prepping, in which rampant variation can exist in everything from
training to solutions to application technique.
Limiting the choices
Every solution includes its own specific manufacturers' instruction
for use (IFU). If you're serious about reducing variation in your skin
prepping practices and the expense of buying solutions from several
manufacturers, look to scale back on the number of skin prep solu-
tions your facility uses. "I always tell administrators they've got to
limit the choices to four or five at the most," says Dr. Saleh.
But if you're going to ask surgeons to do away with the prepping
solutions and protocols to which they're accustomed, you need to do
it the right way.
"Surgeons are driven by numbers and data," says Jesse Hixson,
MSN, RN, CNOR, director of nursing at Allegheny Health Network in
Monroeville, Pa. "You have to show them the current cost per case
and what the cost per case is likely to be after the changes to the
prepping protocols are made."
Mr. Hixson approached surgeon leaders with a proposal to stan-
dardize the prepping and draping material at his facility, so that every-
thing was incorporated into a customized pack. The streamlined and
standardized approach was trialed within the orthopedics service line.
While the surgeons did have to make some sacrifices for the greater
good, they were happy with the results of the standardization in terms
of cost containment, efficiency and efficacy, says Mr. Hixson. The
small test run had a domino effect with other specialties. In the end,
the facility reduced their main skin prep solutions to just three, plus a
povidone-iodine prep for ophthalmic cases.
Dr. Saleh was able to reduce the number of prepping products a
facility stocked by teaming up with administration to look at the
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