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Patient Safety
KEY POINTS:
New SCIP Measures for Normothermia, Urinary Catheters
As reported in the last issue of The OR Connection, the Surgical Care Improvement Project (SCIP) introduced two new performance measures effective October 1, 2009, in the areas of normothermia and urinary catheters. To clarify, here are the key points to remember regarding each measure:
SCIP Infection Measure #9: Urinary catheter removed on Postoperative Day 1 (POD 1) or Postoperative Day 2 (POD 2) with day of surgery being day zero.
SCIP Infection Measure #10: Surgery patients for whom either active warming was used intraoperatively for the purpose of maintaining normothermia or who had at least one body temperature equal to or greater than 96.8 degrees F/36 degrees C recorded within the 30 minutes immediately prior to Anesthesia End Time or the 15 minutes immediately after Anesthesia End time.
Rationale: It is well-established that the risk of catheterassociated urinary tract infection (UTI) increases with increasing duration of indwelling urinary catheterization. Studies have shown the following: • Bacteriuria will develop in 26 percent of patients after two to 10 days of catheterization; 24 percent Rationale: Core temperatures outside the normal range pose a risk in all patients undergoing surgery. Studies of those patients will develop symptomatic have shown the following: urinary tract infection and bacteremia will • Impaired wound healing, adverse cardiac events, develop in 3.6 percent. altered drug metabolism and coagulopathies • Patients who had indwelling catheters for more are associated with unplanned perioperative than two days postoperatively were 21 percent hypothermia. more likely to develop a urinary tract infection; • Incidence of surgical site infections among those significantly less likely to be discharged to home with mild perioperative hypothermia was three and had a significant increase in mortality at times higher than with normothermic periopera30 days. tive patients. • Hypothermia is associated with a significant increase in adverse outcomes, an increased chance of blood products administration, Source: Specifications Manual for National Hospital Inpatient Quality myocardial infarction and mechanical ventilation. Measures. Available at http://www.qualitynet.org/dcs/ContentServer?c= • Adverse outcomes resulted in prolonged hospital Page&pagename=QnetPublic%2FPage%2FQnetTier4&cid=1228695698425. stays and increased healthcare expenditures.
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The OR Connection