Partnering to prevent infections

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Sometimes it's good to be below average. Yampa Valley Medical Center's hospital-acquired infection numbers are below the national average, and Infection Preven-

tion Coordinator Meg Montgomery, RN, is working to keep them there.

"Patient safety is the goal and responsibility of everyone who works at YVMC," Montgomery said. "The number-one defense against infection is intensive hand washing. We teach hand hygiene, emphasize it through constant reminders and track compliance monthly in every patient care department."

Another important safeguard is the use of antibiotics before and after surgery. YVMC stays current with the "gold standard" of care in administering medications.

"The number of drug-resistant organisms continues to rise, and we don't want to add to this problem by over-prescribing antibiotics," Montgomery explained. "We have a very limited and precise window of time in which to use antibiotics. These antibiotics are specifically matched to the type of procedure and are used to lower the risk of infection."

Infection prevention measures actually begin before a patient arrives at YVMC for a scheduled surgery. A pre-operative nurse takes a thorough medical history to establish infection risk factors. Each patient is given instructions about washing without irritating the skin the night before surgery.

"We also instruct patients not to shave the operative site or surrounding area prior to surgery," YVMC Quality Services Director Judy Zuccone said. "Shaving may create microscopic openings in the skin that increase the risk for infection."

Patients can help themselves by being in the best possible health prior to surgery. Surgeons and hospital staff encourage patients to follow healthy lifestyle habits. They also discuss infection risk factors, including smoking, drinking excessively, obesity, a history of previous infection or a chronic illness.

Zuccone closely monitors infection prevention at YVMC. "Unfortunately, despite our best efforts, infections can still occur," she said. "This is why, during the pre-operative consent process, your surgeon will always discuss with you the risk of infection."

When even the best precautions and healthiest habits are not enough to prevent a hospital-acquired infection, Montgomery investigates all aspects of patient care in an attempt to find the cause of infection.

"We look at the surgery preparation, staff members, surgeons, the length of surgery, sterile processing of instruments, which operating room was used and our compliance with standards," she said. "When infections have occurred, we have not been able to identify any common source."

Patients are strongly advised to take precautions against infection throughout the recovery process, which could take weeks to months after surgery.

"When in the hospital and upon return home, ensure that your family and any visitors do not have active infections of any type that may put you at risk," Zuccone advised.

YVMC sends patients home with instructions on how to prevent post-operative infections. A nurse also makes a follow-up telephone call to each patient to check on progress.

"It is crucial to understand and comply with these discharge instructions," said David Wilkinson, M.D., medical director of quality management at YVMC.

Montgomery said patients are responding to education and advice. "People are asking the right questions and are taking an active role in protecting themselves from infection," Montgomery said.

Any patient who has concerns or questions about infection after surgery is encouraged to call his or her physician. Montgomery also is available at 871-2430.

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