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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solution to do the work that it's supposed to do, it needs to dry completely, and sometimes that takes several minutes," says Ms. Greene. She points out busy sur- geons in high-volume facilities often don't want to wait for the full dry time to elapse. Another common mistake — one that surgical leaders must do everything in their power to pre- vent — is not following a prep manufacturer's application instructions. "You really need to follow exactly what the manufac- turer says in terms of how long the solution needs to dry and how it gets applied," says Ms. Greene. Picking the right prep By far, the two most common skin prepping solutions used by facili- ties are CHG and povidone iodine. Both have advantages, disadvan- tages and different application methods, but is either product clearly superior? Not according to the research, says Ms. Greene: "Studies demonstrate that CHG and povidone iodine are equally effective." • CHG. One of the advantages of chlorhexidine is that it's not inactivated when it comes in contact with blood and organic matter, says Ms. Greene. That makes it an extremely effective antiseptic and often preferrable option for surgical skin prep before surgery. The downside, says Ms. Greene, is that CHG isn't as visible on the skin as povidone iodine. The solution also shouldn't be used near certain areas, such mucous membranes. For appli- cation, CHG requires a back-and-forth scrubbing technique — from the least contaminated area to the most contaminated (clean to dirty) — over the prep site. • Povidone Iodine. Though visibility on the skin is excellent, organic matter decreases the activity of povidone iodine, which can be drawback, according to Ms. Greene. However, it's an effective choice for prepping around the eyes and mucous membranes, and on patients who are sensitive to chlorhexidine solutions. In terms of familiarity, clinicians may be more comfortable with the application technique, which focuses on concentric circles as opposed to CHG's back-and-forth scrub. "You begin at the inci- sion site, carry the prep to the periphery and use an ever-winding circular motion — always progressing from clean to dirty," says Ms. Greene. While many surgeons have their preferred skin prep solution, there's no reason you can't have both CHG and povidone iodine at the ready and ensure your staff is well-trained in using both. In fact, Ms. Greene says many healthcare organiza- tions will provide both in order to account for sur- geon preference. But regardless of whether your facility offers many options for solutions or just one or two, the most important thing is ensuring skin prepping protocols are standardized and con- sistently applied. OSM 4 6 • 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 SPOT CHECK By routinely observing staff's skin prepping techniques, you'll be able to catch issues or shortcuts before they become ingrained habits. David Reidy/CHOC

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