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Avoid Infection Control Disasters
Expert-led workshop tackles hot-button issues in SSI prevention.
Donna Nucci
Publish Date: May 25, 2016
OR Excellence
Donna Nucci, RN, CIC, MS Donna Nucci, RN, CIC, MS

Speaker Profile

  • Working as a nurse for 25 years provided her with knowledge of infection control challenges in multiple practice settings.
  • Consulted with APIC to implement the infection preventionist competency model at surgical facilities.
  • Provides on-site and remote mentorship for new infection preventionists.

Donna Nucci, RN, CIC, MS, has spent years assessing the best ways to prevent surgical site infections. At OR Excellence, she'll put attendees through the paces with an interactive and informative boot camp on best practices in hand hygiene, endoscope reprocessing, medication injection practices and more. During her "How to Avoid an Infection Control Disaster" workshop, Ms. Nucci will tailor the presentation to the concerns of those in attendance. "We're going to have a conversation," she says. "I want to know the specific issues attendees are facing, and come up with effective ways to solve them."

  • Understanding the dangers. I developed a comprehensive risk assessment tool with the epidemiologist at my hospital that can be used as an annual assessment. It defines risk in 8 areas, including the types of patients you care for, the kinds of surgeries you perform and your geographical area. If you're doing colonoscopies, is there really a risk that you're exposing patients to C. diff? How much bioburden will accumulate if you don't have the right tools to clean your cannulated instruments? The risk assessment tool answers those questions.
  • Focus on riskiest areas. Facility leaders might think their problems lie in one area, but the risk assessment tool might prove other more urgent issues need corrective action. By using the tool, administrators can identify the projects they truly need to focus on in order to lower infection risks.
  • Bundled approaches. We established bundles of care at Yale-New Haven Hospital for SSI prevention that include antibiotic prophylaxis, nasal decolonization and standardized skin preps. The Joint Commission and CDC want to see the bundles facilities have in place to standardize care, which gets all the stakeholders together to discuss the best ways to prevent specific kinds of infections. That way, they do the exact same thing for every single patient. Bundles establish the standard of care and eliminate the variables that might lead to infection.
  • Endoscope reprocessing. We'll address the gap between national guidelines and actual practice. For example, if you store unused scopes in state-of-the-art cabinets with the right air exchanges and nobody touches them, you don't need to reprocess them every 5 days between uses, as AORN recommends. There's also variation in preparing scopes for reprocessing at the point of care — the time between when a scope exits the patient and when it gets placed into an automatic reprocessor.
  • Medication management. Anesthesia providers don't get proper education on how medication should be prepared for administration. They simply don't have a good working knowledge of safe injection practices and tend to cut corners. Anesthesia providers at many centers I've worked at ignore the "60-minute rule" — the length of time agents can remain in a syringe without being used — by drawing up medications for the entire day, instead of preparing medications for a specific case. Whenever I present on this topic, half of the audience hasn't even heard of the 60-minute rule, let alone understand the best ways to ensure it's followed. OSM