University of Tennessee Medical Center- Knoxville, TN
Number of licensed beds: 581
Teaching
Urban
Exemplar Hospital Contact Name: Becky Ashin, Orthopaedic Service Line Manager
Email:
Phone: 865-305-8388
We give permission to IHI to make public all the information on this Project JOINTS Exemplar Hospital application.
Enhanced Surgical Site Infections Prevention Bundle element (identify one per sheet): Bathing or showering with chlorhexidine gluconate (CHG) soap for at least three days before surgery
In a few sentences, describe qualitatively in what ways your hospital has been successful in implementing this element of the Enhanced Surgical Bundle. Please answer the following questions:
What key changes did your organization make to incorporate or support bathing or showering with CHG soap for at least three days before surgery? What were the changes in existing processes your organization had to make in order for this to become part of the routine?
Our joint patients were already instructed in Joint Class to bathe/shower 2 times prior to surgery (the night before and morning of surgery) with Hibiclens. We provided information on purchasing Hibiclens and we did not track compliance.
We have updated our materials to instruct patients to use Endure (HGC product) and we now provide it to all of our patients at their Joint Class. Extensive instructions are provided on how and when to use it. We have developed a tracking/checklist and patients are instructed to complete the form and turn it in when they come for surgery. If they forget it, we will have copies for their nurse on the unit to complete.
How did you roll out this practice? Did you test it with one patient, a few, or all to start?
We updated our materials and created an education handout about ProjectJOINTS and why UTMC was implementing this enhanced practice to reduce their risk of infection. We worked with our Materials Management to determine what product would be used and the costs. We found that Hibiclens was staining the hospital laundry and the hospital switched to using Endure. Costs were approved by Administration in order to provide this at no cost to our patients.
We implemented this with all of our patients who attend Joint Class.
What lessons have you learned as you've implemented this practice? What tips do you have to share?
We feel we will have better compliance since we are providing the HCH soap to our patients and they don’t have to worry about purchasing or finding the product. Education – materials and the class are critical to implementation.
[ X ] This practice is used for at least 95% of hip/knee arthroplasty cases.