Outpatient Surgery Magazine

Manager's Guide to Patient Skin Preparation - February 2014

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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Patient Skin Preparation_Layout 1 1/28/14 11:37 AM Page 28 S U R G I C A L S K I N A N T I S E P S I S examine the literature for best practices (as you know, most surgeons base their clinical decisions on peer-reviewed research). Our team found that chlorhexidine gluconate (CHG) combined with alcohol appears to be most effective for skin asepsis, followed by povidone-iodine and alcohol in cases where CHG is inappropriate (such as around open wounds, the eyes or mouth). During one of your regular education sessions attended by nurses, surgeons and anesthesia providers, present the findings of your literature review and identify which prepping products will be used moving forward. Focus on the evidence that supports the agents that are most effective for the procedures you host, notify the surgical team that surgeon preference cards will be adjusted and remove all non-approved products from the ORs and supply inventory. Share the same information at a follow-up operative staff meeting, and post a summary of the findings on a prominent bulletin board (or e-mail a copy to the staff). Stress to your nurses that the infection control department (or your infection preventionist) backs the change to the prepping regimen, and that the surgeons have agreed on the standardized products. Standardized prepping practices will empower nurses, who won't be afraid to suggest the appropriate product when it's called for. They'll remind surgeons in the ORs, "Hey, CHG would be best for this patient, based on the literature and the procedure. We're going to use that, OK?" If another one of your preps is more appropriate, they can suggest its use. This soft-sell approach won't be confrontational if everyone is on board with the effort to standardize your preps. 2. Reinforce compliance CHG/alcohol single-use products became our first product choice (due to their long-lasting properties), iodine/alcohol single-use second, and traditional povidone-iodine paint-and-scrub third. When all the non-compliant products were removed, there wasn't much complaining, likely because the surgeons had helped initiate the change — it's really key that they be involved from the beginning on any process improvement project. 2 8 SUPPLEMENT TO O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M O N T H 2014

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