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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 P R I L 2 0 1 4
S K I N P R E P P I N G
I
n 2012, Mercy Medical Center in Canton,
Ohio, adopted a standardized skin-prep-
ping regimen that reduced the incidence
of infection from 3.7% to 0.6% (3 infections
in 498 orthopedic procedures). Lead author
Melissa Lingle, RN, CNOR, the facility's clin-
ical manager of surgical services, spells
out the 6 steps the facility took:
• Educate OR staff on the fundamentals
of aseptic technique, followed by ongoing
reinforcement.
• Provide chlorhexidine wipes for patients, educate them on SSI pre-
vention and instruct them to scrub operative sites daily for the 3 days
immediately preceding their surgeries. Screen patients, via nasal swabs,
for MRSA.
• Scrub operative sites again with chlorhexidine wipes in pre-op before
transporting patients to the OR.
• Emphasize strict adherence to aseptic technique by all staff before,
during and after surgery.
• Apply silver-impregnated absorbent dressings to incision sites imme-
diately post-closure.
• Apply a new silver-impregnated dressing on the third day after sur-
gery, and keep it in place for an additional 7 days (unless there is exces-
sive bleeding, in which case the wound is examined and the dressing is
changed immediately). Goal is to maintain incision coverage for a full 10
days.
— Jim Burger
PROCESS IMPROVEMENT
Standardizing Skin Preps is the
First Step Toward Reducing SSIs
HOW TO What steps should
you take to standardize preps?
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