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Pulse Home Health Care practices skilled health care procedures firmly rooted in the latest research and best practice policies. We routinely mail bulletins to physicians and other medical referral sources to highlight how we help patients and to explain the scientific basis for different services. Here we share selected physician bulletins about Pulses' Home Health Services. If you have questions about how home health could help you, please contact us today.

Surgical Site Infections
Triple the Mortality Rate Among Elderly Patients

SurgeryA study published recently in the Journal of the American Geriatrics Society examined the effects of surgical site infections (SSI) on patients age 65+.1 Dr. Kaye and colleagues performed a retrospective, matched outcome study with 1,337 subjects. Tracking results for only 90 days post-surgery, they found that SSI triples the mortality rate (15.3% vs. 5.2%), increases hospital charges by an average of $41,124, and increases the rate of hospital re-admission by more than 400%. The authors conclude that because outcomes attributable to SSI are severe, optimal management of SSI is particularly important among elderly patients.

The Centers for Medicare and Medicaid Services (CMS) recently expanded its list of “hospital-acquired” conditions that are non-reimbursable because CMS deems them preventable. Such non-reimbursable SSIs include infections following bariatric surgery, laparoscopic gastric bypass, gastroenterostomy, laparoscopic gastric restrictive surgery, coronary artery bypass grafting, and orthopedic procedures involving the spine, neck, shoulder, or elbow.2 However, most patients these days are sent home with healing wounds and with patient/family implemented wound care instructions. For this reason, most surgical site infections become manifest in the home environment.3 but the exact extent to which hosocomial infections contribute to the prevalence of SSI is unkown.4 Having drains in place increases the likelihood that an SSI can be acquired in the home, and it is known that at least some health care related infections are introduced in the home environment.4

The literature often comments that physicians and hospitals have no control over post-discharge variables. This observation should be qualified by the fact that many elderly patients at risk of SSI will qualify for home health services designed to prevent hosocomial infections, ensure adherence to postsurgical instructions, teach family caregivers, monitor SSI, manage SSI in the home, and/or prevent unnecessary re-hospitalization. While being age 65+ in itself ranks as a significant risk factor for SSI, additional risk factors include poor postoperative glycemic control, obesity, diabetes mellitus, malnutrition, prolonged inpatient stay, infection at a remote site, immunosuppressive drugs, and duration of surgery.5

When these patients are homebound, even temporarily due to surgery, home health is often appropriate. Pulse Home Health Care can provide wound care including negative pressure wound therapy, patient and family teaching, skilled wound monitoring, nutritional intervention, assistance with glycemic control, and more. Promptly identifying and managing SSI in the less costly home environment can serve as a major cost saver for patient and payor while also protecting patient safety.

Medicare Home Health Compare

A National Leader in Wound Care

Medicare’s risk adjusted, objective outcome reporting shows that your patients’ wounds are more likely to heal when your patients are with Pulse Home Health Care. Compared to national averages, your patients with Pulse are 13% more likely to achieve wound healing or improvement during the home health episode.

Please offer Pulse Home Health Care to your patients.

 

References

  1. Kaye K, Anderson D, Sloane R, et al. The effect of surgical site infection on older operative patients. J Am Geriatr Soc. 2009; 57(1): 46-54.
  2. Olsen K. Prevention of surgical site infections: Improving compliance with the surgical care improvement project measures. Medscape Pharmacists. July 14, 2009.
  3. Sands K, Vineyard G, Platt R. Surgical site infections occurring after hospital discharge. J Infect Dis 1996; 173: 963-70.
  4. Manangan L, Pearson M, Tokars J, et al. Feasibility of national surveillance of health-care-associated infections in home-care settings. Emerging Infectious Diseases. 2002; 8 (3): 233-236.
  5. Mangram AJ, Horan TC, Pearson ML, et al. The Hospital Infection Control Practices Advisory Committee. Guideline for the prevention of surgical site infection. Infect Control Hosp Epidemiol 1999; 20: 247-280. 

 


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