Roy Boukidjian RN, CIC Northridge Hospital Medical Center Dignity Health

WHAT IS GOING ON IN THE OR  You Don’t know what you Don’t know!

 Observation is Key!

MULTIPLE FINDINGS ○ Multiple Findings:  Traffic in your operating room

MULTIPLE FINDINGS ○ Multiple Findings:  Doors Propped Open

MULTIPLE FINDINGS ○ Multiple Findings:  Positive Air Circulation

MULTIPLE FINDINGS ○ Multiple Findings:  SCRUBS in the OR

MULTIPLE FINDINGS ○ Multiple Findings:  Cleanliness of OR Suites

MULTIPLE FINDINGS ○ Multiple Findings:  Expired Material

MULTIPLE FINDINGS ○ Multiple Findings:  Surgical Instrumentation

MULTIPLE FINDINGS ○ Multiple Findings:  Surgical SCRUBBING!!!!

MULTIPLE FINDINGS ○ Multiple Findings:  Post-Operative Care

MULTIPLE FINDINGS ○ Multiple Findings:  Post-Operative Care (Continued)

Suggestions:  Use CHG wash cloths pre-op  Let the antiseptic solution dry prior to incision by placing timers  Place timers on surgical scrub sinks  Produce a strict policy on surgical scrubs  Empower staff  Distribute findings to unit staff  Work with EVS and Facilities

C-diff Findings and Analysis

NHMC Hospital Acquired C difficile

10,0 9,0 8,0 7,0 6,0 5,0 4,0 3,0 2,0 1,0 0,0 Switched to Polymerase Chain Reaction (PCR) testing Identified issues with solution concentration Identified issues with interpretation of precautions 2010 2011 Incidence per 1000 discharges Out of 15 specimens that tested positive using the PCR method in December, only 4 came back positive using Toxin A and B which gives us an average of 26.6% accuracy when using Toxin A and B.