Among her many duties at Our Lady of Lourdes, Lent is responsible for the health ministry’s surgical sterilization protocols. Along with the ministry’s leadership team and infection control committee, she also monitors the use of antibiotics, particularly in the cases of hip and knee replacement surgeries.

The volume of patients with hip and knee replacements continues to grow at Our Lady of Lourdes, in large part due to an emphasis on strict pre- and postsurgery patient education, appropriate use of antibiotics for these patients and an expanding in-home orthopedic rehabilitation practice. These initiatives make for some of the lowest surgical site infection rates for these procedures throughout all of Ascension.

“Our orthopedic surgeons and support teams have strict protocols for specific surgical site preparation and cleaning,” explained Lent. “All the orthopedic teams emphasize low traffic in the operating rooms and those teams to a large degree work with specific surgeons. This means literally that many of the surgical teams stay in the operating room through a patient’s entire surgery despite shift changes, reducing traffic in and out of the operating room.

“Further, the teams work together to reduce variabilities in protocols for instrument cleaning and sterilization. Knowing your surgical team, having that team work with patients on education and therapy, eliminating these variabilities in approach and care, significantly cuts down on the chance for surgical site infections.”

According to Lisa Sturm MPH, CIC, Director of Infection Prevention at Ascension’s Center of Excellence for Antimicrobial Stewardship and Infection Prevention, Dr. Schreiber and Elijah Murrell, Ascension’s Director of Performance Excellence, formed a team effort just over a year ago to survey the System’s 80-100 orthopedic surgical sites for best practices in hip and knee surgeries. They benchmarked those ministries with the lowest surgical site infections and use of antibiotics.

The initial survey was organized by Mohamad Fakih, MD, MPH, Senior Medical Director for Ascension’s Center of Excellence for Antimicrobial Stewardship and Infection Prevention and led by Michelle Flood, RN, MSN, CIC, FAPIC and Sturm. This summer, the survey was refreshed in partnership with Ascension’s national Musculoskeletal Service Line Excellence Council and related affinity groups, and focused on adherence to best practices, readmission rates and antimicrobial utilization.

“Our Lady of Lourdes came out as a top performer with low infections for hip and knee surgeries and low readmission rates,” said Sturm. “They adhere to all the best practices and their infection control protocols are very uniform. Our Lady of Lourdes has a ‘hard-wired patient education process’, which means the entire preoperative and postoperative process is defined and communicated for both the patient and their multidisciplinary team. Everyone’s expectations for how to achieve the best outcomes are crystal clear to the patients and the health ministry’s providers and associates.

“We know, for example, the actual incision time for a hip or knee replacement is a key variable to infection risk. So, if the surgical team works well together, they can anticipate the surgeon’s requirements during surgery, cutting down on the time needed to do that specific surgical procedure. Now that means some accommodation on everyone’s part, but you can see their success in very, very good patient outcomes.”