septic. Everyone knows that a critical process is underway and the
person/persons in pink (most prepping is handled solely by our circu-
lator, but some cases will require 2 staff members) aren't members of
the sterile field. The gowns not only cut down on disruptions —
everyone knows not to interrupt the person prepping the patient —
but they also help us prevent infection, as the gown fully covers the
nurses' arms so those squamous epithelial cells don't fall into the ster-
ile field.
If you're thinking of going the designated gown route, be pre-
pared: You're bound to at least get an influx of questions in the
beginning. Why do we need an extra gown? What's wrong with
the way we've always done things? As a facility leader, you'll
need to be patient, persistent and, above all, informative about
the "why" part of your processes.
Tell staff we're taking these extra precautions because surgical
site infections are the most common type of infection associated
with surgery (500,000-750,000 annually), and any basic skin
movement releases 1,000 skin particles per minute and is a
major source of microbial contamination and transmission in
the perioperative setting.
2. Reduce variation and standardize.
Standardization is
another key component of skin prepping. You want to make sure
staff follow the same exact process for each and every patient to
reduce the variations or shortcuts that tend to crop up when time
gets tight. While we do let our surgeons choose which antiseptic
agent they want applied to the patient — an alcohol-based solution
with 2% chlorhexidine gluconate (CHG), an alcohol-based solution
with iodine povacrylex or betadine — we require the prepping to
follow the manufacturer instructions for use to a T.
5 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • D E C E M B E R 2 0 1 9
