Surgical Care Improvement Project (SCIP) Updates for Discharges

Every year there are updates to SCIP to focus on evidence-based practices that improve clinical outcomes for surgical patients. In 2012, several important changes have been added to SCIP which will begin affecting patients toward the end of 2011. Patients who have surgery at the end of December 2011, will fall into this metric if discharged in January 2012.  The additions are listed below:

  1. Reason to extend antibiotics: Demeclocycline was administered post-operatively for the treatment of syndrome of inappropriate antidiuretic hormone hypersecretion (SIAHD) or hyponatremia.
  2. New category of antibiotic recommendations for patients with a principal procedure of a hysterectomy and secondary colon procedure.
  3. There must be documentation on post-operative day 1 and day 2 of a reason to continue urinary catheterization. Day 0 is defined as the day of surgery.
  4. If a beta blocker is held or discontinued after arrival but prior to surgery because of a contraindication the case will be excluded but the contraindication must be documented
  5. Beta-blocker peri-operative dose now also requires a post-operative dose
  6. The patient must receive a beta blocker or have a contraindication on the day prior to or the day of surgery AND on post-operative day 1 or post-operative day 2
  7. Hypotension (systolic pressure <= 100) and concurrent use of intravenous inotropic medications during the perioperative period have been added to Bradycardia as conditions that are acceptable reasons for not administering a beta-blocker dose peri-operatively.

The big difference for SCIP in 2012 is that Laparscopic surgeries are no longer excluded from any of the SCIP measures, and any laparoscopic procedures should mirror those performed for open procedures.

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