Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/771120
"Every surgeon has his preference and it rarely changes," says Ms. Sherman. "It's a waste of time, effort and money to try." Skin prepping is hardly complex, but it is by no means a simple process. There's a right way — and there are many wrong ways — to safely prepare your patient's skin. As Sheila Tesiny, RN, CNOR, the clinical coordinator of outpatient surgery at Henry Mayo Newhall Hospital in Valencia Calif., says, "The prep is the start to a successful case. Never underestimate the importance of it." As you'll see in these 10 tips, there's more to safe prepping than starting at the incision site and spiraling outward. 1. Don't assume your nurses know the proper application tech- nique. Review prep manufacturers' directions and compare them to what's actually being performed in the ORs. If necessary, conduct in- service training to ensure consistent technique in all cases. "You'd be surprised at how many variations people put into their own prac- tices," says Jesse Hixson, MSN, RN, CNOR, an OR manager at West Virginia University Health Care. "If someone has bad technique, they're bringing a breach in sterility to the surgical table." 2. Don't default to a circular motion. A circular application has tradi- tionally been recommended for a povidone-iodine paint, moving from clean to dirty. Chlor-hexidine gluconate (CHG) formulations require a back-and-forth scrubbing motion over the site, starting at the least con- taminated area and moving to the most contaminated. One iodine-alco- hol product recommends a single-stroke motion to cover the site, not a back-and-forth one, before letting the solution dry completely. When prepping an incision site that is more highly contaminated than the sur- rounding skin (anus, axilla or open wound, for example), prep the area of lower bacterial contamination first and then the areas of higher con- tamination, says AORN. Regardless of technique, apply the prep in an area that is large enough to allow for an extension of the incision, addi- 1 4 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J a n u a r y 2 0 1 7