M A Y 2 0 1 6 O U T P A T I E N TS U R G E R Y. N E T 1 7
Just because your OR nurses have plenty of
experience in skin prepping doesn't mean
that they don't need a refresher on how to do
it properly. In fact, a new study published in
Surgical Infections found that nurses who
routinely perform patient skin antisepsis still
make plenty of mistakes
(osmag.net/vJPmM2).
The study's authors looked at 30 nurses
at 4 different hospitals who routinely per-
form surgical skin preparation. The nurses
completed a questionnaire asking about their
familiarity with two of the most common
skin prep formulas: chlorhexidine gluconate-
isopropyl alcohol and povidone-iodine scrub
and paint. The OR staffers prepped one ankle
of a healthy patient using either the CHG or
povidone-iodine formula. They then prepped
the opposite ankle using the other prep solu-
tion. Two independent evaluators reviewed
their work using standardized checklists
based off each prep manufacturer's instructions for use.
They found that even though the nurses had worked in the OR
for an average of 13 years and had 9 years of skin prepping expe-
rience, none of them performed all of the manufacturers' steps
correctly. All essential formula-specific application steps were
performed correctly 90% of the time with the CHG solution, com-
pared with only 33.3% of the time with the povidone-iodine for-
mula. There was no correlation between the nurses' experience
or familiarity with the product and the number of correct steps
completed with either formula.
"This study demonstrates existing problems with infection
prevention, as those tasked with pre-operative skin preparation
do so with tremendous incongruence according to manufacturer
guidelines," the study's authors write. "Standardization of the
prep solutions as well as simplification and education of the cor-
rect techniques may enhance protocol compliance."
— Kendal Gapinski
CONTINUING EDUCATION
Standardize and Simplify
To Improve Prepping Performance
• APPLICATION OF LEARNING It's important to hold regular skin-prepping training sessions,
even for veteran nurses.
Pamela
Bevelhymer,
RN,
BSN
