Those efforts began with paring down the multiple versions of the
same prepping agent the hospital bought from various manufacturers.
Each prep came with different instructions for use, which led to
inconsistencies in how the products were applied, says Julie Trivedi,
MD, medical director of infection prevention at UTSW. She suggests
you identify the preps you use for your high-volume procedures, cate-
gorize them according to prep type and identify a single manufacturer
to supply them. That's how UTSW trimmed the number of prepping
products it used from 10 to 4.
Dr. Trivedi also points to the importance of reviewing where various
prepping products are stored, how they're supplied to the ORs and if
surgical teams ultimately end up using them as supplied. At UT
Southwestern, for example, some prepping solutions and supplies
were included in pre-packaged OR kits. Surgeons, however, would
instead request an off-the-shelf option. "There were a lot of free-float-
ing products in use, and that didn't help our efforts to limit the choic-
es," says Dr. Trivedi.
Also involve your facility's purchasing and supply chain managers,
who are the gatekeepers for which products enter your facility. Work
with them to identify the best manufacturers from whom to buy prep-
ping agents, limit the number of options you stock and make sure
only intended products reach the OR.
3. Bring in outside help
Ask the manufacturers of each prep you settle on for the instructions
for use, says Ms. Hasnain. "Each company provided us with up-to-date
information on how their product is supposed to be applied, and the
reasons for the specific application methods," she says.
You can also ask prep manufacturers to perform in-house audits of
your staff's prepping practices and educate them on the proper way to
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