Griffin FA, Resar RK. IHI Global Trigger Tool for Measuring Adverse Events. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2007.

IHI Innovation Series white paper

This white paper provides comprehensive information on the development and methodology of the IHI Global Trigger Tool, with step-by-step instructions for using this easy-to-use method to accurately identify adverse events (harm) and measure the rate of adverse events over time.

Odom-Forren J. Preventing surgical site infections. Nursing2006. 2006 Jun;36(6):58-63.

Surgical site infections (SSIs) account for about 40 percent of all hospital-associated infections among surgical patients in the US, despite continued efforts to reduce or eliminate them. The bad news is that nearly 3 percent of postoperative patients develop an SSI, prolonging hospital stays and raising costs. Patients who develop SSIs are twice as likely to die as other postoperative patients. The good news is that between 40 percent and 60 percent of SSIs can be prevented. That’s why the IHI includes preventing SSIs in its 100,000 Lives Campaign. In this article, the author, a perianesthesia and perioperative nursing consultant, reviews how SSIs develop, and describes the four evidence-based components of care endorsed by the Campaign for preventing them.

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Griffin FA. Best-practice protocols: Preventing surgical site infection. Nursing Management. Nov 2005;36(11):20-26.

Inconsistent application of infection control practices may contribute to differences in SSI rates and mortality of surgical patients. This article is part of a series that describes the Institute for Healthcare Improvement's 100,000 Lives Campaign recommended interventions from a nursing management perspective.

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Pryor DB, Tolchin SF, Hendrich A, Thomas CS, Tersigni AR. The clinical transformation of Ascension Health: Eliminating all preventable injuries and deaths. Joint Commission Journal on Quality and Patient Safety. 2006 June;32(6):299-308.

In 2002 Ascension Health, a 67-hospital not-for-profit health care system, embarked on a journey of clinical transformation to eliminate preventable injuries or deaths. This transformational change implies a much greater pace of change than that reflected in traditional, incremental change processes. Their improvement activities focused on eight priorities for action: JCAHO National Patient Safety Goals; preventable mortality; adverse drug events; falls; pressure ulcers; surgical complications; nosocomial infections; and perinatal safety. [This article is the first in a series.]

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Belda FJ, Aguilera L, Garcia de la Asuncion J, et al. Supplemental perioperative oxygen and the risk of surgical wound infection: A randomized controlled trial. Journal of the American Medical Association. Oct 2005;294(16):2035-2042.

This article describes a study which intended to test the hypothesis that supplemental oxygen reduces infection risk in patients following colorectal surgery. The study concluded that patients receiving supplemental inspired oxygen had a significant reduction in the risk of wound infection.

Dellinger EP, Hausmann SM, Bratzler DW, et al. Hospitals collaborate to decrease surgical site infections. American Journal of Surgery. 2005;190(1):9-15.

This paper describes the results of the National Surgical Infection Prevention Collaborative designed to decrease surgical site infections through improving the use of proven surgical infection prevention practices: appropriate antimicrobial agent selection, timing, and duration; normothermia; oxygenation; euglycemia; and appropriate hair removal.  Sponsored by the Centers for Medicare & Medicaid Services (CMS), this year-long collaborative improvement effort involved 44 hospitals and demonstrated a 27 percent decrease in infection rates.

Zerr KJ, Furnary AP, Grunkemeier GL, Bookin S, Kanhere V, Starr A. Glucose control lowers the risk of wound infection in diabetics after open heart operations. Annals of Thoracic Surgery. 1997;63(2):356-361.

This paper reports on a retrospective chart review study of diabetic patients who underwent cardiac surgery between 1987 and 1993, before and after a glucose control protocol was implemented.  Its objective was to assess the effect of a glucose control protocol on the risk of deep wound infection.

Zanetti G, Giardina R, Platt R. Intraoperative redosing of cefazolin and risk for surgical site infection in cardiac surgery. Emerging Infectious Diseases. 2001;7(5):828-831.

This is a retrospective cohort study done to assess the effect of intraoperative redosing of antimicrobial prophylaxis on the occurrence of surgical site infection following prolonged cardiac procedures. The study population included 1,548 patients who had cardiac surgeries at Brigham and Women’s Hospital between April 1, 1998, and September 30, 1999.

van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. New England Journal of Medicine. 2001;345(19):1359-1367.

This is a report from a prospective, randomized controlled study involving adults admitted to the surgical intensive care unit on mechanical ventilation.  This study examined whether normalization of blood glucose levels with insulin therapy would improve prognosis for critically ill patients with or without diabetes.

Pestotnik SL, Classen DC, Evans RS, Burke JP. Implementing antibiotic practice guidelines through computer-assisted decision support: Clinical and financial outcomes. Annals of Internal Medicine. 1996;124(10):884-890.

This study reports on the outcomes and effects of a hospital-wide computer-assisted decision support program for antimicrobial usage. For the surgical prophylaxis group, the study found that the implementation of the program increased the timeliness of administration of antibiotics, reduced the rates of antibiotic-associated adverse drug events and mortality, and stabilized the emergence of antibiotic-resistant pathogens.