THE IMPORTANCE OF BEING NURSE:
THE IMPORTANCE OF BEING NURSE:
A KEY-ROLE IN PERIOPERATIVE CARE
A KEY-ROLE IN PERIOPERATIVE CARE
AND A MISSION OF RESPONSIBILITY
AND A MISSION OF RESPONSIBILITY
SALVATORE GIAMPICCOLO
SALVATORE GIAMPICCOLO
P.O. “Michele Chiello”
THE IMPORTANCE OF BEING
THE IMPORTANCE OF BEING
NURSE: A KEY-ROLE IN
NURSE: A KEY-ROLE IN
PERIOPERATIVE CARE AND A
PERIOPERATIVE CARE AND A
MISSION OF RESPONSIBILITY
MISSION OF RESPONSIBILITY
quality of results
quality of results
evaluates
evaluates
quality of performance
quality of performance
and then
and then
KEY-ROLE OF
KEY-ROLE OF
THE NURSE
THE NURSE
This is
the
question
KEY-ROLE IN THE
KEY-ROLE IN THE
PERIOPERATIVE CARE
PERIOPERATIVE CARE
PREVENTION OF THE
PREVENTION OF THE
SURGICAL SITE INFECTIONS
SOMETHING ABOUT SSI*
SOMETHING ABOUT SSI*
90% of SSI are contracted in the operating theatre
Staff behaviour
Importance of prevention
*Surgical Site Infection *Surgical Site Infection
MEASURES OF DEMONSTRATED
MEASURES OF DEMONSTRATED
EFFECTIVENESS
EFFECTIVENESS
• Sterilization
• Hand washing
• Closed-circuit vesical catheterization
• Correct management of cardiovascular
catheter s
• Sterile clothing in the operating theatre
NURSING RESEARCH IN OPERATING
THEATRE*
• Senic* Project
*Study on the Efficacy of Nosocomial Infection Control
• Predictability of SSI – Importance of Behaviour
• Guidelines
Guideline for Prevention of Surgical Site
Infection, 1999
Linee Guida sulla Profilassi
Studio sulla diffusione ed adozione delle
Linee Guida per la Prevenzione delle ISC*
Salvatore Giampiccolo
P.O. “Michele Chiello” Piazza Armerina
AUSL 4 Enna
*
*Infezioni del Sito ChirurgicoInfezioni del Sito Chirurgico
Foreword: dr.ssa Maria Luisa Moro
Foreword: dr.ssa Maria Luisa Moro
Doors in the
Doors in the
operating theatre
operating theatre
are:
are:
The global national value is 44%, with a fluctuation from a
minimun of 22,22% to a maximum of 65,63%
Is the area of surgical cut washed before the
Is the area of surgical cut washed before the
disinfection of the operating field?
disinfection of the operating field?
The global national
value is 49%, with a
fluctuation from a
Is the antibiotic prophylaxis practised
Is the antibiotic prophylaxis practised
before the induction?
before the induction?
The global national value is 57%, with a fluctuation from a minimum of 27,27%
To a maximum of 76,92%
Are the carpets, shoe covers and nebulizers,
Are the carpets, shoe covers and nebulizers,
used to prevent infections?
used to prevent infections?
The global national
value is
40%, with a fluctuation
After contaminated or dirty operations, is the
After contaminated or dirty operations, is the
operation theatre closed or subjected to special
operation theatre closed or subjected to special
cleaning?
cleaning?
The global national value
is
17%, with a fluctuation
from a minimum of 0%
Right answer: never
Do you usually carry out the microbiological
Do you usually carry out the microbiological
sampling of the air and surfaces of the
sampling of the air and surfaces of the
operating theatre?
operating theatre?
The global national
value is 21%, with a
fluctuation from a
minimun
The value of guidelines
The value of guidelines
• To spread the guidelines
• To check their application
• To assess the performance of the individual
• To acquire results
EBN
EBN
SKILLS
SKILLS
TO KNOW
TO KNOW
TO BE ABLE TO DO
TO BE ABLE TO DO
DAILY BEHAVIOUR
DAILY BEHAVIOUR
PREFERENCES OF
PREFERENCES OF
PATIENTS
PATIENTS
AVAILABLE
AVAILABLE
RESOURCES
RESOURCES
AUTONOMY
AUTONOMY
RESPONSIBILITY
RESPONSIBILITY
TO PLAN– TO ASSESS = RESULTS
STANDARD TOOLS
STANDARD RESULTS?
GUIDELINES
PROTOCOLS
PROCEDURES
BEHAVIOURAL VARIABLE
(Tool that can’t be standardized)
VALIDATION OF DEI BEHAVIOUR
CONSOLIDATED HABITS NEVER
SUBJECTED TO VERIFICATION OF SCIENTIFIC
VALIDITY BECAUSE THEY WERE NEVER
MEASURED WITH INDICATORS
CAN WE DO BETTER?
CAN WE DO BETTER?
quoted in
quoted in Richard Platt, MD, Msc, Progress in Surgical-Site Infection Surveillance Richard Platt, MD, Msc, Progress in Surgical-Site Infection Surveillance
