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CPH awarded Exemplar status

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POTSDAM - Canton-Potsdam Hospital was recently awarded Exemplar status for its involvement in Cohort One of the Institute for Healthcare Improvement’s (IHI) Project JOINTS Initiative, a federally-funded program designed to speed adoption of proven methods to prevent surgical site infections (SSIs) after hip and knee replacement surgery.

The acronym JOINTS stands for “Joining Organizations in Tackling SSI.” New York is one of five states that participated in the six-month Cohort One. The project will now expand to subsequent cohorts, with each building upon the successes of the previous.

Launched in April of 2011, Project JOINTS focuses on hip and knee replacement surgery, mainly because post-surgery infections can be catastrophic for the patient and their families. Treatment can mean multiple surgeries, months of medical and physical therapy, prolonged periods of recuperation and often considerable pain and sizeable out-of-pocket expenses. For some, permanent disability and long-term financial problems are the results.

As part of Cohort One, the five states tested an enhanced surgical site infection bundle of five evidence-based interventions designed to prevent staph infections (the most common type of orthopedic infection) in patients undergoing total joint replacement surgery. The five interventions included Staphylococcus aureus (Staph) testing within 30 days of surgery for all total joint patients; decolonizing of MRSA (methicillin-resistant Staphylococcus aureus) and MSSA (methicillin-susceptible Staphylococcus aureus) patients before surgery; reliably giving the appropriate antibiotics to the patient before surgery; clipping (rather than shaving) hair at the surgical site and preparing skin at the surgical site with an antiseptic solution that contains alcohol. Many hospitals had already implemented clipping rather than shaving at surgery sites and appropriate pre-surgical antibiotic treatments as part of an earlier initiative, so the focus was on the remaining three new initiatives.

At Canton-Potsdam Hospital, a team approach was implemented consisting of nurses, physicians, pharmacy, infection control and operating room staff. As a result, 100 percent compliance was achieved for the six-month time period of May to December 2011. Surgeons ordered joint protocol for all patients; all patients consented to testing; pre-operative nurses successfully collected nasal swabs, checked results and provided patient education to infection-positive patients; all positive patients completed decolonization; all patients were given correct antibiotic at the correct time on the day of surgery and all patients received the appropriate surgical skin preparation. As a result, there were no staph infections among total joint patients during the period. All procedures utilized as part of CPH’s participation in Project JOINTS have now been implemented as official joint replacement protocol at the hospital.

Canton-Potsdam Hospital’s project coordinator and operating room nurse, Lisa McDonald, BSN, RNFA, shared Canton-Potsdam Hospital’s best practices for early success with participating hospitals in the other four states via webcasts throughout the six-month period.

“We hope that our team’s willingness to share our hands-on experience with other hospitals will help make total joint replacement surgery safer for patients across the country,” Ms. McDonald said. “We strive to treat our patients like family, give them the best treatment possible, have them up and walking soon and progressing at their personal best. But most importantly, we want them to know how important infection prevention is and how it is related to their most optimal recovery.”

Two hundred hospitals participated in Cohort One of Project JOINTS. Canton-Potsdam Hospital was one of only six hospitals to achieve Exemplar status for all three new initiatives. Exemplar hospitals were the leaders in implementing and consistently practicing the bundle initiatives.

The CPH team networked with other hospitals, helping to guide the implementation of these initiatives in other rural hospitals. McDonald and members of the CPH team recently spoke during a web conference to help lead the way for Cohort Two (Wisconsin, Mississippi, Maryland, Oregon and California), which began its work on May 1. The web conference was presented live to two hundred hospitals in these states.

At the conference, the CPH team networked with other hospitals, helping to guide their implementation of these initiatives by sharing the knowledge gained over the past year. McDonald was also invited to attend information-sharing site visits to hospitals in Wisconsin that will be part of Cohort Two.

“This was a registered nurse-led initiative that would not have developed without the commitment and dedication of the nurses involved,” said Cathy Schantz, MSN, RNC-OB, NEA-BC, vice president for Patient Care Services/chief nursing officer at Canton-Potsdam Hospital.

“The Exemplar designation highlights CPH’s dedication to providing safe, quality care to our patients and community, centered on evidence-based research and practices,” Schantz said.

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