1. Western Node Collaborative Surgical Site Infection Prevention

2. Background Victoria General Hospital and the Royal Jubilee Hospital THR & TKR spreading to Colorectal at VGH To reduce Surgical Site Infection rates by applying consistent and reliable changes to the key areas of prophylactic antibiotic administration, hair removal, body temperature monitoring and glucose monitoring. Started Oct 2005 End date Sept 2007 SSI Prevention is congruent with the VIHA wide culture of patient safety which has been successfully developed in our care areas The project has the support of Nurse Managers, Clinical Nurse Educators, Quality Improvement Consultants and a Part Time Coordinator

3. Aim To prevent SSI by implementing four components of care. Initial goal is to reduce our current infection rate by 50% Long Term goal is to eliminate SSI

4. Team Members Project Director Eileen Goudy Nurse Managers: Edna Payne & Petra Hraksy Clinical Nurse Educators: Dayle Mclean & Fern Christensen QI Consultant Sue Vincent SDC, OR & PAR staff Project Coordinator

5. Changes Tested Physician Prepared Orders (PPOs)Have Been Changed Audit Tools Are Being Added to Charts in SDSA Admission Areas Ongoing (slippage) Monitoring

6. Results Run Charts of our Key Measures

10. Keys to Success and Lessons Learned Regular Communication Island Wide Responsibility OR Practice Group Keep It Simple Identify Champions Talk it up!!!

11. Next Steps and Plans for Spread Plans in place to spread to two other hospitals on Vancouver island Identify team members Articulate the support they can expect Identify what is unique about each site Involve Infection Control upfront Exercise Island wide stakeholder mentoring

12. Contact Information Eileen.Goudy@viha.ca Edna.Payne@viha.ca Petra.Hrasky@viha.ca Dale.McLean@viha.ca Fern.Christensen@viha.ca Sue.Vincent@viha.ca Helga.Avila@viha.ca