DNP 840 Discuss a health care policy or practice that has been advanced through lobbying efforts at the national level
Thank you for your post. It resonates with me on many levels. The historical aspect you outlined coupled with bringing me down memory lane with SCIP. In response to inconsistent compliance with infection prevention measures, the Centers for Medicare & Medicaid Services collaborated with the U.S. Centers for Disease Control and Prevention to initiate the Surgical Care Improvement Program (SCIP) in 2002 (Schonberger, R. B. et. all, 2015). As a nurse surgical nurse, a core measure lead at that time, I vividly remember the vision focused on reducing the morbidity and mortality associated with postoperative surgical site infection by addressing antibiotics use and early discontinuation, catheter removal within 48 hours postoperatively, use of clippers for hair removal, controlled blood sugars on preop, first and second postop days and maintenance of normothermia. This was an excellent best, demonstrated practice for the care of the surgical patient. The guidelines are clear and create ease of use, even for novice nurses or new physicians. There is strong evidence that implementing protocols that standardize practices reduces the risk of surgical infection. The SCIP initiative targets complications that account for a significant portion of preventable morbidity and cost (Schonberger, R. B. et. all, 2015). SCIP ensures reduced surgical site infection rates, lesser duration of hospital stay, decreased incidence of deep venous thrombosis, and reduced postop morbidity and mortality. Process measures are becoming routine, and as we practice more evidence-based medicine, it falls to us, the surgeons, and Nurses, to be active, not only in the implementation and execution of these measures but in the investigation of clinical questions and the writing of protocols. We are responsible for ensuring that out-of-date practices are removed from use and that new practices are appropriate, achievable, and effective.
Schonberger, R. B., Barash, P. G., & Lagasse, R. S. (2015). The Surgical Care Improvement Project Antibiotic Guidelines: Should We Expect More Than Good Intentions?. Anesthesia and analgesia, 121(2), 397–403. https://doi.org/10.1213/ANE.0000000000000735
