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Herald Citizen – JOINTS Initiative comes to Cookeville.

JOINTS Initiative comes to Cookeville
by Amye Wright

Orthopedic surgeon Dr. James McKinney, left, explains a total knee replacement surgery and the risk of surgical site infections to a potential patient. Herald-Citizen Photo/Amye Wright

Orthopedic surgeon Dr. James McKinney, left, explains a total knee replacement surgery and the risk of surgical site infections to a potential patient. Herald-Citizen Photo/Amye Wright

COOKEVILLE — Dr. James McKinney along with the staff at the Upper Cumberland Orthopedic center have joined forces with an initiative that will work to eliminate infections following certain procedures.

McKinney’s involvement with several related committees lead him to also work with the Institute for Healthcare Improvement’s federally-funded Project JOINTS — Joining Organizations IN Tracking SSI — initiative.

“We’ve involved in (JOINTS) because we want to see the very best outcomes for our patients,” McKinney said.

The orthopedic center works closely with CRMC and provides most of the hospital’s orthopedic surgery services. The relationship isn’t exclusive but is “very tight,” says McKinney.

With the help of JOINTS, the group hopes to reduce the risk of infection and multiple surgeries by adopting methods proven to prevent surgical site infections, SSIs, after total hip and knee replacement surgeries.

“Our infection rates are very low at our hospital but we want to try to get to zero,” Stephanie Etter RN and Infection Prevention Manager for Cookeville Regional Medical Center said. “So this is just a project that helped us to implement the best practice initiatives through the American College of Orthopedic Surgeons.”

Some of the newly suggested practices include:

* Patientbathing or showering with a special antibacterial soap for at least three days before surgery

* Screening patients for the presence of Staph prior to surgery and treating those testing positive

* Preparing skin at the surgical site with an antiseptic solution that contains alcohol.

According to Etter and McKinney, CRMC and the orthopedic center already implement many of those practices and local SSI cases area make up less than one percent.

But, knee and hip replacements are two of the most commonly performed surgeries in the U.S., according to IHI. Depending on patient risk, it is estimated that between 6,000 and 20,000 SSIs occur annually after these types of surgeries and the number is predicted to rise substantially in coming years due to an aging population staying more active.

An infection in or around the surgical site of a total joint replacement can result in “devastating” outcomes including additional surgeries, months of medical and physical therapy, considerable pain and extensive out-of-pocket costs.

Prior to surgery, patients are given hygiene sheet that tells patients how to bath with a special antibacterial soap and also instructs them to avoid things like shaving the area or bending or stooping for extended periods.

“It’s really important for the public to follow those instructions before surgery,” Etter said. “Patient safety is our priority (and) we want to be proactive in decreasing our patients’ risk for post-operative infection by implementing the latest (and) best guidelines.”

Tennessee was one of only five states chosen to participate in this pilot initiative.

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