David Bernard
INFECTION PREVENTION
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O U T P AT 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 | A U G U S T 2 0 1 4
Are There Benefits to Pre-Op Bathing?
What we know and how to improve this skin prep practice.
W
hile the evidence is strong that pre-op patient skin antisep-
sis effectively reduces microorganisms on the skin, current
research is inconclusive on whether that reduces surgical
site infections. "It's vague," says AORN Perioperative Nursing
Specialist Amber Wood, MSN, RN, CNOR, CIC, CPN. "But we know
the patient needs to be clean."
Even if we don't know how well pre-op bathing, showering or wiping
works, you should still advise patients to do it. That's the latest recom-
mendation from AORN, which suggests you instruct patients "to bathe
or shower before surgery with either soap or a skin antiseptic on at
least the night before or the day of surgery." (Emphasis added.) More
than one-third (36%) of the 190 surgical facility leaders that Outpatient
Surgery Magazine polled don't even bother giving patients pre-op
bathing instructions (see "What Are Your Pre-Op Bathing Instructions
to Patients?"). For those that do, only 13% tell patients to wash or wipe
for 2 or more nights.
Keep them compliant
Getting patients to comply with pre-op bathing instructions is chal-
lenging when, as Ms. Wood freely admits, "we don't know what the
optimal bathing procedures are." Among the questions that remain
unanswered:
• Which is better: antiseptics or plain or antimicrobial soaps?
• Should patients wash the whole body or just the surgical site?
• How long before surgery should you bathe or shower?
• How many times should you bathe or shower?
Since the potential benefits outweigh the risks, though, AORN rec-
ommends that you "develop a mechanism for evaluating and selecting