Spine Surgical Site Infection Prevention Bundle Pre-Op Intra-Op Post-Op Patient uses CHG wipes the night before surgery IV Gent (1.5mg/kg) & Ancef (2 g) within 60 min prior to incision Vancomycin for Beta-lactam allergic patients within 120 min prior to incision Anesthesiologist: Set Redosing Alarm for Gent q8, Ancef q4 during Time Out Re-dose Patient with IV antibiotic prophylaxis Use Vancomycin Powder in Wound Site/Bone Graft Dilute 3% betadine soak/ 3 Liters NS lavage Saline Soak (3 min) and Wash Standardized Impervious Dressing (e.g. Aquacell) Discontinue Antibiotics within 24 hours Minimize Dressing Changes Sterile Changing of Dressing Patient Label:

Next Steps Determine standardized way to distribute CHG wipes to all patients before surgery Get Tobramycin into the PICIS/Omnicell F/U with Sandy Hyman on Betadine packets found in the foley kits Get Vancomycin Powder approved Develop measures for tracking compliance in report card format CHG  SSU call