| Nanette Lavoie-Vaughan, M.S.N., ARNP-C |
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References
1. Dacey MJ. Mediastinitis. eMedicine website. Available at:
www.emedicine.com/med/topic2798.htm. Accessed April 6, 2005.
2. Carey MJ. Mediastinitis. eMedicine website. Available at:
www.emedicine.com/emerg/topic307.htm. Accessed April 6, 2005.
3. King R and Barnes A. Mediastinitis. Curr Treatment Options Infect Dis.
2003;5:377-386.
4. El Oakley RM, Wright JE. Postoperative mediastinitis: classification and
management. Ann Thorac Surg. 1996;61(3):1030-1036.
5. Thomas S. An introduction to the use of vacuum assisted closure.
Available at:
http://www.worldwidewounds.com/2001/may/Thomas/Vacuum-Assisted-Clo
sure.html. Accessed April 6, 2005.
6. Swearingin P, Keen J. Manual of Critical Care Nursing: Nursing
Interventions and Collaborative Management. 4th ed. St. Louis, MO:
Mosby; 2001.
1. Dacey MJ. Mediastinitis. eMedicine website. Available at:
www.emedicine.com/med/topic2798.htm. Accessed April 6, 2005.
2. Carey MJ. Mediastinitis. eMedicine website. Available at:
www.emedicine.com/emerg/topic307.htm. Accessed April 6, 2005.
3. King R and Barnes A. Mediastinitis. Curr Treatment Options Infect Dis.
2003;5:377-386.
4. El Oakley RM, Wright JE. Postoperative mediastinitis: classification and
management. Ann Thorac Surg. 1996;61(3):1030-1036.
5. Thomas S. An introduction to the use of vacuum assisted closure.
Available at:
http://www.worldwidewounds.com/2001/may/Thomas/Vacuum-Assisted-Clo
sure.html. Accessed April 6, 2005.
6. Swearingin P, Keen J. Manual of Critical Care Nursing: Nursing
Interventions and Collaborative Management. 4th ed. St. Louis, MO:
Mosby; 2001.
Infection Control Intervention for Cardiac Patients
Nalini Rao has developed a clinical process model for infection
control intervention in cardiac surgery patients. It’s based on a
seven-part intervention program.
Step 1: Prospective surveillance of superficial and deep
chest infections. By identifying patients with
clinical risk factors (such as diabetes, immune
deficiency, malnutrition, hepatic dysfunction,
alcohol or drug abuse, COPD, and obesity),
measures to prevent postoperative infection can
be implemented.
Step 2: Post-discharge follow-up of patients readmitted
within 30 days with any wound-related
complications.
Step 3: Use of chlorhexidine showers the night before
surgery and the morning of surgery.
Step 4: Do not shave the site. Clip only the hair necessary
for operative preparation the morning of surgery.
Step 5: Administer prophylactic antibiotics before and
during surgery in patients at high risk.
Step 6: Segregate surgical instruments between the graft
harvest site and the chest cavity.
Step 7 Implement preoperative, individualized insulin
protocol for diabetic patients before surgery.
Source: Rao N, Schilling D, Rice J, Ridenhour M, Mook W, Santa E. Prevention
of postoperative mediastinitis: a clinical process improvement model. J Healthc
Qual. 2004;26(1):22-7.
Nalini Rao has developed a clinical process model for infection
control intervention in cardiac surgery patients. It’s based on a
seven-part intervention program.
Step 1: Prospective surveillance of superficial and deep
chest infections. By identifying patients with
clinical risk factors (such as diabetes, immune
deficiency, malnutrition, hepatic dysfunction,
alcohol or drug abuse, COPD, and obesity),
measures to prevent postoperative infection can
be implemented.
Step 2: Post-discharge follow-up of patients readmitted
within 30 days with any wound-related
complications.
Step 3: Use of chlorhexidine showers the night before
surgery and the morning of surgery.
Step 4: Do not shave the site. Clip only the hair necessary
for operative preparation the morning of surgery.
Step 5: Administer prophylactic antibiotics before and
during surgery in patients at high risk.
Step 6: Segregate surgical instruments between the graft
harvest site and the chest cavity.
Step 7 Implement preoperative, individualized insulin
protocol for diabetic patients before surgery.
Source: Rao N, Schilling D, Rice J, Ridenhour M, Mook W, Santa E. Prevention
of postoperative mediastinitis: a clinical process improvement model. J Healthc
Qual. 2004;26(1):22-7.
| Nanette Lavoie-Vaughan, M.S.N., APN |
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References
1. Dacey MJ. Mediastinitis. eMedicine website. Available at:
www.emedicine.com/med/topic2798.htm. Accessed April 6, 2005.
2. Carey MJ. Mediastinitis. eMedicine website. Available at:
www.emedicine.com/emerg/topic307.htm. Accessed April 6, 2005.
3. King R and Barnes A. Mediastinitis. Curr Treatment Options Infect Dis.
2003;5:377-386.
4. El Oakley RM, Wright JE. Postoperative mediastinitis: classification and
management. Ann Thorac Surg. 1996;61(3):1030-1036.
5. Thomas S. An introduction to the use of vacuum assisted closure.
Available at:
http://www.worldwidewounds.com/2001/may/Thomas/Vacuum-Assisted-Clo
sure.html. Accessed April 6, 2005.
6. Swearingin P, Keen J. Manual of Critical Care Nursing: Nursing
Interventions and Collaborative Management. 4th ed. St. Louis, MO:
Mosby; 2001.
1. Dacey MJ. Mediastinitis. eMedicine website. Available at:
www.emedicine.com/med/topic2798.htm. Accessed April 6, 2005.
2. Carey MJ. Mediastinitis. eMedicine website. Available at:
www.emedicine.com/emerg/topic307.htm. Accessed April 6, 2005.
3. King R and Barnes A. Mediastinitis. Curr Treatment Options Infect Dis.
2003;5:377-386.
4. El Oakley RM, Wright JE. Postoperative mediastinitis: classification and
management. Ann Thorac Surg. 1996;61(3):1030-1036.
5. Thomas S. An introduction to the use of vacuum assisted closure.
Available at:
http://www.worldwidewounds.com/2001/may/Thomas/Vacuum-Assisted-Clo
sure.html. Accessed April 6, 2005.
6. Swearingin P, Keen J. Manual of Critical Care Nursing: Nursing
Interventions and Collaborative Management. 4th ed. St. Louis, MO:
Mosby; 2001.
Infection Control Intervention for Cardiac Patients
Nalini Rao has developed a clinical process model for infection
control intervention in cardiac surgery patients. It’s based on a
seven-part intervention program.
Step 1: Prospective surveillance of superficial and deep
chest infections. By identifying patients with
clinical risk factors (such as diabetes, immune
deficiency, malnutrition, hepatic dysfunction,
alcohol or drug abuse, COPD, and obesity),
measures to prevent postoperative infection can
be implemented.
Step 2: Post-discharge follow-up of patients readmitted
within 30 days with any wound-related
complications.
Step 3: Use of chlorhexidine showers the night before
surgery and the morning of surgery.
Step 4: Do not shave the site. Clip only the hair necessary
for operative preparation the morning of surgery.
Step 5: Administer prophylactic antibiotics before and
during surgery in patients at high risk.
Step 6: Segregate surgical instruments between the graft
harvest site and the chest cavity.
Step 7 Implement preoperative, individualized insulin
protocol for diabetic patients before surgery.
Source: Rao N, Schilling D, Rice J, Ridenhour M, Mook W, Santa E. Prevention
of postoperative mediastinitis: a clinical process improvement model. J Healthc
Qual. 2004;26(1):22-7.
Nalini Rao has developed a clinical process model for infection
control intervention in cardiac surgery patients. It’s based on a
seven-part intervention program.
Step 1: Prospective surveillance of superficial and deep
chest infections. By identifying patients with
clinical risk factors (such as diabetes, immune
deficiency, malnutrition, hepatic dysfunction,
alcohol or drug abuse, COPD, and obesity),
measures to prevent postoperative infection can
be implemented.
Step 2: Post-discharge follow-up of patients readmitted
within 30 days with any wound-related
complications.
Step 3: Use of chlorhexidine showers the night before
surgery and the morning of surgery.
Step 4: Do not shave the site. Clip only the hair necessary
for operative preparation the morning of surgery.
Step 5: Administer prophylactic antibiotics before and
during surgery in patients at high risk.
Step 6: Segregate surgical instruments between the graft
harvest site and the chest cavity.
Step 7 Implement preoperative, individualized insulin
protocol for diabetic patients before surgery.
Source: Rao N, Schilling D, Rice J, Ridenhour M, Mook W, Santa E. Prevention
of postoperative mediastinitis: a clinical process improvement model. J Healthc
Qual. 2004;26(1):22-7.
| Recognizing Mediastinitis |