clinical and business cases for each. Surgeons had to list the
Strengths, Weaknesses, Opportunities and Threats (SWOT) associ-
ated with their products of choice. The analysis revealed two
dozen products were being used for prepping, so a meeting was
held to focus on the essential products they planned to keep. Then,
administration came in with critical information in terms of pric-
ing, supply availability and the ever-important customer service
component.
"If a product's vendor will instruct my team on exactly how to use
a prepping solution according to its IFUs, provide regular teaching
support and pick up the phone whenever we call, that's going to
have significant play in terms of my decision," says Dr. Saleh.
Technique matters
Limiting your choices of prepping solutions will cut down on variations
in application requirements, but you still need to be vigilant to prevent
poor prep. "You have to keep entering the OR and conducting blind
audits," says Mr. Hixson. "If you're not constantly critiquing staff, they
get lax in their practice."
During audits, make sure staff follow these basic skin prepping
practices:
• Proper application. Have a clear understanding of how each prep-
ping solution needs to be applied. For example, when performing a
chlorhexidine gluconate prep, start at the incision site and work out
in concentric circles. Don't reverse direction once you move away
from the site. "Some clinicians have a tendency to [go back] into the
area they just prepped," says Mr. Hixson. "Explain to them that mov-
ing from a dirty to clean area can contaminate the area around the
surgical site."
• Adequate coverage. Properly assess the patient prior to prepping
M A Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 3 5