The Prevention of Surgical Site Infection in Elective Colon Surgery

Pubmed Article

Infections at the surgical site continue to occur in as many as 20% of elective colon resection cases. Methods to reduce these infections are inconsistently applied. Surgical site infection (SSI) is the result of multiple interactive variables including the inoculum of bacteria that contaminate the site, the virulence of the contaminating microbes, and the local environment at the surgical site. These variables that promote infection are potentially offset by the effectiveness of the host defense. Reduction in the inoculum of bacteria is achieved by appropriate surgical site preparation, systemic preventive antibiotics, and use of mechanical bowel preparation in conjunction with the oral antibiotic bowel preparation. Intraoperative reduction of hematoma, necrotic tissue, foreign bodies, and tissue dead space will reduce infections. Enhancement of the host may be achieved by perioperative supplemental oxygenation, maintenance of normothermia, and glycemic control. These methods require additional research to identify optimum application. Uniform application of currently understood methods and continued research into new methods to reduce microbial contamination and enhancement of host responsiveness can lead to better outcomes.

Partnering with Patients and Families to Strengthen Approaches to the Opioid Epidemic

Institute for Patient and Family Centered Care (IPFCC)

This whitepaper showcases the many opportunities for patients, families, and individuals with lived experience to collaborate in shaping and implementing policies and programs related to the opioid epidemic. While work in this area is evolving, several “spotlight examples” provide a starting point for thinking about new strategies and opportunities and reflect existing structures that can be utilized and expanded to accelerate the process of building meaningful partnerships.

Assessment of the Appropriateness of Antimicrobial Use in US Hospitals

Journal of the American Medical Association (JAMA) & Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

Importance Hospital antimicrobial consumption data are widely available; however, large-scale assessments of the quality of antimicrobial use in US hospitals are limited.

Objective  To evaluate the appropriateness of antimicrobial use for hospitalized patients treated for community-acquired pneumonia (CAP) or urinary tract infection (UTI) present at admission or for patients who had received fluoroquinolone or intravenous vancomycin treatment.

Conclusions and Relevance The findings suggest that standardized assessments of hospital antimicrobial prescribing quality can be used to estimate the appropriateness of antimicrobial use in large groups of hospitals. These assessments, performed over time, may inform evaluations of the effects of antimicrobial stewardship initiatives nationally.

Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel

National Pressure Injury Advisory Panel (NPIAP)

The purposes of this National Pressure Injury Advisory Panel (NPIAP) Position Paper are to:

  1. Summarize the current NPIAP position regarding unavoidable pressure injuries.
  2. Examine the effects of the COVID-19 crisis on the scope of what is considered an unavoidable pressure injury.
  3. State the position of the NPIAP regarding determinations of unavoidable pressure injuries during the COVID-19 crisis.
  4. Renew the NPIAP call to collaborate on the development of criteria for the determination of unavoidable pressure injuries in acute care.

Unavoidable Pressure Injury during COVID-19 Pandemic: A Position Paper from the National Pressure Injury Advisory Panel

National Pressure Injury Advisory Panel (NPIAP)

The purposes of this National Pressure Injury Advisory Panel (NPIAP) Position Paper are to:

  1. Summarize the current NPIAP position regarding unavoidable pressure injuries.
  2. Examine the effects of the COVID-19 crisis on the scope of what is considered an unavoidable pressure injury.
  3. State the position of the NPIAP regarding determinations of unavoidable pressure injuries during the COVID-19 crisis.
  4. Renew the NPIAP call to collaborate on the development of criteria for the determination of unavoidable pressure injuries in acute care.

Skin Manifestations with COVID-19

National Pressure Injury Advisory Panel (NPAIP)

Many reports are occurring concerning areas of purpuric/purple skin and purple toe lesions in patients diagnosed with COVID-19 (SARS-CoV-2). Wound care providers are being asked if these skin lesions are forms of Deep Tissue Pressure Injury and/or “skin failure”. Early reports of COVID-19 related
skin changes included rashes, acral areas of erythema with vesicles or pustules (pseudo-chilblain), other vesicular eruptions, urticarial lesions, maculopapular eruptions, and livedo or necrosis. The pattern and presentation of skin manifestations with COVID-19 is more than rashes. The purpose of this paper is to guide the wound care clinician in determining if the “purple skin” being seen is a deep tissue pressure injury or a cutaneous manifestation of COVID-19.