cases. That was consistent with national benchmarks, but we wanted
to exceed the national average. First, though, we needed to identify
specific opportunities for improvement.
• Knowledge deficits. We recognized that staff members weren't
clear on how long application of the prep should be, and the length of
dry time for each. We had an opportunity to remind clinicians of the
need for and purpose of proper skin prepping as a best practice in the
effort to protect against SSIs.
• Multiple solutions. Before we started this project, we typically
used three different skin prep agents. While all were effective, our OR
nurses and techs were switching among the three depending on indi-
vidual surgeon preferences, a lack of standardization that led to con-
fusion regarding how each solution should be properly applied. To
reduce that knowledge deficit and simplify our practice, we decided
to standardize on a single skin prep solution for all of our surgeries,
and educate staff members on its proper use.
There was also a lack of standardization in terms of who was prep-
ping the patient. Sometimes it was a nurse; other times it was the sur-
geon.
• Inadequate dry time. We have clocks in the OR, but staffers
weren't always watching them to ensure prepping solutions had been
allowed enough time to dry before drapes were applied. In some
cases, a staff member was keeping time, but wasn't communicating it
to the rest of the team. The scrub tech would start draping before the
required dry time was observed.
Establishing standards
Armed with that information, we set about on standardizing our skin
prep process in order to increase our rates of compliance. Here's what
we did:
F E B R U A R Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 6 1
