Surgical Care Improvement Project and Tissue Banking in

Surgical Care Improvement Project and Tissue Banking in the OR

Surgical Care Improvement Project (SCIP) What is it? Many surgical complications are caused by error, or by not following evidence-based guidelines, which account for 22% of preventable deaths. Participation in the SCIP program prevents complications from occurring.

Surgical Care Improvement Project (SCIP) Four Target Areas: ◦ Surgical Site Infections Antibiotics, blood sugar control, hair removal, normothermia. ◦ Perioperative Cardiac Events Use of beta blockers perioperatively. ◦ Venous Thromboembolism Appropriate prophylaxis. ◦ Ventilator Associated Pneumonias Head of bed elevated, rapid weaning protocol, Pepitic Ulcer Disease (PUD) prophylaxis.

SCIP Directives Remember the acronym (CATS): ◦ Clippers: if hair is removed, clippers are the best option. NEVER use a razor. ◦ Antibiotics: should be administered within 1 hour of incision time and discontinued within 24 hours, according to national guidelines (unless Gentamicin and Vancomyacin are ordered; then administer 2 hours prior to incision time). ◦ Temperature: normothermia—Colorectal surgery patients should be normothermic within the first hour post surgery. ◦ Sugar: cardiac surgery patients should have a controlled blood glucose of < 200 mg/dl on the first and second day post-op.

Tissue Banking Tissue banking (human cells and tissues) encompasses: ◦ Procuring ◦ Processing ◦ Preserving ◦ Storing

Tissue Banking Human tissue includes (not limited to): ◦ ◦ ◦ Bone Cartilage Ligaments Tendons Dura Mater Sclera Corneas Heart Valves/Conduits Fascia Vessels Skin

Tissue Banking Nursing Responsibilities Biggest responsibility is prevention of infections. To achieve this goal, nurses must be current on regulations, standards, and recommended practices related to surgical tissue banking to promote patients free of signs and symptoms of infection.

Tissue Tracker CMC is using online Tissue Tracking It is logged in when it is received When the tissue is used it is recorded in EPIC Tissue Tracker sends the patient information and tissue usage back for registration.

AORN Recommended Practices for Surgical Tissue Banking Recommended Practice I: “Facilities procuring, processing and/or preserving tissue, and facilities storing tissue for potential transfer to a different facility, must register as tissue banks with the FDA. ” Recommended Practice II: “Facilities procuring, processing, preserving, storing or distributing tissue to other facilities should have defined oversight with authority and accountability for all activities performed. ”

AORN Recommended Practices for Surgical Tissue Banking Recommended Practice III: “Surgical tissue bank personnel must be knowledgeable about the aspects of tissue banking in which they participate. ” Recommended Practice IV: “Potential donors, their family members, and recipients of tissue should be treated with respect, dignity and sensitivity, and their rights should be protected. ”

AORN Recommended Practices for Surgical Tissue Banking Recommended Practice V: “Tissue for transplantation must be recovered only from suitable donors. ” Recommended Practice VI: “Tissue must be recovered, processed and transplanted in clean, controlled environments appropriate for sterile surgical procedures. ”

AORN Recommended Practices for Surgical Tissue Banking Recommended Practice VIII: “Tissue must be recovered and processed in a manner that minimizes microbial growth, contamination and cross-contamination. ” Recommended Practice IX: “Tissue must be prepared, processed and preserved in a manner that minimizes microbial growth and optimizes the condition of the tissue for transplantation. ”

AORN Recommended Practices for Surgical Tissue Banking Recommended Practice X: “Allograft tissue obtained from an outside tissue bank should be handled in a manner consistent with the source facility’s, or manufacturer’s, written instructions. ” Recommended Practice XI: “Tissue is transported and stored in a manner that minimizes the risk of compromise or contamination. ”

AORN Recommended Practices for Surgical Tissue Banking Recommended Practice XII: “Tissue should be quarantined until all steps of the tissue-banking process have been reviewed and found acceptable. ” Recommended Practice XIV: “A quality management program must be in place to evaluate the structure, processes and outcomes of tissuebank services. ”

AORN Recommended Practices for Surgical Tissue Banking Recommended Practice XV: “Policies and procedures for preserving, storing and maintaining tissue should be established, reviewed annually, and readily available in the practice setting. ”