surgical personnel to the patient or
vice versa, (Martindale& Deveney 2013). Furthermore, the windows of the operation room must
be kept safely operation to allow for free circulation of air, and to discourage air-borne
infections.
The operational room, being a critical perioperative environment, requires intensive care
and well-ordered management plans in order to ensure the safety of patients, (Matatov, Reddy,
Doucet, Zhao & Zhang 2013). There has been an increasing concern on the safety of patients
during the perioperative process and after. Clinicians are highly concerned and focused on
improving the safety of patients in this critical setting. A successful surgery process means a
successful recovery process, (Eichhorn 2013).
Conclusion
Patient infections often occur in surgical incision sites in the postoperative phase.
Surgical site related infection cases do not only to the loss of loved ones, but they also increase

the cost of clinical care. Hence, operation room care management is key for a successful
management of risks that come about during the perioperative process. Prevention of surgically
related infections can be realized by a number of ways, which include strictly following the
perioperative assessment protocols, proper management of the operation room and adherence to
the internationally recognized nursing interventions in the perioperative setting. A proper nursing
management program, coupled with an effective management of the operation room procedures,
can help to successfully lower patient infections that are acquired in the hospital especially
during the perioperative process.
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