Surgical Clinical Care Measures

What is a surgical infection?

Local wound infections, urinary tract infections (caused by bladder catheter) and pneumonia (due to impaired breathing/coughing, caused by sedation and analgesics during the first few hours of recovery) may endanger the health of patients after surgery.

Antibiotics are effective in reducing the occurrence of such infections, even in "sterile" operative cases, as long as the drugs are properly selected and administered.

Infection after surgery is always a concern for healthcare providers. While the chances of getting an infection are small, it could have a serious affect on your health.

Some things that you and your healthcare facility can do to prevent surgical infections include:

  • Hair removal: Hair around the surgical site should be removed just before the surgery with clippers, not a razor.
  • Antibiotics: Antibiotics are not needed for all surgeries, but they can help prevent infection in some cases. When they are used, they should be given one hour before the start of your surgery.
  • Wound care: Your doctor should provide you with instructions on how to care for your wound after surgery. These instructions should include when you can remove the bandage and if you can get the incision wet.
  • Signs of infection: After surgery, watch for signs of infection such as fever, chills, sweats and redness around the incision.

Click Why is this important? next to each indicator below to find out why each care measure is important.

Below are some of the recommended care measures given to patients when appropriate. The percentage includes only patients whose history and condition indicate the treatment is appropriate. Talk to your healthcare provider if you have questions about your treatment.

Surgical Care Quality Care Measures - Higher percentages are better

 

MedStar Franklin Square Medical Center 

MedStar Georgetown University Hospital 

MedStar Good Samaritan Hospital 

MedStar Harbor Hospital 

MedStar Montgomery Medical Center 

MedStar St. Mary's Hospital

MedStar Union Memorial Hospital 

MedStar Washington Hospital Center 

Average for all reporting hospitals in the U.S. 

Percent of surgical patients who receivedWhy is this important?preventative antibiotic(s) one hour before incision

97%

98%

98%

97%

99%

100%

64%

99%

99%

Percent of surgical patients who received the Why is this important?appropriate preventative antibiotic(s) for their surgery

95%

99%

98%

98%

99%

99%

98%

100%

99%

Percent of surgery patients whose preventative Why is this important?antibiotic(s) are stopped within 24 hours after surgery

97%

96%

97%

92%

98%

98%

95%

97%

98%

Percent of cardiac surgery patients with controlled Why is this important?6 a.m. post-operative blood glucose

N/A

N/A

N/A

N/A

N/A

N/A

93%

96%

97%

Percent of surgery patients whose urinary catheters were Why is this important?removed on the first or second day after surgery

97%

97%

97%

96%

99%

100%

89%

95%

97%

Percent of surgery patients who were actively warmed in the O.R. or whose body temperature was near Why is this important?normal by end of surgery.

100%

100%

100%

99%

100%

100%

95%

99%

100%

Percent of surgery patients Why is this important?taking beta blockers before and after surgery

98%

97%

94%

92%

98%

98%

97%

97%

98%

Percent of surgery patients who received treatment Why is this important?to prevent blood clots within 24 hours before or after selected surgeries to prevent blood clots

97%

97%

98%

97%

99%

98%

96%

97%

98%

N/A = This hospital treated patients in this condition, but no patients met the criteria for inclusion in the measure collection or no data is available.

  • Averages for US hospitals are for the time period 10/1/2012 - 9/30/2013 except where noted. MedStar Health data is for the time period 1/1/2013 - 12/31/2013 (+ MedStar St. Mary's began reporting Core Measures to MedStar Q2 FY10).
  • Next data report is expected in September 2014.
  • U.S. National Average Source: www.hospitalcompare.hhs.gov

Why are these care measures important?

Percent of surgical patients who received preventative antibiotic(s) one hour before incision
Research shows that patients who get antibiotics within the hour before their surgery are less likely to get infections. Getting an antibiotic earlier or after surgery starts is not as effective. This measure shows you if the hospital gives antibiotics at the right time.

Percent of surgical patients who received the appropriate preventative antibiotic(s) for their surgery
Certain antibiotics are recommended to help prevent wound infection for particular types of surgery.

Percent of surgery patients whose preventative antibiotic(s) are stopped within 24 hours after surgery
Taking antibiotics before surgery can reduce the likelihood of an infection after surgery. However, taking them for more than 24 hours after surgery is not usually recommended and can cause side effects such as diarrhea and stomach ache. When an infection is the reason that surgery is needed, a longer course of antibiotics may be needed. Talk to your doctor about his or her recommendation.

Percent of cardiac surgery patients with controlled 6 A.M. post-operative blood glucose
All heart surgery patients get their blood sugar checked after surgery. Any patient who has high blood sugar after heart surgery has a greater chance of getting an infection. This measure tells how often the blood sugar of heart surgery patients was kept under good control in the days right after their surgery.

Percent of surgery patients whose urinary catheters were removed on the first or second day after surgery
Sometimes surgical patients need to have a urinary catheter, or thin tube, inserted into their bladder to help drain the urine. Catheters are usually attached to a bag that collects the urine.

Surgery patients can develop infections when urinary catheters are left in place too long after surgery. Infections are dangerous for patients, cause longer hospital stays, and increase costs.

This shows the percent of surgery patients whose urinary catheters were removed on the first or second day after surgery. Research shows that most surgery patients should have their urinary catheters removed within 2 days after surgery to help prevent infection.

Percent of surgery patients who were actively warmed in the O.R. or whose body temperature was near normal by end of surgery.
Hospitals can prevent surgical wound infections and other complications by keeping the patient's body temperature near normal during surgery. Medical research has shown that patients whose body temperatures drop during surgery have a greater risk of infection and their wounds may not heal as quickly. Hospital staff should make sure that patients are actively warmed during and immediately after surgery to prevent drops in body temperature.

Percent of surgery patients taking beta blockers before and after surgery
Many people who have heart problems or are at risk for heart problems take drugs called beta blockers. It is important that surgery patients who were already taking beta blockers before coming to the hospital were given beta blockers during the time period just before and after their surgery.

Percent of surgery patients whose doctors ordered treatments to prevent blood clots (venous thromboembolism) for certain types of surgeries
This measure tells how often surgery patients' doctors ordered treatment to prevent blood clots from forming in the veins after certain surgeries.

Percent of surgery patients who received treatment to prevent blood clots within 24 hours before or after selected surgeries to prevent blood clots
This measure tells how often surgery patients received treatment to prevent blood clots within 24 hours before or after certain surgeries.

Emergency CareHeart AttackHeart FailurePneumoniaCore IMMVTE