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Quality Definitions and Methodology

Effective Surgical Care

Hospitals can reduce the risk of wound infection after surgery by providing the right medicines at the right time on the day of surgery.

OP-7. Prophylactic Antiobiotic Selection

Hospitals can prevent surgical wound infections. Medical research shows that surgery patients who get antibiotics within the hour before their surgery are less likely to get wound infections.

Hospital staff should make sure patients get the antibiotic that works best for their type of surgery.

Higher numbers are better.

SCIP-CARD-2. Patients on beta blocker at admission who received beta blocker during perioperative period

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 numbers are better.

SCIP-INF-2. Prophylactic Antibiotic Selection

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 numbers are better.

SCIP-INF-4. Blood glucose controlled in days following heart surgery

Even if heart surgery patients do not have diabetes, keeping their blood sugar under good control after surgery lowers the risk of infection and other problems. "Under good control" means their blood sugar should be 200 mg/dL or less when checked first thing in the morning.

Higher numbers are better.

SCIP-INF-6. Safe method of hair removal from surgical site used when needed

Preparing a patient for surgery may include removing body hair from skin in the area where the surgery will be done. Medical research has shown that shaving with a razor can increase the risk of infection. It is safer to use electric clippers or hair removal cream.

Higher numbers are better.

SCIP-INF-9. Urinary catheter removed within two days following 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.

This shows the percent of surgery patients whose urinary catheters were removed on the first or second day after surgery. Research shows that most surgery patients should have their urinary catheters removed within 2 days after surgery to help prevent infection.

Higher numbers are better.

SCIP-INF-10. Patients having surgery who were actively warmed in the operating room or whose body temperature was near normal by the end of surgery

Hospitals can prevent surgical wound infections and other complications by keeping the patient's body temperature near normal during surgery. Medical research has shown that patients whose body temperatures drop during surgery have a greater risk of infection and their wounds may not heal as quickly. Hospital staff should make sure that patients are actively warmed during and immediately after surgery to prevent drops in body temperature.

This measure shows the percent of patients whose body temperature was normal or near normal during the time period 15 minutes before the end of surgery to 30 minutes after anesthesia ended.

SCIP-VTE-1. Recommended Venous Thromboembolism Prophylaxis Ordered

Certain surgeries increase the risk that the patient will develop a blood clot (venous thromboembolism). 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 cause death.

To help prevent blood clots from forming after surgery, doctors can order treatments to be used just before or after the surgery. These include blood-thinning medications, elastic support stockings, or mechanical air stockings that help with blood flow in the legs.

Higher numbers are better.