Free Essay: Review of Regulations and Standards for Surgical Site Infection

Surgical site infection is the contagion or negative effect that occurs on the site of surgical operation. Particularly, this infection usually happens at or around the part of the body where the operation was performed. Additionally, surgical site infections can be superficial where the only part involved is the dermis (Mangram, 2009). However, other infections can be more profound that may affect the parts under the skin like epidermis. Several regulations have been put in place to prevent the infections that arise out of surgeries. These regulations are contained in different instruments that are devised to safeguard people who undergo the service. The instruments that contain these regulations and standards include Center for Disease Control and Prevention (CDC), Occupational Safety and Health Administration (OSHA), Centers for Medicare and Medicaid (CMS), Joint Commission, and New York State Department of Health (NYSDOH).

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The Center for Disease Control and Prevention (CDC) has provided several guidelines that are supposed to be obeyed before a medical practitioner performs an operation (Cdc.gov, 2015). These guidelines include the cleaning of hands and arms with an antiseptic agent before performing an operation, which should be washed up to the elbow. Additionally, before and after caring for each patient, CDC requires that doctors and nurses disinfect their hands using an alcohol-based hand rub or with plenty of soap and water. According to Cdc.gov (2015), doctors/nurses should remove excessive hair before the surgery if the hair is on or around the area of surgery. This can be done through the use of electric clippers. To keep the surgery area free from germs, doctors and nurses should cover their hair, wear masks, gloves and gowns in the course of the surgery. Finally, Sixty minutes before the start of the surgical operation, the patient should take antibiotics. The intake should, however, be discontinued 24 hours after the surgical operation.

Occupational Safety and Health Administration (OSHA) standards, on the other hand, provide adequate information on how to keep a workplace healthy and safe. According to Dimenstein (2015), OSHA contains mechanisms for the enforcement of those measures so that doctors and nurses do not ignore them. Specifically, OSHA standards require that a surgical medic should wear masks as well as protective eyewear such as goggles or solid shielded glasses. These materials prevent the splashes of blood from reaching him/her. Additionally, they avert infectious materials that may drop out of the eye, nose or mouth from contaminating the surgical area in the course of the surgery (Dimenstein, 2015). Further, the standards demand that any garment worn by a doctor or nurse that has been penetrated by blood should be removed immediately after the surgery and before the surgeon proceeds to the next patient. Surgical caps and hoods, as well as shoe covers/boots, should be worn as a precautionary measure. This is particularly important where the surgeon anticipates gross contamination.

The Centre for Medicare and Medicaid (CMS) has some other regulation and standards that are used to ensure that surgical site infections are prevented and properly handled if they happen. However, this instrument is more of an enforcement mechanism than a regulatory one (Cms.gov, 2015). In this regard, CMS is concerned with regulating all the matters about laboratory testing. In so doing, it uses the Clinical Laboratory Improvement Amendments (CLIA) whereby it covers more than 251,000 laboratory entities. Additionally, its concern is on laboratory testing that is of high quality and free from infections. Moreover, all laboratories must be certified fully in order for them to receive any payment from CMS. Particularly, the center has quality control mechanisms that it uses to gauge the safety of the laboratories (Cms.gov, 2015).

The Joint Commission (TJC) is an organ that accredits more than 20,000 healthcare facilities in the United States. Its functions are to raise the standard of healthcare in the US. In so doing, it investigates the quality of service that a healthcare organization offers before it accredits it to continue operating. As such, any facility that does not follow the regulations on surgical site infection set out in CMD and OSHA is not accredited. The New York State Department of Health (NYSDOH) is the last arm that regulates by setting standards the prevalence of surgical site infections. To achieve this, it ensures that all facilities of health in New York offer quality care. Specifically, NYSDOH ensures that doctors and nurses are well equipped before operations so that they do not contaminate the surgical sites. Additionally, it works with the local communities to ensure that infectious diseases that can contaminate the surgical sites are eliminated.

Teaching Strategies and Resources

When teaching on the prevention of surgical site infection, the instructor needs to have different apparatus that are used in the performance of surgical operations. Specifically, there are a number of things required in a class for the prevention of surgical site infections. The instructor will require using the following strategies and resources for the students to be able to understand how surgical site infections can be prevented.

Teaching Strategies

To demonstrate how to prevent surgical site infection, the instructor should use experiment as the strategy. Firstly, he/she should open all the windows to ensure that there is an adequate supply of air. In any case, proper ventilation is one of the requirements for any surgical operation. Next, he/she will have to wear the protective garments, protective eyewear, as well as the gumboots. This should happen before the start of the surgical operation. Afterwards, the instructor should wash his/her hand with soap and plenty of water. After that, he/she should wear two pairs of the sterile gloves. The instructor then takes the species that is the subject of the surgery and cleans using the antiseptic liquid. This ensures that the site is clean and free from any foreign micro-organisms which might be infectious. Before the start of the surgery, he/she should disinfect all the surgical equipment.

Teaching Resources

Species

This should be in the form of a tissue of the skin that will be used as the surgical site. It could be the tissue of an animal that will represent the dermis, and which is used as the surgical site in a real surgical operation. The species should possibly be two to ensure that the transition of successive operations can be best explained.

Antiseptic Liquid

This is required to clean the surgical site before the beginning of the surgical operation. This liquid can be in the form of clinical spirit. This spirit kills almost all the germs that can be present in the surgical site. Additionally, the liquid keeps the site free from any contamination in the course of the surgical operation.

Soap and Water

These are needed as they are used as the method of cleaning the hands of the surgeon. The water should be clean and free from germs. The soap, on the other hand, should be one which kills almost 100% of all germs. As such, it should not just be an ordinary soap but soap that is proven to kill the majority of germs upon washing hands.

Scrub Suits/Protective Garments

It will be important that the teacher has his/her own garment that will be worn in the course of the operation. A scrub suit is a uniform that consist of a shirt and a pair of pants. This garment should be those that are prescribed by the CDC and OSHA standards. In this case, it should be able to prevent the penetration of the blood in case it spills from the species (Tortorice, 2015). Additionally, it should be free from germs as it can contaminate the surgical site of the species. Further, every person that will be involved in the operation should have two garments that will be used in the two surgical operations.

Eyewear; Goggles/Solid Shielded Glasses

As mentioned earlier, it is a requirement that nurses and doctors should wear protective eye wears that can prevent foreign materials from accessing the surgical sites. As such, in the class teaching, the instructor should wear protective eyewear in the course of the surgery.

Masks

Surgical masks are important in surgical operations as they prevent incidences of microbial contamination. Specifically, the wearing of these masks is fundamental in protecting the nose and mouth from inadvertent exposures such as the spillage of blood from the surgical site.

Surgical Caps/Hoods and Gumboots

To prevent the surgical site from infection by the surgeons hair and scalp, it is important that the instructor procures a surgical cap/hood. Gumboots/shoe covers reduce the number of infectious organisms that might get access to the operating suite. Additionally, surgical gumboots will help in preventing the instructor from exposure to blood and other body fluids in the course of surgical operation.

Sterile Gloves

After the instructor has donned the sterile gowns, it is important that he/she wears the sterile gloves. This is meant to prevent the transmission of micro-organisms from the hands of the surgical team to the surgical site. Additionally, they prevent the contamination of the doctors/nurses hands with the patients blood and other body fluids. Possibly, the instructor should procure two pairs of sterile gloves as the wearing of two gloves has been shown to reduce any possibility of micro-organisms being transmitted from the surgeons hands to the surgical site.

Surgical Gowns and Drapes

To create a form of barrier between the surgical site and any potential sources of bacterial, it is important that a surgeon wears surgical gowns/drapes before the start of the surgical operation. These gowns and drapes can either be disposable or reusable. According to Gray & Hawn (2015), the gowns should not be able to permit any traces of blood and body liquids. This is both important for the surgeon as well as the patient. In any case, the gowns should be reinforced with membranes coatings or films so as to be up to the standards required of them by the American Society for Testing and Materials.

Antibiotics

These are used to prevent the effect of any antibodies that might have invaded the body through the surgical site in the course of the operation. They are supposed to be administered immediately after the operation so that any effects of infection will be countered. It is important that they are procured because they serve as preventive measures.

References

Cdc.gov,. (2015). CDC - FAQs about SSI's - HAI. Retrieved 19 November 2015, from http://www.cdc.gov/HAI/ssi/faq_ssi.html

Cms.gov,. (2015). Regulations & Guidance - Centers for Medicare & Medicaid Services. Retrieved 19 November 2015, from https://www.cms.gov/Regulations-and-Guidance/Regulations-and-Guidance.html

DIMENSTEIN, I. (2015). OSHA standards for infection exposure in the surgical pathology laboratory - GROSSING TECHNOLOGY in SURGICAL PATHOLOGY. GROSSING TECHNOLOGY in SURGICAL PATHOLOGY. Retrieved 19 November 2015, from http://grossing-technology.com/osha-standards-for-infection-exposure-in-the-surgical-pathology-laboratory/Gray, S., & Hawn, M. (2015). Prevention of Surgical Site Infections. S U R G I C A L P A T I E N T C A R E S E R I E S.

Mangram, A. (2009). GUIDELINE FOR PREVENTION OF SURGICAL SITE INFECTION, 1999. INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 247, 10-22. Retrieved from http://www.cdc.gov/hicpac/pdf/SSIguidelines.pdf

Tortorice, J. (2015). CEUFast - Surgical Site Infection Surveillance (infection co). Ceufast.com. Retrieved 19 November 2015, from https://ceufast.com/course/surgical-site-infection-surveillance-infection-co