b'Veteran OwneeddlSb maasilD le Bc ui v r e S n i ss s eC V ESSI is Devastating for Patients and a Financial Burden to theHealth Care SystemPatient Factors 125X 2X 2X Xmore likely to be more likely to be more likely to more likely toreadmitted after admitted to ICU3 die after surgery3 die after surgerydischarge3 with MRSA infection4Financial Factors#1 $90 $10 9.7k BSSI is most Cost of SSI in Estimated annual costs Average length of staycommon & costly problemprosthetic joint implants exceed $10 Billion31 increased 9.7 days31in health care.31 exceeds $90,0005Many if Not Most Wounds are Contaminated During Surgery Lack of traffic control, too many in roomImproper Hand Antisepsis Poor Communication AmongLack of Hand HygieneImproper Surgical AttireTeam Factors That Contribute Patient Body Colonization Unsterile Instruments Financial Constraints to Contamination Risk Lack of Pre-Op ShowerUse of Staples or Steri-Strips Poor Leadership in the Operating RoomContaminated Environment Increase in Hospitalization Days Inadequate Surgical ProphylaxisSurgical IrrigationPre-Operative Factors Peri-Operative Factors Organizational FactorsPatient Factors Surgeon Technique Environment Factors Care Delivery Problems Lack of Discontinuation ofMRSA or MSSA NasalAntibiotics after 24 hours Colonization Poor Staff Levels Contaminated EnvironmentInfection at Another SiteUse of Drains Design, Availability & Lack of Hand HygieneObese Lack of Re-Dosing of AntibioticMaintenance of Equipment Contamination of Incision Post- Diabetic Poor Surgical TechniqueWork Load and Shift PatternsOp SmokerEnvironment & Physical Plant Inadequate Staffing for Post- Op CareImmunosuppressive Agents Problems(Air Handling System)Lack of Foley Catheter Removal Within 48 Hours42 Prontosan'