Outpatient Surgery Magazine - Subscribers

Secrets to Speedier Room Turnover - November 2013 - Outpatient Surgery Magazine

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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Page 92 of 156

OSE_1311_part2_Layout 1 11/6/13 9:40 AM Page 93 I N F E C T I O N P R E V E N T I O N shied away from making prep recommendations. Here are 4 evidencebased and common-sense recommendations about skin antisepsis that you can hang your surgical cap on. 1. Use alcohol, but safely CDC guidelines support using an alcohol-based prep, but do so safely. Free-pouring alcohol is a fire risk because of its fumes and vapors. (Be wary of the doc who says: "I'm going to use some Betadine and then pour some alcohol, and that way, I've met the standards, so I don't have to use a product that contains both.") Let alcohol skin preps dry for 3 minutes; if it gets into really hairy areas, it can take much longer to dry. That's a safety concern, particularly in the presence of a source of ignition, like a cautery or a laser. There can also be a fire hazard if the prep area gets too wet and liquid pools underneath the patient. 2. Chlorhexidine with alcohol vs. povidone-iodine with alcohol Which is better? Unfortunately, the initial studies haven't really compared them head to head, so this is an ongoing area of debate. I like the fact that the chlorhexidine with alcohol is very effective for a longer period of time than the alcohol-based prep with povidoneiodine. And many would argue that it's superior overall. The Institute for Healthcare Improvement is a huge proponent of chlorhexidine. I expect the new CDC guidelines to recommend a minimum prepping protocol of the night before and morning of a procedure. We probably don't have evidence yet to support beginning the prep 3 days in advance, but it makes some logical sense to do so. There's a slight drawback with chlorhexidine. Depending on skin color, the prep can be very hard to see. Neither the orange nor the blue colors are really vibrant on the skin. And some physicians ask, what is N O V E M B E R 2013 | 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 9 3

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