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CPH says Project JOINTS bringing impressive results

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POTSDAM - Just four months after launching its Project JOINTS (Joining Organizations in Tackling Surgical Site Infections) initiative in April of 2011, Canton-Potsdam Hospital (CPH) began seeing impressive results of zero surgical site infections for elective total knee and hip replacement surgeries.

CPH is now in its 19th consecutive month with zero infections. Only a few hundred organizations across the country, including CPH, were invited to participate in trialing Project JOINTS, an initiative of the Institute of Healthcare Improvement (IHI). Results of the trial have shown significant reduction in SSIs. Based on this success, IHI is now expanding Project JOINTS nationally as a best practice for all healthcare facilities.

CPH staff have been formally invited to speak at the IHI’s 24th annual National Forum on Thursday. Participating will be members of the hospital’s operating room, ambulatory surgery, lab, and infection prevention team including Lisa McDonald, Karen Cox, Jeanette Dempsey, Nancy Foisy, Sally Remington, and Nancy Wood. Participants will share their process for implementing the project and how they are able to maintain their zero SSIs status through utilization of these best practices.

“The Project JOINTS Program holds healthcare organizations to a rigorous set of standards and protocols to follow. To ensure the best care for our patients, we’ve been diligent to adhere to those standards,” noted Sue Hodgson, MHSA, RN, CPHQ, FACHE, vice president of Quality and Performance Improvement and Chief Nursing Officer. “We recognize return visits, readmission, prolonged therapy, repeat surgeries, and redundant imaging scans are typically unnecessary if we all perform consistently. Through this program, we work collaboratively with our patients and set them up for a successful recovery.”

Infection prevention specialist at CPH expressed the criticality of re-evaluating and re-identifying areas that pose risks for infection prior to making an incision. Correct hand washing, skin preparation, and proper protective wear (gowns, masks, gloves, and hair covers) dramatically reduce the presence of bacteria. Equally as important to minimizing the risk for an infection is the precise timing and dosage of antibiotics.

“Success is tightly hinged on pre-screenings and patient education,” said Lisa McDonald, BSN, RN, RNFA, CNOR, CPH Project JOINTS coordinator.

“Our Pre-op Nurses provide education and one-on-one consults prior to surgery to ensure everyone is comfortable with the pre and post-surgery expectations. During a consult, patients participate in a simple nasal swab screening to determine the presence of bacteria. Depending on the results, some patients might require a second set of cleansing wipes to use or the provider might prescribe antibiotics be administered. It’s very common for individuals to test positive; however, we’ve adopted best practice measures to eliminate the bacteria from the skin so that it does not get into the wound and develop into an infection,” McDonald added.

As a natural extension of Project JOINTS, CPH and its providers have adopted additional processes for reducing infections. Recently CPH established a multimodal total joint pain protocol, wherein providers develop a combination of medications for each patient, depending on their individual needs.

“Pain management is an integral part of healing. Similar to uncontrolled blood sugar contributing to higher rates of infection and slower wound healing, high pain levels after surgery can also increase complications and risks,” McDonald noted.

CPH’s quality and safety results are monitored and assessed by external organizations that benchmark against national standards and report out progress to the public. Individuals can compare hospitals in their area by visiting http://medicare.gov/hospitalcompare/ and typing in a zip code or hospital name.

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