Archive Infection Control 2019

Solving the Surprising Skin Prep Problem

Believe it or not, there's a good chance your staff isn't complying with proper application protocols.

Hellen Johnson

Hellen Johnson


Pamela Bevelhymer, RN, BSN, CNOR
SKIN IN THE GAME Prepping is the first defense against SSIs, which account for about 157,500 infections and $3.2 billion in healthcare costs each year.

You're probably aware that most surgical site infections are caused by patients' microbial skin flora flaking into surgical wounds. You also know skin prepping eliminates resident and transient microbes on the body's first line of defense against infection and prevents the growth of microorganisms around the incision site. But are you certain your staff applies pre-op skin prep solutions correctly and allows enough time for them to dry? Don't count on it. National statistics show that surgical teams follow proper application instructions and allow for adequate dry times in fewer than half of all cases.

You need to ensure your staff isn't part of that troubling trend, and internal audits are a proven way to identify where gaps in best practices are occurring. There are many competency tools available to help guide observations of your team in prepping action, including AORN's Competency Verification Tool for Skin Antisepsis ( or the Agency for Healthcare Research and Quality's (AHRQ) Surgical Skin Preparation Audit Tool ( Some tips for effective auditing include:

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