Perioperative Infection Prevention: Moving from Idea to Innovation


Its often the small things that can lead to impactful change in healthcarehaving the courage to share an idea during a team meeting, taking the time to learn about new technologies and approaches, making the effort to collaborate with a colleague.

By Rosemarie Schroeder, BSN, RN, CNOR
Its often the small things that can lead to impactful change in healthcarehaving the courage to share an idea during a team meeting, taking the time to learn about new technologies and approaches, making the effort to collaborate with a colleague.

Perioperative nurses and infection preventionists need to be working together to look for and implement innovative ideas. But how? First, we must clearly understand what innovation is, how we can find it, and how we can grow it in our own practice and our collaborative work with each other.

What is innovation?
A discipline. This is according to Scott Anthony, author of The Little Black Book of Innovation. In his May 30, 2012 Harvard Business Review blog post he defines innovation as:
"Something different that has impact."
He notes several important ideas that resonate well for healthcare:
Innovation is a discipline to be mastered and managed a process that combines discovering an opportunity, blueprinting an idea to seize that opportunity, and implementing that idea to achieve results.
Innovation is about small ideas, not big-bangs.
Everyone in an organization should think about doing something different that has impact.

I have chosen innovation as the theme for my AORN presidency because we can use innovation as a discipline to systematically think about and implement the kind of changes we need in the perioperative environment today.

Who drives innovation?
We do. This we in perioperative care includes everyone who has a stake in patient safety:
Infection preventionists who shape and analyze best practices for halting the spread of dangerous infections.
Frontline nurses who prepare our patients for surgery and guide them through the surgical process.
Environmental services partners who maintain a healthy physical environment for our patients.
OR directors like me who must make decisions that impact the different facets of perioperative care.

And we cant forget the physicians, surgical technologists, sterile processing specialists, supply chain managers and C-Suite folks at the top. From our different vantage points we each have daily opportunities to identify innovative ideas for change.

Where do we find innovation?
Right in front of us. Our work to protect patients is not getting easierin some ways, its becoming more complex. These complexities are forcing us to change the way we think and act in providing safe patient care.

Consider some of the infection prevention challenges we face:
Dangerous healthcare-acquired infections continue to be transmitted.
Bioburden is being discovered on surgical instruments after sterile processing.
Pathogenic bacteria are being discovered on hard surfaces and soft surface textiles in the perioperative setting.
Simple safety practices, such as appropriate hand hygiene and double-gloving are still not being followed consistently.
Within these challenges lie the seeds of innovationwe cant let these opportunities for impactful change slip past us.

How do we identify opportunities for innovation?
Brainstorm new ideas. Now is the time to be identifying and talking about different approaches to our most pressing infection prevention concerns.

So, here is my challenge to you:
Grab a pen and paper or pull up the notes app on your phone or tablet.
Jot down five infection prevention goals you are working toward in your daily practice.
Review this list every day and be looking for new opportunities to address these goals. Be sure to look in your daily reading and workplace interactions, and dont forget to write down your idea before it slips away.
Blueprint the idea by identifying the needed steps and players for implementation.
Collaborate with colleagues to put the idea into action

Here are the top five infection prevention goals on my list:
1. Prevent surgical site infections
2. Support best practices for sterile technique in all perioperative practice settings
3. Pilot improved practices for environmental cleaning in the OR
4. Find effective ways to boost hand hygiene and double gloving compliance
5. Learn about new approaches that reduce infection transmission, including recent improvements around textiles, technology and evidence-rated research.

Here are some of the AORN resources I am exploring to get new ideas for reaching these goals:
The 2013 edition of AORNs Perioperative Standards and Recommended Practices, with new evidence-rated practice recommendations for Prevention of Transmissible Infections, Sterile Technique, Safe Environment of Care and Sterilization.
AORN Congress in San Diego, March 2-7, 2013 (for the education sessions and face-to-face brainstorming with colleagues working in the periop setting, industry and regulatory worlds).
AORN Journal. Explore the Article Collection for Infection Prevention.

During my AORN presidency, I look forward to hearing from infection preventionists and OR colleagues so we can spread knowledge and fuel innovation by finding something different that has impact in our infection prevention efforts. We know whats at stake if we dont find new ways to prevent infectionour patients lives.

Rosemarie Schroeder, BSN, RN, CNOR, is the 2013-2014 AORN president and director of surgical services at St. Joseph's Hospital with Ministry Health Care in Marshfield, Wis.


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