Surgical Care Improvement

Surgical infections remain a common complication of surgery. Surgical site infections account for approximately 40% of all hospital-associated infections among surgical patients in the USA, and 3% of all post-operative patients will develop infections. Using preventative measures, such as appropriate antibiotics before, during and up to 24 hours after surgery, clipping the operative site versus shaving, and keeping the patient warm during the perioperative period, has been shown to reduce the likelihood of infection as a complication. These measures show some of the standards of care.

Key

	At or better than U.S. National average
	Near National average
	Room for Improvement

Blue Ribbon = best possible value

Additional information is available by clicking the links highlighted in blue.

Nassau University Medical Center
	Hospital Quality Measures	NUMC	National Average
In-patient Surgical Care Infection Prevention measures of care: July 1, 2014 – June 30, 2015
SCIP-Inf-1 Risk-Adjusted Percent of surgery patients who were given an antibiotic at the right time (within one hour before surgery) to help prevent infection Surgical wound infections can be prevented. Medical research shows that surgery patients who get antibiotics within the hour before their surgery are less likely to get wound infections. Getting an antibiotic earlier, or after surgery begins, is not as effective. Hospital staff should make sure surgery patients get antibiotics at the right time. Higher percentages are better.	Prophylactic antibiotic received within one hour prior to surgical incision		99
SCIP-Inf-2 Percent of surgery patients who were given the right kind of antibiotic to help prevent infection Surgical wound infections can be prevented. Medical research has shown that certain antibiotics work better to prevent wound infections for certain types of surgery. Hospital staff should make sure patients get the antibiotic that works best for their type of surgery. Higher percentages are better.	Prophylactic antibiotic selection for surgical patients		99
SCIP-Inf-3 Percent of surgery patients whose preventive antibiotics were stopped at the right time (within 24 hours after surgery) Antibiotics are often given to patients before surgery to prevent infection. Taking these antibiotics for more than 24 hours after routine surgery is usually not necessary. Continuing the medication longer than necessary can increase the risk of side effects such as stomach aches and serious types of diarrhea. Also, when antibiotics are used for too long, patients can develop resistance to them and the antibiotics won’t work as well. Higher percentages are better.	Prophylactic antibiotics discontinued within 24 hours after surgery end time		98
SCIP-Card-2 Percent of surgery patients who were taking heart drugs called beta blockers before coming to the hospital, who were kept on the beta blockers during the period just before and after their surgery It is often standard procedure to stop patients’ usual medications for awhile before and after their surgery. But if patients who have been taking beta blockers suddenly stop taking them, they can have heart problems such as a fast heart beat. For these patients, staying on beta blockers before and after surgery makes it less likely that they will have heart problems. Higher percentages are better.	Surgery patients on Beta-Blocker Therapy prior to admission who received a Beta-Blocker during the perioperative period		98
SCIP-VTE-2 Percent of patients who got treatment at the right time (within 24 hours before or after their surgery) to help prevent blood clots after certain types of surgery Many factors influence a surgery patient’s risk of developing a blood clot, including the type of surgery. When patients stay still for a long time after some types of surgery, they are more likely to develop a blood clot in the veins of the legs, thighs, or pelvis. A blood clot slows down the flow of blood, causing swelling, redness, and pain. A blood clot can also break off and travel to other parts of the body. If the blood clot gets into the lung, it is a serious problem that can sometimes cause death. Treatments to help prevent blood clots from forming after surgery include blood-thinning medications, elastic support stockings, or mechanical air stockings that help with blood flow in the legs. These treatments need to be started at the right time, which is typically during the period that begins 24 hours before surgery and ends 24 hours after surgery. Higher percentages are better.	Surgery patients who received appropriate Venous Thromboembolism Prophylaxis within 24 hours prior to surgery, to 24 hours after surgery		100
SCIP-UC-1 Percent of surgery patients whose urinary catheters were removed on the first or second day after surgery Sometimes surgical patients need to have a urinary catheter, or thin tube, inserted into their bladder to help drain the urine. Catheters are usually attached to a bag that collects the urine. Surgery patients can develop infections when urinary catheters are left in place too long after surgery. Infections are dangerous for patients, cause longer hospital stays, and increase costs. Higher percentages are better.	Surgery patients whose urinary catheters were removed on the first or second day after surgery.		98

Surgical Care Improvement

Key

Additional information is available by clicking the links highlighted in blue.

Risk-Adjusted

Percent of surgery patients who were given an antibiotic at the right time (within one hour before surgery) to help prevent infection

Percent of surgery patients who were given the right kind of antibiotic to help prevent infection

Percent of surgery patients whose preventive antibiotics were stopped at the right time (within 24 hours after surgery)

Percent of surgery patients who were taking heart drugs called beta blockers before coming to the hospital, who were kept on the beta blockers during the period just before and after their surgery

Percent of patients who got treatment at the right time (within 24 hours before or after their surgery) to help prevent blood clots after certain types of surgery

Percent of surgery patients whose urinary catheters were removed on the first or second day after surgery

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