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Hospital in Rochester, N.Y. But what Ms. Greene says you can count on is that a high degree of evidence will back the CDC's potential recommendation that you use an alcohol-based prep. The value of alcohol-based preps may be increasingly clear, but for surgeons and staff who are used to other preps, the transition won't necessarily be seamless.
Against their religion?
When the CDC releases its new prepping guidelines, your challenge will be to get your surgeons to incorporate the changes in practice.
"Some surgeon preferences are very strongly based on where they did their residencies and how they were taught," says Jennifer Zinn, RN, MSN, CNS-BC, CNOR, who co-authored a 2010 AORN study on intraoperative skin preps (tinyurl.com/ljzfqqf). "I think what is going to be important is to really establish strong clinical studies that the recommendations are based on.
"It'll be interesting to see the literature review and background that supports the CDC recommendation," adds Ms. Zinn, a clinical nurse specialist for perioperative services at Moses Cone Health System in Greensboro, N.C.
Orthopedic surgeon Anthony DiGioia III, MD, agrees. "I always liken surgical preps to religion," he says. "If you try to get surgeons to change, it's hard to even discuss, because even though you may have best practices, it's so entwined in what we do. There's always resistance to change."
But Dr. DiGioia, the medical director of the Bone and Joint Center at MageeWomens Hospital of UPMC in Pittsburgh, Pa., has seen reluctance evolve into acceptance and enthusiasm over the last couple of years, as his facility took part in the IHI Project JOINTS program. One of the components of the program's "bundle" approach toward reducing SSIs is alcohol-based skin preps.
"There are 6 surgeons in our program, including 1 or 2 that were less willing to switch," Dr. DiGioia recalls. "But everyone came around, and once it was adopted, people saw the positive consequences. We have not had anyone opt out at all. Now it's just part of our routine."
