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Archive July 2019 XX, No. 7

4 Steps to Better Skin Prepping

Improve application practices in your ORs with advice and lessons learned from experts at the University of Texas Southwestern Medical Center.

Daniel Cook

Daniel Cook, Editor-in-Chief


UT Southwestern
PHYSICIAN CHAMPION Michael Wait, MD, professor of cardiovascular and thoracic surgery, helped push for improved prepping practices at the University of Texas Southwestern in Dallas.

How difficult is it to prep the skin for surgery? You pick an antiseptic agent and paint it on in concentric circles, beginning at the incision site and working outward, or scrub it in with a back-and-forth brushing motion. What can possibly go wrong? As it turns out, plenty — and your OR team might not even be aware they're slacking.

When infection prevention experts at the University of Texas Southwestern Medical Center in Dallas noticed an uptick in surgical site infection rates, they audited the surgical team's prepping practices during 51 procedures performed in May 2017.

"We noticed staff didn't always meet required application times, use the correct application method or allow enough time for preps to dry," says Doramarie Arocha, PhD, MS, MT(ASCP)SM, CIC, FAPIC, epidemiologist and director of infection prevention and control at UT Southwestern. "In fact, they were performing those basic prepping steps correctly in less than 50% of observed cases."

Dr. Arocha says these results are on par with national averages, suggesting improper prepping is a problem in ORs across the country, possibly even yours. The essential first step to improving prepping practices is to get out from behind your desk, slip on some scrubs and observe your surgical team in action.

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