Infection Prevention: A Perioperative Nurse's Guide to preventing surgical site infections

Infection prevention for perioperative nurses: a vital role in patient safety

Infection prevention is a foundation of perioperative care. Perioperative nurses are on the front lines, ensuring that surgical procedures are safe and that patients are protected from infections, particularly surgical site infections (SSIs). With SSIs being a common and costly complication, perioperative nurses play an essential role in minimizing risks and promoting optimal outcomes.

Challenges of infection prevention in the operating room

Perioperative nurses work in environments where the risk of infection is inherently high. Operating rooms, despite being clean environments, can still harbor pathogens that hinder recovery, particularly with wounds, and pose a threat to patients. Infections can lead to prolonged hospital stays, increased medical costs, and, in severe cases, death.

For perioperative nurses, infection prevention is not just about following protocols—it’s about safeguarding patient health and delivering high-quality care.

Factors that interfere with wound healing

Several factors can delay or interfere with wound healing, making infection more likely:

• Age and comorbidities: Older patients or those with underlying conditions such as diabetes or obesity are more prone to wound healing complications.
• Smoking: Smoking reduces blood flow to the wound, depriving tissues of oxygen and nutrients essential for healing.
• Malnutrition: A lack of adequate nutrition, particularly protein, vitamins, and minerals, can slow down the healing process.
• Medications: Steroids, chemotherapy, and other medications that suppress the immune system can delay wound healing and increase the risk of infection.
• Poor oxygenation: Hypoxia impairs the body's ability to fight infections and deliver oxygen to healing tissues.

Nursing interventions to prevent infections

Perioperative nurses can implement several interventions to reduce infection risks:

1. Hand hygiene: Proper and frequent handwashing or use of alcohol-based hand sanitizers is the foundation of infection prevention. This simple step dramatically reduces the transmission of pathogens.
2. Surgical site preparation: Cleaning the surgical site with antiseptic agents before surgery, ensuring hair removal is done safely (with clippers instead of razors), and using appropriate skin preparation techniques all minimize contamination risks.
3. Aseptic technique: Maintaining a sterile field and ensuring that all instruments, drapes, and devices are sterilized is critical. Nurses should also monitor for any breaks in aseptic technique during the procedure.
4. Appropriate use of antibiotics: Administering prophylactic antibiotics within the recommended time frame before surgery is a key strategy in preventing infections.
5. Temperature control: Maintaining normothermia during surgery is associated with reduced SSI rates. Hypothermia can impair immune function and wound healing, increasing infection risk.

Wound healing tactics and techniques

It’s important for perioperative nurses to employ techniques that promote wound healing and prevent infections such as:

1. Wound assessment: Regular assessment of the surgical site for signs of infection, such as redness, swelling, or discharge, allows for early intervention.
2. Dressing management: Proper application and timely changes of sterile dressings help to protect the wound from contamination while promoting a moist environment conducive to healing.
3. Nutritional support: Ensuring that patients receive adequate nutrition, including protein and micronutrients like vitamin C and zinc, supports the body's natural healing processes.
4. Hydration and oxygenation: Encouraging fluid intake and, if necessary, oxygen therapy, can improve blood flow and oxygen delivery to the wound site.
5. Patient education: Educating patients on proper wound care, signs of infection, and the importance of a healthy lifestyle (e.g., smoking cessation) can prevent complications post-surgery.

Interventions to prevent surgical wound infections

1. Strict adherence to sterile technique: Every step of the surgical process must follow sterile technique protocols to prevent contamination.
2. Preoperative skin antisepsis: Using the appropriate antiseptic agents before surgery reduces the microbial load on the skin, minimizing the risk of SSIs.
3. Antibiotic stewardship: Ensuring that antibiotics are administered correctly and only when necessary helps prevent the development of infections and antimicrobial resistance.
4. Maintaining a clean surgical environment: Regular cleaning and disinfecting of the operating room and equipment, along with proper ventilation and air filtration systems, minimize the presence of harmful bacteria.
5. Minimizing OR traffic: Reducing the number of personnel and movements in and out of the operating room helps prevent contamination of the sterile field.

Infection prevention is a shared responsibility within the surgical team, but perioperative nurses play a unique and pivotal role. By implementing targeted interventions, closely monitoring patient conditions, and educating patients and staff, perioperative nurses help ensure that the surgical experience is as safe and infection-free as possible. This vigilance in infection control is essential to patient safety and the promotion of optimal recovery outcomes.

When and where are the AORN Guidelines Workshops?

AORN Guidelines Workshops are in-person, interactive educational events designed to provide perioperative team members with a deep understanding of the latest AORN Guidelines for Perioperative Practice.

These workshops offer:

• In-depth exploration of recent updates to the AORN Guidelines
• Practical tips for implementing evidence-based best practices in the OR
• Hands-on demonstrations of the newest OR technologies
• Networking opportunities with fellow perioperative professionals

By attending an AORN Guidelines Workshop, participants can enhance their knowledge, skills, and confidence in delivering optimal patient care.

Guidelines Workshops event information