Outpatient Surgery Magazine

Worth Every Penny - January 2021 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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wipes are required for all total joint, spine and car- dio patients). If nurses discovered that a patient did- n't comply with the antisepsis policy, the prepping process was completed in the pre-op area. The facility also ramped up its patient education efforts. "We wanted to make sure that every patient was given clear information, based on their proce- dures, about what they needed to do for skin anti- sepsis," says Ms. Swaby. For instance, information on whether the sur- gical procedure warranted CHG cleansing at home on the days leading up to surgery was included in information packets given to patients when their cases were scheduled. Finally, Stamford developed a pre-op skin prep assessment tool nurses use to document what they discovered in the pre-op phase. "We worked with our informatics partners to develop a tool that nurs- es could use to enter information directly into our EMR," says Ms. Swaby. The major benefit of the assessment tool is being able to track whether the surgical team is compliant with best prepping practices and identify staff mem- bers who may need extra education on ensuring patients' skin is properly treated before surgery. "It's a way for us to look back at individual charts and say, 'OK, was this patient assessed for pre-op prep, yes or no?'" explains Ms. Swaby. Deviation remediation Whether it's your pre-op antisep- sis protocols or the prep that takes place just prior to the surgi- cal incision, standardization is what you're ultimately striving for with skin prepping practices. "The more standardized you are in your approach, the more it becomes a habit and the fewer opportunities there are for staff members to question practices that lead to their own devia- tions," says Linda R. Greene, RN, MPS, CIC, infection prevention manager at the University of Rochester (N.Y.) Medical Center's Highland Hospital. Of course, there are plenty of obstacles that can impact the consistency of a standardized skin prep- ping process: surgeon preference, supply issues related to purchasing and the pressure staff feel to cut corners in an effort to begin cases on time and keep the case schedule on track. Although Ms. Greene is quick to point out that everyone in the healthcare industry is always com- mitted to doing everything as safely and as thor- oughly as possible, there is a tremendous amount pressure, particularly in the outpatient surgery world, to move quickly. "Oftentimes in the OR, it's about speed and it's about room turnover," says Ms. Greene. "That can lead to variation, and that varia- tion can impact how effectively you prep the skin." Variation and the subsequent improper prepping techniques can increase the risk of patients acquir- ing an SSI. So, what can facility leaders do to pro- mote standardization? "Monitor staff's practices in real time," says Ms. Greene. "To make sure every- one is aware of the policy, go around and ask peo- ple, 'OK, show me how you perform a skin prep.'" By observing everyone's practices, you may be able to catch problematic deviations or shortcuts before they become ingrained habits. Ms. Greene believes the most common prepping mistake among surgical teams is not allowing solu- tion to fully dry after application. "In order for the 4 4 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • J A N U A R Y 2 0 2 1 REPEAT AFTER ME The more standardized your skin prep protocols, the fewer opportunities there are for staff to create their own deviations from proper practice. Pamela Bevelhymer

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