Project JOINTS Exemplar Hospital Application
Portage Health – Hancock, Michigan
Number of licensed beds: 36
Non-Teaching
Rural
Exemplar Hospital Contact Name: Kathy Manderfield - Unit Manager of Perioperative Services
Email: kmanderfield@portagehealth.org
Phone: 906-483-1335
We give permission to IHI to make public all the information on this Project JOINTS Exemplar Hospital application.
Enhanced Surgical Site Infections Prevention Bundle element (identify one per sheet): Use of an alcohol-containing
antiseptic agent for preoperative skin preparation
1.
When we joined Project JOINTS, we were already using Chloraprep as our primary pre-op skin preparation in
the OR.
2. Our surgeons were 100% on board for the change from Betadine to Chloraprep (unless contraindicated) as our
primary skin prep. All of our surgeons are employed by the hospital, so we made the change institution wide to
include ED, clinic and any other service that was currently using betadine.
3. We began by educating the nursing staff in the clinics, Perioperative Services and Managers of the ED, IPU and
OB. Because of our small size, it was decided to make the change for all patients at the same time. Go live with
our new prep began in May of 2010
4. Prior to the education of the nurses, we had taken our concerns about our current prep to the Surgery Section
Committee and Infection Prevention Committee. Both were unanimous in their support for the use of
Chloraprep
In a few sentences, describe in what ways your hospital has been successful in implementing this element of the
Enhanced Surgical Bundle. Please answer the following questions:
What key changes did your organization make to incorporate or support use of an alcohol-containing antiseptic agent
for preoperative skin preparation? What were the changes in existing processes your organization had to make in order
for this to become part of the routine?
1. We had 100 % support from both the Surgery Section committee and the Infection Prevention Committee. We
now use Chloraprep as the primary skin prep hospital wide. Again, the most important and basic element was
the education of the nursing staff as to why Chloraprep is superior to Betadine through evidence based learning.
How did you roll out this practice? Did you test it with one patient, a few, or all to start?
Because of our small size, we decided to roll it out for all patients at the same time. We began using Chloraprep house
wide in May 2010. We report post-op infections to both our Surgery Section Committee and our Infection Prevention
Committee.
What lessons have you learned as you've implemented this practice? What tips do you have to share?
The surgeons will be much more receptive to new ideas and practices if there is a track record of evidence based
medicine.
Indicate which statement best summarizes your organization’s level of implementation of this Enhanced Surgical
Bundle element:
[ X] This practice is used for 100% of hip/knee arthroplasty cases.
[ ] We have a well-tested protocol and use it for some hip/knee arthroplasty cases.