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Martin Kiernan speaks on implementing the quality standard in practice

Martin KiernanMartin Kiernan

Martin began his presentation by focusing on why do we need the Standard? The following key points were highlighted:

- SSI are avoidable Healthcare-associated Infections
- NICE guidance is based on robust evidence
- Although more is always needed
- SSIs are a significant burden
- The standards are a concise set of statements designed to drive measurable quality improvements

The presentation went on to look at surgical site infection:
- So…. Why did SSI figure so strongly in the latest national prevalence study
- Shorter length of stay etc
- Possibly the most preventable healthcare-associated infection
- Evidence exists for much of what we do
- Could it possibly be that NICE CG74 has not been universally adopted (and implemented)??

The Magnificent Seven..
Evidence based; Preoperative preparation; Antibiotic prophylaxis; Normothermia; Discipline; Information; Treatment
Surveillance; PANDITS – scholars or teachers

Martin furthermore advised on treatment:
People with SSI are offered treatment with an antibiotic that covers the likely causative organisms and is selected based on local resistance patterns and the results of microbiological tests
Implementation
- Antibiotic policies are based on local resistance patterns, evidenced by update process
- Local audit of patients with SSI to check for treatment in line with policy

Surveillance:
People having surgery are cared for by healthcare providers that monitor SSI rates (including post-discharge infections) and provide feedback to relevant staff and stakeholders for continuous improvement through adjustment of clinical practice
Implementation:
- Surveillance schemes – CCG to fund and agree
- Feedback mechanisms
- Action plans
- Readmission rates

The presentation was concluded by focusing on the standards which are based on the best available evidence and there should be no argument about their introduction. 
The ones that got away:
- Pre-op skin prep
Alcohol plus Chlorhexidine or Iodine
- Antimicrobial sutures
Those responsible for commissioning a service should take an active interest in the quality of what they are buying.

The key points form the presentation:

- Why do we need the Standard: SSI are avoidable Healthcare-associated Infections
- Surgical site infection is possibly the most preventable healthcare-associated infection, there is evidence for a lot of things that we do
- It's important to follow up on infection control
- Preparation: goal is to ensure that those having surgery have clean skin without unnecessary micro-abrasions from shaving
- Every surgeon should read 'The Checklist Manifesto' by Atul Gwande
- You should learn from 'near misses', why not maintain a log 

Scroll down for full presentation

 

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Download: Martin Kiernan's Presentation

16 September 2014

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    Partner Organisations

    The Tavistock and Portman NHS Foundation TrustInPracticeClinical Audit Support CentrePlayoutJust For Nurses
    GGI (Good Governance Institute) accredited conferences CPD Member ASGBI (Association of Surgeons of Great Britain and Ireland) professional partner BADS (British Association of Day Surgery) accredited conferences