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Washington State Hospital Association

Partnership for Patients Reducing Surgical Site Infections Board Presentation September 10, 2012 Abbreviated Version of Dr. Dellinger’s Presentation at WSHA Safe Table 7/10/12. Washington State Hospital Association. 15. Partnership for Patients. 40 – Percent reduction in harm

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Washington State Hospital Association

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  1. Partnership for Patients Reducing Surgical Site Infections Board Presentation September 10, 2012 Abbreviated Version of Dr. Dellinger’s Presentation at WSHA Safe Table 7/10/12 Washington State Hospital Association 15

  2. Partnership for Patients • 40 – Percent reduction in harm • 20 – Percent reduction in readmissions • 13 – by 2013 Saving Lives 2

  3. 10 Targeted Strategies Infection Reduction: • Catheter-associated urinary tract infections (CAUTI) • Central line-associated blood stream infections (CLABSI) • Surgical site infections (SSI) • Ventilator-associated pneumonia (VAP) Nursing Care: • Injuries from falls and immobility • Pressure ulcers High Risk: • Adverse drug events • Obstetrical adverse events • Venous thromboembolism or blood clots (VTE) Continuity of Care: 10. Prevention of readmissions Cultural Transformation Leadership Engagement 3

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  5. Partners Hospitals, physicians and nursing working together to reduce harm Surgical Care Outcomes Assessment Project (SCOAP) Northwest Organization of Nurse Executives (NWONE) Qualis Health Many others 17

  6. Medical Evidence Known for Over 15 YearsPerioperative Glycemic Control Reduces Mortality and Reduces Complications 18

  7. Many National Articles on Death and Complications 1. Alexanian, S., McDonnell, M., and Akhtar, S. 2. Umpierrez M.D., G. et al 3 19 Evidence indicates that hyperglycemia during the perioperative period for surgery is a marker of poor clinical outcome and mortality.1 In general surgery patients, the risk for “serious” postoperative infections (sepsis, pneumonia, and wound infection) increased 5.7-fold when any postoperative day one blood glucose was > 220 mg/dL.2

  8. Composite InfectionHyperglycemia vs No HyperglycemiaAll Patients 30% of all hyperglycemic patients were not diabetic! All p<0.01 SCOAP data courtesy of Sung (Steve) Kwon 20

  9. Composite InfectionHyperglycemia vs No Hyperglycemia Non-Diabetic Patients Diabetic Patients SCOAP data courtesy of Sung (Steve) Kwon 21

  10. Mortality in Hyperglycemic Patients With and Without Use of Insulin SCOAP data courtesy of Sung (Steve) Kwon 22

  11. Questions 23

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