Download Panel - Marlies van Dijk

Checklist overlap:
Prevention of
Surgical Site Infection
and
Venous Thromboembolism
Marlies van Dijk,
Western Node Leader
Safer Healthcare Now!
Safe Surgery Saves Lives – March 4, 2009
Safer Healthcare Now!
Started in 2005
• Provide support to healthcare teams to implement
evidence based practice (10 interventions)
• Getting Started Kits, Tools, Measurement worksheets
• Web platform: Communities of Practice
• Over 1000 National Clinical Teams working on various
interventions
• 177 SSI teams (229 surgical procedures) – since 2005
• 13 VTE teams (New intervention in 2008)
Supports the Checklist
• Systematic way of looking at the problems
• Establishing communication
• Breaking Silos
Checklist opens the door :
- Universal framework for surgical care
- To build stronger teams
- To speak up!
- Bringing patient safety culture into the OR
 Patient positioning and
support / Warming devices
 ASA Class
Postoperative glucose
and temperature
 Expected
procedure time
 Medications
- Antibiotic prophylaxis: double dose?
- Glycemic control
- Anticoagulant therapy (e.g., Warfarin)?
-Antibiotic Prophylaxis:
Repeat dose?
-Normothermia?
 VTE Prophylaxis
- Anticoagulant
- Mechanical
Perceptions vs. Reality
Current Status?
• Antibiotic Admininstration within 60 minutes
of incision ~ 50% (Bratzler)
• Antibiotic Discontinuation within 24 hrs of
surgery end time ~ 40% (Bratzler)
• Normothermia; one dedicated team; taken it
from 30-70% over a 2 year period
Routine Use of Recommended Prophylaxis
in Canadian Hospitals
100%
Appropriate use
75%
The care
gap
50%
25%
0
94%
86%
36%
33%
30%
32%
11%
W. Geerts
Interested in Quick and
Sustainable Results
• 40-60% of SSI are preventable
• Antibiotics within 60 minutes of incision is
essential
• Maintain normothermia during surgery
• Easy wins and affordable
• Implementing preprinted order sets for DVT
Tips for Implementation
• Time to consolidate our efforts!
• Quick cycles of the improvement model have
worked for SSI
• Solutions to match local environment
• Present your business case to leadership
• Pockets of excellence – but now what …
• Time sensitive ….
saferhealthcarenow.ca
Surgical Site Infection Lead
Dr. Claude Laflamme, Director of Cardiac Anesthesia/TEE,
Sunnybrook Health Sciences Centre
Venous Thromboembolism Lead
Dr. William Geerts, Senior Scientist,
Sunnybrook Health Sciences Center
Marlies van Dijk
Western Node Leader
Safer Healthcare Now!
[email protected]