Archive Infection Control 2018

5 Ways to Standardize Skin Prepping Practices

Applying preps the same way every time eliminates the variables that increase infection risk.

Brittany Harvey

Brittany Harvey, MSN, MBA, RN, CNOR


Skin Prep
LESS IS MORE Stocking a variety of skin prepping agents leaves too much room for error.

Look at your patients' skin. Look closer. You can't see them, but they're there. Millions of microorganisms that have the potential to cause infection if they flake off into surgical incisions. That's not unlikely to happen, either, considering that skin sheds approximately 10 million particles each day. Skin antisepsis is therefore the critical first step of eliminating a major source of microbial contamination and transmission in the OR, but standardizing prepping practices is no easy task. It took us 2 years and lots of hard work to integrate uniform routines into routine practice. Here are the keys to our ongoing efforts to protect patients from themselves.

1. Partner with patients

On Site
ON SITE Prepping requirements differ depending on the type and location of surgery. For example, chlorhexidine-based products can't be used around the eyes.

Patients who are scheduled to undergo complex procedures such as joint replacements should be required to shower the day before surgery with chlorhexidine gluconate (CHG) soap. Also have them treat their skin with CHG wipes before donning gowns in pre-op. Educating patients about how to use CHG products, stressing the importance of prepping the skin before surgery and even providing patients with kits that contain all the supplies needed for pre-op bathing will boost their compliance with your directives.


2. Make it easy

Staff should be able to implement standardized prepping protocols without a lot of extra effort. Include needed prepping supplies on surgeons' preference cards to ensure the items are picked and ready in the room before each case. You don't want to give your staff the opportunity to not comply with your prepping protocols with "supplies aren't easily accessible" and "it's inconvenient" excuses. The goal is to make your standardized skin prep methods easy to implement and impossible to ignore by giving staff the tools and knowledge they need to do the job correctly each time.

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