SCIP & ERAS (Exam II) Flashcards
Complications lasting 30 days decrease median survival rate by ____%.
69%
What are the antibiotic performance metrics associated with the SIP (Surgical Infection Prevention Project)?
- ABX started within 1 hr of incision
- ABX regimen consistent w/ guidelines
- ABX d/c within 24hours of surgery stop
What did compliance with three metrics of SIP project look like?
Not great
When was the Surgical Care Improvement Project (SCIP) implemented?
What was the intended result?
- Aimed at reducing surgical mortality and morbidity. Reduce surgical complications by 25%
What national organization was notably missing from the SCIP steering committee?
AANA
we must advocate for our profession
What are the three antibiotic measures associated with the SCIP?
- ABX within 1 hour of incision
- Correct ABX based on procedure
- D/C ABX in 24 hours unless documented reason. (within 48 hours for cardiac sx)
What are the two antibiotics that can be given within 2 hours of incision?
Vancomycin and Fluoroquinolones
When must ABX be discontinued after Cardiac Surgery?
Within 48 hours of cardiac surgery
What are the β-blocker measures associated with the SCIP? (2)
- β blocker within 24 hours of surgery start for all patients on chronic β blocker therapy.
- β blocker restarted after surgery for all patients on chronic β blocker therapy.
What is the hair removal measure associated with the SCIP?
- Documentation of appropriate hair removal w/ clippers only (no razors).
What is the foley catheter measure associated with the SCIP?
Urinary catheter removal on or before POD 2 unless order for extension exists. (must be documented)
What is the blood sugar measure associated with the SCIP?
Cardiac patients need a controlled post-operative blood glucose of ≤ 200 mg/dL prior to surgery and after.
What are the DVT measures associated with the SCIP? (3)
- SCDs placed for all surgeries longer than 1 hour.
- Orders for DVT prophylaxis on post-operative admission orders.
- RN administration of DVT prophylaxis within 24 hours of surgery end.
What are the temperature measures associated with the SCIP? (2)
- Normothermic or active warming in OR
- 1st temp in PACU ≥ 96.8F within 15 minutes of leaving OR.
What are the new ASA guidelines for preoperative fasting periods?
What pre-medications are typically given in the pre-operative area?
Midazolam (and/or fentanyl)
COX-2 Inhibitor (Paracoxib, celecoxib, etc)
A 70kg patient was NPO for 8 hours. What is this patients calculated fluid deficit?
(4-2-1 rule)
40ml + 20mL + 50mL = 110mL/hr
110 x 8hrs = 880 mL deficit
How much of a fluid deficit occurs due to bowel prep?
2-3L