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Guide for the Prevention of Mediastinitis Surgical Site Infections Following Cardiac Surgery",[649],{"type":573},{"text":651,"type":303},". APIC; 2008. ",{"text":653,"type":303,"marks":654},"https://apic.org/wp-content/uploads/2019/02/APIC-Mediastinitis-Elimination-Guide.pdf",[655,657],{"type":355,"attrs":656},{"href":653,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":659},[660,671],{"type":15,"attrs":661,"content":662},{"textAlign":53},[663,665],{"text":664,"type":303},"Canadian Journal of Infectious Diseases and Medical Microbiology ",{"text":666,"type":303,"marks":667},"https://www.hindawi.com/journals/cjidmm",[668,670],{"type":355,"attrs":669},{"href":666,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":495,"content":672},[673],{"type":498,"content":674},[675],{"type":15,"attrs":676,"content":677},{"textAlign":53},[678,680,684,686],{"text":679,"type":303},"Chow AW, Evans GA, Nathens AB, et al. Canadian practice guidelines for surgical intra-abdominal infections. ",{"text":681,"type":303,"marks":682},"Can J Infect Dis Med Microbiol J Can Mal Infect Microbiol Medicale",[683],{"type":573},{"text":685,"type":303},". 2010;21(1):11-37. doi:10.1155/2010/580340 ",{"text":687,"type":303,"marks":688},"Canadian Practice Guidelines for Surgical Intra-Abdominal Infections (hindawi.com)",[689,692],{"type":355,"attrs":690},{"href":691,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":401},"https://www.hindawi.com/journals/cjidmm/2010/580340/",{"type":512},{"type":498,"content":694},[695,706],{"type":15,"attrs":696,"content":697},{"textAlign":53},[698,700],{"text":699,"type":303},"Canadian Nosocomial Infection Surveillance Program (CNISP) ",{"text":701,"type":303,"marks":702},"https://www.canada.ca/en/public-health/services/surveillance.html#a6",[703,705],{"type":355,"attrs":704},{"href":701,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":495,"content":707},[708],{"type":498,"content":709},[710],{"type":15,"attrs":711,"content":712},{"textAlign":53},[713,715],{"text":714,"type":303},"Canadian Patient Safety Institute. CNISP Protocols. The Canadian Nosocomial Infection Surveillance Program (CNISP) Publications. ",{"text":716,"type":303,"marks":717},"https://www.healthcareexcellence.ca/en/resources/healthcare-associated-infection-surveillance/the-canadian-nosocomial-infection-surveillance-program-cnisp-publications/",[718,720],{"type":355,"attrs":719},{"href":716,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":401},{"type":512},{"type":498,"content":722},[723,734],{"type":15,"attrs":724,"content":725},{"textAlign":53},[726,728],{"text":727,"type":303},"Centers for Disease Control and Prevention ",{"text":729,"type":303,"marks":730},"https://www.cdc.gov/",[731,733],{"type":355,"attrs":732},{"href":729,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":495,"content":735},[736,755],{"type":498,"content":737},[738],{"type":15,"attrs":739,"content":740},{"textAlign":53},[741,743,747,749],{"text":742,"type":303},"Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection. ",{"text":744,"type":303,"marks":745},"JAMA Surg",[746],{"type":573},{"text":748,"type":303},". 2017;152(8):784-791. doi:10.1001/jamasurg.2017.0904 ",{"text":750,"type":303,"marks":751},"https://jamanetwork.com/journals/jamasurgery/fullarticle/2623725",[752,754],{"type":355,"attrs":753},{"href":750,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":756},[757],{"type":15,"attrs":758,"content":759},{"textAlign":53},[760,762],{"text":761,"type":303},"Centers for Disease Control and Prevention (CDC). Central Line-associated Bloodstream Infection (CLABSI). Healthcare-associated Infections. Published April 19, 2019. ",{"text":763,"type":303,"marks":764},"https://www.cdc.gov/hai/bsi/bsi.html",[765,767],{"type":355,"attrs":766},{"href":763,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":769},[770,781],{"type":15,"attrs":771,"content":772},{"textAlign":53},[773,775],{"text":774,"type":303},"CIRCULATION ",{"text":776,"type":303,"marks":777},"https://www.ahajournals.org/journal/circ",[778,780],{"type":355,"attrs":779},{"href":776,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":495,"content":782},[783,802],{"type":498,"content":784},[785],{"type":15,"attrs":786,"content":787},{"textAlign":53},[788,790,794,796],{"text":789,"type":303},"Nishimura Rick A., Carabello Blase A., Faxon David P., et al. ACC/AHA 2008 Guideline Update on Valvular Heart Disease: Focused Update on Infective Endocarditis. ",{"text":791,"type":303,"marks":792},"Circulation",[793],{"type":573},{"text":795,"type":303},". 2008;118(8):887-896. doi:10.1161/CIRCULATIONAHA.108.190377 ",{"text":797,"type":303,"marks":798},"http://circ.ahajournals.org/content/118/8/887.full.pdf",[799,801],{"type":355,"attrs":800},{"href":797,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":803},[804],{"type":15,"attrs":805,"content":806},{"textAlign":53},[807,809,812,814],{"text":808,"type":303},"Warnes Carole A., Williams Roberta G., Bashore Thomas M., et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease. ",{"text":791,"type":303,"marks":810},[811],{"type":573},{"text":813,"type":303},". 2008;118(23):e714-e833. doi:10.1161/CIRCULATIONAHA.108.190690 ",{"text":815,"type":303,"marks":816},"http://circ.ahajournals.org/content/118/23/e714.full.pdf",[817,819],{"type":355,"attrs":818},{"href":815,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":821},[822,833],{"type":15,"attrs":823,"content":824},{"textAlign":53},[825,827],{"text":826,"type":303},"European Heart Journal ",{"text":828,"type":303,"marks":829},"https://www.escardio.org/Journals/ESC-Journal-Family/European-Heart-Journal",[830,832],{"type":355,"attrs":831},{"href":828,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":495,"content":834},[835],{"type":498,"content":836},[837],{"type":15,"attrs":838,"content":839},{"textAlign":53},[840,842],{"text":841,"type":303},"Habib G, Hoen B, Tornos P, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): The Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Eur Heart J. 2009;30(19):2369-2413. doi:10.1093/eurheartj/ehp285 ",{"text":843,"type":303,"marks":844},"http://eurheartj.oxfordjournals.org/content/30/19/2369.long",[845,847],{"type":355,"attrs":846},{"href":843,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":849},[850,861],{"type":15,"attrs":851,"content":852},{"textAlign":53},[853,855],{"text":854,"type":303},"Health and Human Services ",{"text":856,"type":303,"marks":857},"https://www.hhs.gov/",[858,860],{"type":355,"attrs":859},{"href":856,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":495,"content":862},[863],{"type":498,"content":864},[865],{"type":15,"attrs":866,"content":867},{"textAlign":53},[868,870],{"text":869,"type":303},"Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S. Department of Health and Human Services. National HAI Action Plan. health.gov. Published July 24, 2020. ",{"text":871,"type":303,"marks":872},"https://health.gov/our-work/health-care-quality/health-care-associated-infections/national-hai-action-plan",[873,875],{"type":355,"attrs":874},{"href":871,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":877},[878,890],{"type":15,"attrs":879,"content":880},{"textAlign":53},[881,883],{"text":882,"type":303},"Institute for Healthcare Improvement (IHI) ",{"text":884,"type":303,"marks":885},"www.ihi.org",[886,889],{"type":355,"attrs":887},{"href":888,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},"http://www.ihi.org/",{"type":512},{"type":495,"content":891},[892,911],{"type":498,"content":893},[894],{"type":15,"attrs":895,"content":896},{"textAlign":53},[897,899,903,905],{"text":898,"type":303},"Institute for Healthcare Improvement. ",{"text":900,"type":303,"marks":901},"How-to Guide: Prevent Surgical Site Infections",[902],{"type":573},{"text":904,"type":303},". IHI; 2012. ",{"text":906,"type":303,"marks":907},"http://www.ihi.org/resources/pages/tools/howtoguidepreventsurgicalsiteinfection.aspx",[908,910],{"type":355,"attrs":909},{"href":906,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":912},[913],{"type":15,"attrs":914,"content":915},{"textAlign":53},[916,918,922,923],{"text":917,"type":303},"IHI. 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American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. ",{"text":952,"type":303,"marks":953},"J Am Coll Surg",[954],{"type":573},{"text":956,"type":303},". 2017;224(1):59-74. doi:10.1016/j.jamcollsurg.2016.10.029 ",{"text":958,"type":303,"marks":959},"https://www.journalacs.org/article/S1072-7515(16)31563-0/fulltext",[960],{"type":355,"attrs":961},{"href":958,"uuid":53,"anchor":53,"custom":962,"target":400,"linktype":401},{},{"type":498,"content":964},[965,977],{"type":15,"attrs":966,"content":967},{"textAlign":53},[968,970],{"text":969,"type":303},"National Institute for Health and Care Excellence (NICE) ",{"text":971,"type":303,"marks":972},"www.nice.org.uk",[973,976],{"type":355,"attrs":974},{"href":975,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},"http://www.nice.org.uk/",{"type":512},{"type":495,"content":978},[979,992],{"type":498,"content":980},[981],{"type":15,"attrs":982,"content":983},{"textAlign":53},[984,986],{"text":985,"type":303},"National Institute for Health and Care Excellence (NICE). NICE Surgical Site Infections: Prevention and Treatment. NICE; 2019. ",{"text":987,"type":303,"marks":988},"https://www.nice.org.uk/guidance/ng125",[989,991],{"type":355,"attrs":990},{"href":987,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":993},[994],{"type":15,"attrs":995,"content":996},{"textAlign":53},[997,999,1003,1005],{"text":998,"type":303},"National Institute for Health and Care Excellence (NICE). ",{"text":1000,"type":303,"marks":1001},"Prophylaxis against Infective Endocarditis: Antimicrobial Prophylaxis against Infective Endocarditis in Adults and Children Undergoing Interventional Procedures",[1002],{"type":573},{"text":1004,"type":303},". NICE; 2008. ",{"text":1006,"type":303,"marks":1007},"https://www.nice.org.uk/guidance/cg64",[1008,1010],{"type":355,"attrs":1009},{"href":1006,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":1012},[1013,1024],{"type":15,"attrs":1014,"content":1015},{"textAlign":53},[1016,1018],{"text":1017,"type":303},"The Society for Healthcare Epidemiology of America (SHEA) ",{"text":1019,"type":303,"marks":1020},"https://www.shea-online.org/",[1021,1023],{"type":355,"attrs":1022},{"href":1019,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":401},{"type":512},{"type":495,"content":1025},[1026,1045],{"type":498,"content":1027},[1028],{"type":15,"attrs":1029,"content":1030},{"textAlign":53},[1031,1033,1037,1039],{"text":1032,"type":303},"Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. ",{"text":1034,"type":303,"marks":1035},"Infect Control Hosp Epidemiol",[1036],{"type":573},{"text":1038,"type":303},". 2014;35(6):605-627. doi:10.1086/676022 ",{"text":1040,"type":303,"marks":1041},"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4267723/",[1042,1044],{"type":355,"attrs":1043},{"href":1040,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":1046},[1047],{"type":15,"attrs":1048,"content":1049},{"textAlign":53},[1050,1052,1055],{"text":1051,"type":303},"Marschall J, Mermel LA, Fakih M, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. ",{"text":1034,"type":303,"marks":1053},[1054],{"type":573},{"text":1056,"type":303},". 2014;35(7):753-771. doi:10.1086/676533",{"type":498,"content":1058},[1059,1070],{"type":15,"attrs":1060,"content":1061},{"textAlign":53},[1062,1064],{"text":1063,"type":303},"University of Toronto – Best Practice in Surgery ",{"text":1065,"type":303,"marks":1066},"http://bestpracticeinsurgery.ca/",[1067,1069],{"type":355,"attrs":1068},{"href":1065,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":495,"content":1071},[1072],{"type":498,"content":1073},[1074],{"type":15,"attrs":1075,"content":1076},{"textAlign":53},[1077,1079,1083,1085],{"text":1078,"type":303},"Bonnar P, Dhar P, Rotstein O, et al. ",{"text":1080,"type":303,"marks":1081},"Surgical Site Infection Prevention",[1082],{"type":573},{"text":1084,"type":303},". University of Toronto; 2017. ",{"text":1086,"type":303,"marks":1087},"http://bestpracticeinsurgery.ca/wp-content/uploads/2017/11/SSI-BPS-CPG-Nov20.pdf",[1088,1090],{"type":355,"attrs":1089},{"href":1086,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":498,"content":1092},[1093,1105],{"type":15,"attrs":1094,"content":1095},{"textAlign":53},[1096,1098],{"text":1097,"type":303},"World Health Organization ",{"text":1099,"type":303,"marks":1100},"www.who.int",[1101,1104],{"type":355,"attrs":1102},{"href":1103,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},"http://www.who.int/",{"type":512},{"type":495,"content":1106},[1107],{"type":498,"content":1108},[1109],{"type":15,"attrs":1110,"content":1111},{"textAlign":53},[1112,1114,1118,1120],{"text":1113,"type":303},"World Health Organization. ",{"text":1115,"type":303,"marks":1116},"Global Guidelines for the Prevention of Surgical Site Infection",[1117],{"type":573},{"text":1119,"type":303},". World Health Organization; 2018. ",{"text":1121,"type":303,"marks":1122},"https://www.ncbi.nlm.nih.gov/books/NBK536404/pdf/Bookshelf_NBK536404.pdf",[1123,1125],{"type":355,"attrs":1124},{"href":1121,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},"Clinical and System Reviews, Incident Analyses",{"type":12,"content":1128},[1129,1134,1140,1173],{"type":15,"attrs":1130,"content":1131},{"textAlign":53},[1132],{"text":1133,"type":303},"Given the broad range of potential causes of Post Procedural Infections, in addition to recommendations listed above, we recommend conducting clinical and system reviews to identify latent causes and determine appropriate recommendations.",{"type":15,"attrs":1135,"content":1137},{"textAlign":1136},"left",[1138],{"text":1139,"type":303},"Occurrences of harm are often complex with many contributing factors. Organizations need to:",{"type":1141,"attrs":1142,"content":1144},"ordered_list",{"order":1143},1,[1145,1152,1159,1166],{"type":498,"content":1146},[1147],{"type":15,"attrs":1148,"content":1149},{"textAlign":53},[1150],{"text":1151,"type":303},"Measure and monitor the types and frequency of these occurrences.",{"type":498,"content":1153},[1154],{"type":15,"attrs":1155,"content":1156},{"textAlign":53},[1157],{"text":1158,"type":303},"Use appropriate analytical methods to understand the contributing factors.",{"type":498,"content":1160},[1161],{"type":15,"attrs":1162,"content":1163},{"textAlign":53},[1164],{"text":1165,"type":303},"Identify and implement solutions or interventions that are designed to prevent recurrence and reduce risk of harm.",{"type":498,"content":1167},[1168],{"type":15,"attrs":1169,"content":1170},{"textAlign":53},[1171],{"text":1172,"type":303},"Have mechanisms in place to mitigate consequences of harm when it occurs.",{"type":15,"attrs":1174},{"textAlign":1136},{"_uid":1176,"items":1177,"title":1213,"component":1214,"description":1215},"be3b7a82-b7ec-4b53-a512-e4112073c052",[1178,1189,1197,1205],{"_uid":1179,"image":1180,"title":1184,"component":1185,"description":1186},"458f36cf-6776-4902-a081-12df8c65ad9f",{"id":1181,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1182,"copyright":16,"fieldtype":289,"meta_data":1183,"is_external_url":277},119537678778928,"https://a-ca.storyblok.com/f/850807391887861/600x600/c301964117/checkmark-icon.png",{},"You may use different measures or modify the measures described below to make them more appropriate and/or useful to your particular setting. However, be aware that modifying measures may limit the comparability of your results to others.","small-text-image-item",{"type":12,"content":1187},[1188],{"type":15},{"_uid":1190,"image":1191,"title":1193,"component":1185,"description":1194},"498e534c-913a-4ac0-90da-3396951645da",{"id":1181,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1182,"copyright":16,"fieldtype":289,"meta_data":1192,"is_external_url":277},{},"Evaluate your choice of measures in terms of the usefulness of the final results and the resources required to obtain them; try to maximize the former while minimizing the latter.",{"type":12,"content":1195},[1196],{"type":15},{"_uid":1198,"image":1199,"title":1201,"component":1185,"description":1202},"5c88ef3c-3fd2-442e-b9cf-478a0643de91",{"id":1181,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1182,"copyright":16,"fieldtype":289,"meta_data":1200,"is_external_url":277},{},"Whenever possible, use measures you are already collecting for other programs.",{"type":12,"content":1203},[1204],{"type":15},{"_uid":1206,"image":1207,"title":1209,"component":1185,"description":1210},"6c6d04c8-d218-424c-945d-1f645847d838",{"id":1181,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1182,"copyright":16,"fieldtype":289,"meta_data":1208,"is_external_url":277},{},"Try to include both process and outcome measures in your measurement scheme.",{"type":12,"content":1211},[1212],{"type":15},"Measures","small-text-image",{"type":12,"content":1216},[1217],{"type":15,"attrs":1218,"content":1219},{"textAlign":53},[1220],{"text":1221,"type":303},"Vital to quality improvement is measurement, and this applies specifically to implementation of interventions. The chosen measures will help to determine whether an impact is being made (primary outcome), whether the intervention is actually being carried out (process measures), and whether any unintended consequences ensue (balancing measures). In selecting your measures, consider the following:",{"_uid":1223,"items":1224,"title":1671,"component":438,"description":1672},"ed575e2d-c13a-4a32-9df1-afe3f84c8465",[1225,1467,1631],{"_uid":1226,"title":1227,"ctaLeft":1228,"ctaRight":1229,"component":405,"columnLeft":1230,"columnRight":1234},"31df90e3-3c2a-448e-8c03-8cbb7c9f6e6f","Selection Criteria",[],[],{"type":12,"content":1231},[1232],{"type":15,"attrs":1233},{"textAlign":53},{"type":12,"content":1235},[1236,1246],{"type":15,"attrs":1237,"content":1238},{"textAlign":53},[1239,1244],{"text":1240,"type":303,"marks":1241},"Code",[1242],{"type":1243},"bold",{"text":1245,"type":303},": Condition",{"type":495,"content":1247},[1248,1259,1280,1297,1314,1331,1348,1365,1382,1399,1416,1433,1450],{"type":498,"content":1249},[1250],{"type":15,"attrs":1251,"content":1252},{"textAlign":53},[1253,1257],{"text":1254,"type":303,"marks":1255},"O86.002",[1256],{"type":1243},{"text":1258,"type":303},": Identified as diagnosis type (M), (1), (2), (W), (X) or (Y)",{"type":498,"content":1260},[1261],{"type":15,"attrs":1262,"content":1263},{"textAlign":53},[1264,1268,1270,1274,1276],{"text":1265,"type":303,"marks":1266},"T80.2",[1267],{"type":1243},{"text":1269,"type":303},": Identified as diagnosis type (2) ",{"text":1271,"type":303,"marks":1272},"AND ",[1273],{"type":1243},{"text":1275,"type":303},"Y60–Y84 ",{"text":1277,"type":303,"marks":1278},"in the same diagnosis cluster",[1279],{"type":1243},{"type":498,"content":1281},[1282],{"type":15,"attrs":1283,"content":1284},{"textAlign":53},[1285,1289,1290,1293,1294],{"text":1286,"type":303,"marks":1287},"T81.4",[1288],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1291},[1292],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1295},[1296],{"type":1243},{"type":498,"content":1298},[1299],{"type":15,"attrs":1300,"content":1301},{"textAlign":53},[1302,1306,1307,1310,1311],{"text":1303,"type":303,"marks":1304},"T82.6",[1305],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1308},[1309],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1312},[1313],{"type":1243},{"type":498,"content":1315},[1316],{"type":15,"attrs":1317,"content":1318},{"textAlign":53},[1319,1323,1324,1327,1328],{"text":1320,"type":303,"marks":1321},"T82.7–",[1322],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1325},[1326],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1329},[1330],{"type":1243},{"type":498,"content":1332},[1333],{"type":15,"attrs":1334,"content":1335},{"textAlign":53},[1336,1340,1341,1344,1345],{"text":1337,"type":303,"marks":1338},"T83.6",[1339],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1342},[1343],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1346},[1347],{"type":1243},{"type":498,"content":1349},[1350],{"type":15,"attrs":1351,"content":1352},{"textAlign":53},[1353,1357,1358,1361,1362],{"text":1354,"type":303,"marks":1355},"T84.5–T84.6–",[1356],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1359},[1360],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1363},[1364],{"type":1243},{"type":498,"content":1366},[1367],{"type":15,"attrs":1368,"content":1369},{"textAlign":53},[1370,1374,1375,1378,1379],{"text":1371,"type":303,"marks":1372},"T84.7",[1373],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1376},[1377],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1380},[1381],{"type":1243},{"type":498,"content":1383},[1384],{"type":15,"attrs":1385,"content":1386},{"textAlign":53},[1387,1391,1392,1395,1396],{"text":1388,"type":303,"marks":1389},"T85.7",[1390],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1393},[1394],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1397},[1398],{"type":1243},{"type":498,"content":1400},[1401],{"type":15,"attrs":1402,"content":1403},{"textAlign":53},[1404,1408,1409,1412,1413],{"text":1405,"type":303,"marks":1406},"T87.0*1",[1407],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1410},[1411],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1414},[1415],{"type":1243},{"type":498,"content":1417},[1418],{"type":15,"attrs":1419,"content":1420},{"textAlign":53},[1421,1425,1426,1429,1430],{"text":1422,"type":303,"marks":1423},"T87.1*1",[1424],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1427},[1428],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1431},[1432],{"type":1243},{"type":498,"content":1434},[1435],{"type":15,"attrs":1436,"content":1437},{"textAlign":53},[1438,1442,1443,1446,1447],{"text":1439,"type":303,"marks":1440},"T87.201",[1441],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1444},[1445],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1448},[1449],{"type":1243},{"type":498,"content":1451},[1452],{"type":15,"attrs":1453,"content":1454},{"textAlign":53},[1455,1459,1460,1463,1464],{"text":1456,"type":303,"marks":1457},"T87.4–",[1458],{"type":1243},{"text":1269,"type":303},{"text":1271,"type":303,"marks":1461},[1462],{"type":1243},{"text":1275,"type":303},{"text":1277,"type":303,"marks":1465},[1466],{"type":1243},{"_uid":1468,"title":1469,"ctaLeft":1470,"ctaRight":1471,"component":405,"columnLeft":1472,"columnRight":1476},"b9b8c1e0-53ae-4f62-8dc7-54e61e464643","Codes & Code Descriptions",[],[],{"type":12,"content":1473},[1474],{"type":15,"attrs":1475},{"textAlign":53},{"type":12,"content":1477},[1478,1486],{"type":15,"attrs":1479,"content":1480},{"textAlign":53},[1481,1484],{"text":1240,"type":303,"marks":1482},[1483],{"type":1243},{"text":1485,"type":303},": Code Description",{"type":495,"content":1487},[1488,1498,1508,1518,1528,1539,1549,1560,1571,1581,1591,1601,1611,1621],{"type":498,"content":1489},[1490],{"type":15,"attrs":1491,"content":1492},{"textAlign":53},[1493,1496],{"text":1254,"type":303,"marks":1494},[1495],{"type":1243},{"text":1497,"type":303},": Infection of obstetric surgical wound; delivered with mention of postpartum complication",{"type":498,"content":1499},[1500],{"type":15,"attrs":1501,"content":1502},{"textAlign":53},[1503,1506],{"text":1265,"type":303,"marks":1504},[1505],{"type":1243},{"text":1507,"type":303},": Infections following infusion, transfusion, and therapeutic injection",{"type":498,"content":1509},[1510],{"type":15,"attrs":1511,"content":1512},{"textAlign":53},[1513,1516],{"text":1286,"type":303,"marks":1514},[1515],{"type":1243},{"text":1517,"type":303},": Infection following a procedure, not elsewhere classified",{"type":498,"content":1519},[1520],{"type":15,"attrs":1521,"content":1522},{"textAlign":53},[1523,1526],{"text":1303,"type":303,"marks":1524},[1525],{"type":1243},{"text":1527,"type":303},": Infection and inflammatory reaction due to cardiac valve prosthesis",{"type":498,"content":1529},[1530],{"type":15,"attrs":1531,"content":1532},{"textAlign":53},[1533,1537],{"text":1534,"type":303,"marks":1535},"T82.7",[1536],{"type":1243},{"text":1538,"type":303},": Infection and inflammatory reaction due to other cardiac and vascular devices, implants, and grafts",{"type":498,"content":1540},[1541],{"type":15,"attrs":1542,"content":1543},{"textAlign":53},[1544,1547],{"text":1337,"type":303,"marks":1545},[1546],{"type":1243},{"text":1548,"type":303},": Infection and inflammatory reaction due to prosthetic device, implant, and graft in genital tract",{"type":498,"content":1550},[1551],{"type":15,"attrs":1552,"content":1553},{"textAlign":53},[1554,1558],{"text":1555,"type":303,"marks":1556},"T84.5–",[1557],{"type":1243},{"text":1559,"type":303},": Infection and inflammatory reaction due to internal joint prosthesis",{"type":498,"content":1561},[1562],{"type":15,"attrs":1563,"content":1564},{"textAlign":53},[1565,1569],{"text":1566,"type":303,"marks":1567},"T84.6–",[1568],{"type":1243},{"text":1570,"type":303},": Infection and inflammatory reaction due to internal fixation device (any site)",{"type":498,"content":1572},[1573],{"type":15,"attrs":1574,"content":1575},{"textAlign":53},[1576,1579],{"text":1371,"type":303,"marks":1577},[1578],{"type":1243},{"text":1580,"type":303},": Infection and inflammatory reaction due to other internal orthopedic prosthetic devices, implants, and grafts",{"type":498,"content":1582},[1583],{"type":15,"attrs":1584,"content":1585},{"textAlign":53},[1586,1589],{"text":1388,"type":303,"marks":1587},[1588],{"type":1243},{"text":1590,"type":303},": Infection and inflammatory reaction due to other internal prosthetic devices, implants, and grafts",{"type":498,"content":1592},[1593],{"type":15,"attrs":1594,"content":1595},{"textAlign":53},[1596,1599],{"text":1405,"type":303,"marks":1597},[1598],{"type":1243},{"text":1600,"type":303},": Complication of reattached (part of) upper extremity; infection",{"type":498,"content":1602},[1603],{"type":15,"attrs":1604,"content":1605},{"textAlign":53},[1606,1609],{"text":1422,"type":303,"marks":1607},[1608],{"type":1243},{"text":1610,"type":303},": Complications of reattached (part of) lower extremity; infection",{"type":498,"content":1612},[1613],{"type":15,"attrs":1614,"content":1615},{"textAlign":53},[1616,1619],{"text":1439,"type":303,"marks":1617},[1618],{"type":1243},{"text":1620,"type":303},": Infection of other reattached body part",{"type":498,"content":1622},[1623],{"type":15,"attrs":1624,"content":1625},{"textAlign":53},[1626,1629],{"text":1456,"type":303,"marks":1627},[1628],{"type":1243},{"text":1630,"type":303},": Infection of amputation stump",{"_uid":1632,"title":1633,"ctaLeft":1634,"ctaRight":1635,"component":405,"columnLeft":1636,"columnRight":1640},"298700c3-a866-4c7b-9c20-e87c98c04dea","Additional codes & Inclusions",[],[],{"type":12,"content":1637},[1638],{"type":15,"attrs":1639},{"textAlign":53},{"type":12,"content":1641},[1642,1651],{"type":15,"attrs":1643,"content":1644},{"textAlign":53},[1645,1649],{"text":1646,"type":303,"marks":1647},"Additional Codes",[1648],{"type":1243},{"text":1650,"type":303},": Inclusions",{"type":495,"content":1652},[1653],{"type":498,"content":1654},[1655],{"type":15,"attrs":1656,"content":1657},{"textAlign":53},[1658,1662,1664],{"text":1659,"type":303,"marks":1660},"Y60-Y84",[1661],{"type":1243},{"text":1663,"type":303},": Complications of medical and surgical care (refer to Appendix A) of the ",{"text":1665,"type":303,"marks":1666},"Hospital Harm Indicator General Methodology Notes",[1667],{"type":355,"attrs":1668},{"href":1669,"uuid":53,"anchor":53,"custom":1670,"target":360,"linktype":401},"http://indicatorlibrary.cihi.ca/download/attachments/10453027/Hospital%20Harm%20Indicator%20General%20Methodology%20Notes.pdf?version=1&modificationDate=1561404418000&api=v2",{},"Discharge Abstract Database",{"type":12,"content":1673},[1674,1679,1692,1701],{"type":15,"attrs":1675,"content":1676},{"textAlign":53},[1677],{"text":1678,"type":303},"Discharge Abstract Database (DAD) Codes included in this clinical category: ",{"type":495,"content":1680},[1681],{"type":498,"content":1682},[1683],{"type":15,"attrs":1684,"content":1685},{"textAlign":53},[1686,1690],{"text":1687,"type":303,"marks":1688},"B14",[1689],{"type":1243},{"text":1691,"type":303},": Post Procedural Infections",{"type":15,"attrs":1693,"content":1694},{"textAlign":53},[1695,1699],{"text":1696,"type":303,"marks":1697},"Concept",[1698],{"type":1243},{"text":1700,"type":303},": Infections associated with a medical or surgical procedure.",{"type":15,"attrs":1702,"content":1703},{"textAlign":53},[1704,1708],{"text":1705,"type":303,"marks":1706},"Notes",[1707],{"type":1243},{"text":1709,"type":303},": This clinical group may include inflammatory reactions in the absence of infection.",{"_uid":1711,"content":1712,"component":387},"5d74840d-8140-4d06-a1bb-46e735184517",[1713,1737],{"_uid":1714,"content":1715,"component":386},"8b89c40b-1e60-4131-ace9-d4840e8aabe7",{"type":12,"content":1716},[1717,1722,1728,1733],{"type":340,"attrs":1718,"content":1719},{"level":342,"textAlign":53},[1720],{"text":1721,"type":303},"Success Stories",{"type":340,"attrs":1723,"content":1725},{"level":1724,"textAlign":53},3,[1726],{"text":1727,"type":303},"HSO Leading Practices Library",{"type":15,"attrs":1729,"content":1730},{"textAlign":53},[1731],{"text":1732,"type":303},"Healthcare associated infections are considered a serious threat to the hospitalized patient's safety. Among surgical site infections, those related to orthopaedic procedures are considered severe and can increase morbidity-mortality rates. Factors in the preoperative, intraoperative, and postoperative periods that can help prevent orthopaedic infections include good preoperative skin care, optimal care during the operative phase, high rates of hand hygiene compliance throughout the continuum of care, stringent aseptic technique with postoperative dressing changes and the reduction of any incision site complications such as blisters. In the pre-operative period, the goal is effective skin preparation to reduce the resident microbial count and is achieved by having patients shower using Chlorhexidine 2 per cent, eliminating shaving, and screening for antibiotic resistant organisms such as MRSA. In the operative phase, the administration and timing of prophylactic antibiotics are crucial to the reduction of infection rates. Timing was improved by having Nurses start the infusion when the previous patient leaves the OR. The dose of the antibiotic Ancef was increased from 1 to 2 gms, and antibiotic impregnated cement (methyl methacrylate) was introduced. Perioperative normothermia has been shown to help decrease infections in orthopaedic patients so all patients are provided with warming blankets. Hand Hygiene is considered the single most important way to reduce nosocomial infections. Holland Centre compliances rates went from 28 per cent in 2008 to 85 per cent in 2012 with education, increased access to hand wash stations and products at Point-of-Care. We also now have full compliance with staff not wearing hand or arm jewelry and not eating and drinking in the nursing stations. These two factors are known to decrease infection rates. The introduction of a new wound care product and protocol, reduced the need for dressing changes, allowed greater flexibility for patients mobilizing and showering after surgery, and reduced blistering around the wound. The Holland Centre performs over 2,100 Total Joint procedures annually. A comprehensive process is in place to monitor and report infection rates for 12 months following surgery. In 2011/12 surgical infection rate in total hip and knee replacement patients was 0.00 per cent (compared to the National Healthcare Safety Network (NHSN) target rates of 0.75 per cent for hips and 0.68 per cent for knees). Preliminary data for 2012/13 shows that the program has sustained a 0.00 per cent infection rate for both hip and knee patients. We continually strive to improve practice throughout the entire process in order to eliminate surgical site infections in our patient population.",{"type":15,"attrs":1734,"content":1735},{"textAlign":53},[1736],{"text":523,"type":303},{"_uid":1738,"file":1739,"link":1741,"label":1743,"linkType":355,"component":1744,"linkLabel":1745},"7a0dc658-8ff9-4ca0-8861-5f09f23ab22a",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":289,"meta_data":1740},{},{"id":16,"url":1742,"target":400,"linktype":401,"fieldtype":402,"cached_url":1742},"https://healthstandards.org/leading-practice/best-practice-in-infection-prevention-and-control-in-a-surgical-patient-population/","Best Practice in Infection Prevention and Control in a Surgical Patient Population (Health Standards Organization, 2013)","banner-link","Download the report",{"_uid":1747,"items":1748,"title":1914,"component":438,"description":1915},"d27e0ee6-d543-4ffe-ba19-0beac7b5077d",[1749],{"_uid":1750,"title":1751,"ctaLeft":1752,"ctaRight":1753,"component":405,"columnLeft":1754,"columnRight":1758},"d1d27db9-bb85-49f3-bb9e-7342f7791eb1","Expand to see a full list of references",[],[],{"type":12,"content":1755},[1756],{"type":15,"attrs":1757},{"textAlign":53},{"type":12,"content":1759},[1760,1769,1786,1797,1812,1822,1836,1847,1857,1869,1884,1901],{"type":15,"attrs":1761,"content":1762},{"textAlign":53},[1763,1764,1767],{"text":742,"type":303},{"text":744,"type":303,"marks":1765},[1766],{"type":573},{"text":1768,"type":303},". 2017;152(8):784-791. doi:10.1001/jamasurg.2017.0904",{"type":15,"attrs":1770,"content":1771},{"textAlign":1136},[1772,1774,1778,1780],{"text":1773,"type":303},"Canadian Institute for Health Information. Appendix A. In: ",{"text":1775,"type":303,"marks":1776},"Hospital Harm Indicator: General Methodology Notes",[1777],{"type":573},{"text":1779,"type":303},". Canadian Institute for Health Information; 2019. ",{"text":1781,"type":303,"marks":1782},"https://indicatorlibrary.cihi.ca/display/HSPIL/Hospital+Harm?preview=/10453027/15564910/Hospital%20Harm%20Indicator%20General%20Methodology%20Notes.pdf",[1783,1785],{"type":355,"attrs":1784},{"href":1781,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":15,"attrs":1787,"content":1788},{"textAlign":1136},[1789,1791,1795],{"text":1790,"type":303},"Cataife G, Weinberg DA, Wong H-H, Kahn KL. The Effect of Surgical Care Improvement Project (SCIP) Compliance on Surgical Site Infections (SSI). ",{"text":1792,"type":303,"marks":1793},"Med Care",[1794],{"type":573},{"text":1796,"type":303},". 2014;52 (2 Suppl 1): S66-S73. doi: 10.1097/MLR.0000000000000028.",{"type":15,"attrs":1798,"content":1799},{"textAlign":1136},[1800,1802,1805,1807],{"text":1801,"type":303},"Health Care for All. ",{"text":393,"type":303,"marks":1803},[1804],{"type":573},{"text":1806,"type":303},". 2008. Accessed February 2021. ",{"text":399,"type":303,"marks":1808},[1809,1811],{"type":355,"attrs":1810},{"href":399,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":15,"attrs":1813,"content":1814},{"textAlign":1136},[1815,1817],{"text":1816,"type":303},"Health Standards Organization. Best Practice in Infection Prevention and Control in a Surgical Patient Population. HSO Leading Practices Library. Published 2013. ",{"text":1742,"type":303,"marks":1818},[1819,1821],{"type":355,"attrs":1820},{"href":1742,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":15,"attrs":1823,"content":1824},{"textAlign":1136},[1825,1827,1830,1831],{"text":1826,"type":303},"Institute for Healthcare Improvement (IHI). ",{"text":900,"type":303,"marks":1828},[1829],{"type":573},{"text":904,"type":303},{"text":906,"type":303,"marks":1832},[1833,1835],{"type":355,"attrs":1834},{"href":906,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":15,"attrs":1837,"content":1838},{"textAlign":1136},[1839,1841],{"text":1840,"type":303},"Institute for Healthcare Improvement. One Is Too Many: Viewing Infection Data from the Patient's Perspective. Published 2016. ",{"text":1842,"type":303,"marks":1843},"http://www.ihi.org:80/resources/Pages/AudioandVideo/OneIsTooManyViewingInfectionDatafromPatientsPerspective.aspx",[1844,1846],{"type":355,"attrs":1845},{"href":425,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},{"type":512},{"type":15,"attrs":1848,"content":1849},{"textAlign":1136},[1850,1851,1855],{"text":1826,"type":303},{"text":1852,"type":303,"marks":1853},"IHI Improvement Map",[1854],{"type":573},{"text":1856,"type":303},". IHI; n.d. (Out of print)",{"type":15,"attrs":1858,"content":1859},{"textAlign":1136},[1860,1862],{"text":1861,"type":303},"Johns Hopkins Medicine. Surgical Site Infections. Health: Conditions and Diseases. Accessed February 2021.",{"text":1863,"type":303,"marks":1864}," https://www.hopkinsmedicine.org/health/conditions-and-diseases/surgical-site-infections",[1865,1868],{"type":355,"attrs":1866},{"href":1867,"uuid":53,"anchor":53,"custom":53,"target":400,"linktype":401},"https://www.hopkinsmedicine.org/health/conditions-and-diseases/surgical-site-infections",{"type":512},{"type":15,"attrs":1870,"content":1871},{"textAlign":1136},[1872,1873,1877,1879],{"text":998,"type":303},{"text":1874,"type":303,"marks":1875},"NICE Surgical Site Infections: Prevention and Treatment.",[1876],{"type":573},{"text":1878,"type":303}," NICE; 2019. ",{"text":987,"type":303,"marks":1880},[1881,1883],{"type":355,"attrs":1882},{"href":987,"uuid":53,"anchor":53,"custom":53,"target":53,"linktype":401},{"type":512},{"type":15,"attrs":1885,"content":1886},{"textAlign":1136},[1887,1889,1893,1895],{"text":1888,"type":303},"Public Health Agency of Canada. ",{"text":1890,"type":303,"marks":1891},"Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings",[1892],{"type":573},{"text":1894,"type":303},". Public Health Agency of Canada; 2012. 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