From the Desk of Brent Wise, M.D., Chief of Infectious Diseases at Hospital for Joint Diseases.

At Hospital for Joint Diseases, infection prevention starts before surgery and continues through the entire hospital stay. Our infection rate for primary total joint replacements is less than 1% in the year following surgery. This compares favorably to the national infection rate of 1%-4%. Part of the reason we maintain such a low rate is because we specialize in orthopaedic procedures, and do a large number of them. Studies show that having a primary focus and specializing in that area leads to better outcomes for patients. However, if even one patient develops an infection, we are not satisfied. Therefore, we are now recommending that patients shower with a chlorhexidine gluconate antimicrobial soap such as hibiclens or betasept for 5 days before surgery. This soap helps to reduce common skin bacteria that can cause surgical infections. In addition, we ensure that every patient receives antibiotics appropriately timed for their procedure. Before each procedure begins, the whole team takes a "time out" to assess the patient's needs. We confirm that antibiotics have been appropriately given, or we administer them at that time. Hospital for Joint Diseases is implementing a program to screen many of our surgical patients for methicillin-resistant Staphylococcus aureus (MRSA) prior to surgery. MRSA infections are very rare at our hospital (less than 0.5% in 2007), but in surgeries involving implants, we strive to make that rate zero percent.

Once the surgical procedure is over, our patients continue to receive specialized care in the recovery room and our nursing units. We encourage all patients and families to partner with us by reminding staff members to clean their hands before beginning any care procedures. We take hand hygiene very seriously, and compliance rates are monitored on each of our units. When you come to Hospital for Joint Diseases, you will see our hand hygiene message on our staff members' identification holders, and in signage throughout the facility. We encourage you to help us by reminding our staff if you don't see them washing hands or using Purell hand sanitizer. At Hospital for Joint Diseases, it's our mission to provide top quality care for our patients, including the lowest possible risk of infectious complication.

Preparing for Your Surgery: Reducing the Risk of Infection