Post-cesarean infection is wound contamination that usually occurs after a patient has undergone an abdominal caesarian delivery also known as C-section. In most scenarios, it is due to a bacterial infection at the site of the incision. When an individual contacts the infection there are common symptoms such as swelling at the site on the incision, redness, fever, abdominal pains, and sensitivity at the wound region. Recent research shows a certain group of women are prone to suffer from a post-cesarean wound infection. Women who are obese are most likely to contact a bacterial infection after the procedure. This is not the only group that is more likely to get affected; diabetic women are not lucky enough to escape the predicament. During the period of pregnancy, if a pregnant woman suffers from chorioamnionitis which refers to, amniotic fluid infection and fetal membrane, she will suffer in future in case she undergoes a C-section during delivery. This is because chances of her contacting the infection after the procedure are high.
However, women who undergo good prenatal care during the pregnancy are very lucky because, chances of them contacting the infection after the procedure are quite thin (McKean et al., 2016). During delivery through C-section, it is also important to note that the kind of sutures used in the procedure may determine the possibility of an infection. Staple sutures ad nylon sutures are not the most convenient once to be used because they increase chances of an infection. Notably, polyglycolide (PGA) is the most convenient type of suture to be used due to their biodegradable nature. As a nurse in cases where a patient complains of discomfort in the lower abdomen after the procedure, it is important to focus on looking at the incision wound. The factors to consider are the wound appearance, occurrence of bacteria, presence of common infection, and the healing progress of the incision wound. In most cases, it is important to draw the puss from the wound then do an analysis.
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Factors
Improving patient safety is an important factor to consider in surgical rooms. The promotion of patient safety has been advanced by the establishment of standard procedures for every operating room in hospitals. Apart from the standard procedures, improvement of communication in the surgical rooms has turned out to be working. This is because it has helped overcome errors such as; faulty procedure, wrong blood transfusion, mismatched organs, and disregarded allergies. Such errors, in most cases, usually turn out to be catastrophic (Smith, 2017).
Nurse leadership is essential in ensuring that the necessary resources and manpower are put in place in ensuring good quality care and outcome of the patients after treatment or surgery. As such, nurse administrators at the organizational level contribute in the setting of strategy through their active involvement in senior levels. They have the ability to influence how nursing is perceived and practiced throughout the institution. Apart from that, they also play a major role in ensuring the standard procedures are followed by their co-workers. In rare cases of crisis, they can come up with long-term solutions after communicating with the entire team they run.
Worldwide more than 200 million surgeries are performed each year. However, these policies have not worked in reducing the rates for surgery. Surgical procedures remain expensive for most patients. Current policies as highlighted in World Health Organization (WHO) are, ensuring pre-operative checklist before a surgery, excellent organization of the process to prevent errors, miscommunication, and conflict resolutions. All these policies work to ensure that there are exceptional patient safety and care before and after surgery. Notably, in all scenarios, the safety procedures created are based on scientific evidence, and constant revision of the guidelines is necessary in order to enhance patient safety (McKean et al., 2016).
Recommendations
C-section mortality was on a high in the US due to post-surgery infections; however, preoperative antiseptic shower taken by the patient before the surgery has turned out to be helpful in reducing this infection. In this case study, the patients were required to shower with 4% chlorhexidine gluconate the night before the surgery in an effort to reduce bacteria present on the skin. As stated by Centre for Disease Control and Prevention small clinical surgical trials turned out to be successful a benefit of chlorhexidine shower before the surgery. A recent study on 700 patients showed the ability of chlorhexidine to reduce bacterial fold colonies nine times as compared to povidone iodine. Whether this works for the reduction of infections is a factor that is yet to be established.
The collection of information can only be successful through communication and research. Questionnaires administration to the surgeons and patients on the effective measures being taken in surgical wards will also come in handy. Beneficial research articles can be accessed online, and a means developed to come up with. An assessment of the current safety guidelines in the hospitals is also necessary for coming up with a remedy for issues and complications within the system. After assessment and issuing of the questionnaires, a study on the response of workers, patients and administrators are necessary in order to come up with a long-term solution to the crisis.
The source of the problem would only be determined by proper analysis and assessment of the present standard surgical procedures. Identification of loopholes in the system will be possible after carrying a study on the cases of post-surgery infection. My aim during the study is to establish the factors that led to the infection and the establishment of measures needed to be taken in order to solve the problem.
Quality Improvement
After identification of issues regarding patient safety and the loopholes in the system, it is paramount for the hospitals to implement new policies that will salvage the situation. The administrators and healthcare professionals are trained on how to encourage teamwork and policy observance. System thinking should also be introduced; this will help employees view individual issues as a part of a whole problem during the creation of solutions. The employees should also be educated on how to follow a checklist before any surgical procedure; they should also be made aware of the role they play in healthcare therefore, alerting the necessary individuals in case of errors. When there is teamwork and proper training of the worker's good health care for patients will be guaranteed. However, training will vary according to the policies that the hospital stands for. Notably, employees should all be aware of institutional protocols, the changes made and all steps to be used in all standard procedures. Education may take a period of about two months whereas; implementation will take between six to eight months (Coates et al., 2016).
In conclusion, a nurse plays a significant role in ensuring that the patients get good health care before surgery and after. The employees should also be educated on how to follow a checklist before any surgical procedure; they should also be made aware of the role they play in health care, therefore, alerting the necessary individuals in case of errors. When there are teamwork and proper training of the workers' good health care for patients will be guaranteed.
References
Coates, E., Fuller, G., Wrench, I. J., Wilson, M. J., Stephens, T., & Hind, D. (2016). A quality improvement clinical pathway for enhanced recovery after elective Caesarean Section: results of a consensus exercise and survey.
Forrester, J. A., Koritsanszky, L. A., Amenu, D., Haynes, A. B., Berry, W. R., Alemu, S., ... & Weiser, T. G. (2018). Developing Process Maps as a Tool for a Surgical Infection Prevention Quality Improvement Initiative in Resource-Constrained Settings. Journal of the American College of Surgeons.
McKean, S. (2016). Principles and practice of hospital medicine. J. J. Ross, D. D. Dressler, & D. Scherer (Eds.). McGraw-Hill Medical Publishing Division.
Smith, A. K. (2017). Cesarean Section Surgical Site Infection Prevention Evidence-Based Practices and Implementation Plan .
