No PUN Intended
SSI
What is a Surgical Site Infection?
Old traumatic wound with retained devitalized tissue and existing infection wounds - includes wet gangrene.
What is wound class 4 or dirty/infected?
During a laparoscopic appendectomy the appendix is noted to be inflamed but no purulent drainage noted.
What is contaminated or class III?
Chronic Cholecystitis with Gall Stones
What is Class II/Clean Contaminated?
Might be unaware that wound classification is ultimately their responsibility, as is everything regarding the procedure.
Who is the surgeon?
HAI
What is Healthcare Associated Infection? HAI is a localized or systemic condition resulting from an adverse reaction to the presence of an infectious agent(s) or its toxin(s)
Uninfected wound, no inflammation, closed, and if necessary, with closed drainage.
What is class 1 or clean?
A surgical wound in closed, and a Penrose drain is used for post-op drainage
What is contaminated or class III?
A cesarean section with ruptured membranes with presence of meconium
What is Class III / Contaminated?
Happens towards the end of the surgical procedure when the Circulating RN confirms items such as wound class and procedure.
What is the debriefing?
LOI
What is lack of interest?
Respiratory, alimentary, genital, or urinary tract ENTERING ORGANS without major break in technique.
What is class 2 or clean/contaminated?
C-Section with clear membranes
What is Class II or Clean Contaminated?
Patient had a laparoscopic appendectomy. It was noted in the physician operative note, that there was purulent fluid in the RLQ of the abdomen.
What is Class IV: Dirty/Infected
There is a discrepancy on what wound classification to give for a procedure
When to call Liz or Travis?
AORN
What is the Association of Perioperative Registered Nurses
Open acute wounds, breaks in technique or gross spillage, necrotic without drainage.
What is Class III or Contaminated?
Pilonidal cyst with no inflammation or infection is present
What is Class I or Clean?
Patient had a Laparoscopic Cholecystectomy for acute cholecystitis.
What is Class III / Contaminated
Responsible for determining and documenting the wound class by communicating with the surgeon during and at the end of the procedure.
What is the Circulating RN?
CDC/NHSN
What is the Center For Disease Control/National Healthcare Safety Network?
Non-penetrating blunt trauma.
What is Class I or Clean?
A patient had a previous repair of a flexor tendon one week before presentation. During an altercation, the wound was "crushed" open and became covered in dirt and debris. The patient presented to the emergency department for evaluation and was taken to surgery the same day for washout and repair. There was no description of any necrotic or purulent tissue. The wound was left open after the surgery.
What is Class IV or Dirty / Infected?
Patient admitted with peripheral vascular disease and gangrene of the toes of the left foot. The patient undergoes a BKA.
What is Class I / Clean
Is a collaborative effort between surgeons and perioperative RNs
What is wound classification?