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Archive December 2019 XX, No. 12

Prepped to Perfection

How we made proper skin prepping a top priority.

Mary Wilson

Mary Wilson, BSN, RN, CNOR


Brittany Harvey, MBA, MSN, RN
SEEING PINK Circulators wear designated pink gowns to let others in the OR know they're prepping a patient.

Skin prepping is serious business at our facility. So serious, in fact, that the staff who prep patients before surgery wear different colored gowns than the rest of the OR team. The designated pink gowns — a visual signal to everyone in the OR that nurses and doctors in pink are performing a critical process and are not a member of the sterile field — are a part of our standardized skin prep protocol that we rolled out in 2017. Like all changes, it hasn't always been easy to convince staff the extra steps — not to mention attire — were necessary. But with patience and persistence, we've managed to ingrain these critical safety standards into the collective psyche of our staff. Here's how we made proper skin prep a top priority, and how you can do the same.

1. Preppers wear pink gowns. Like the bulk of our protocols, we started wearing designated prep gowns as a direct result of AORN's skin antisepsis guidelines, which require the person doing the prep to have her arms fully covered to contain shedded skin particles. Whenever AORN puts out or revises a practice standard, it's evidence-based, so our goal is to meet that guideline. Of course, these guidelines don't tell you every granular detail of what you need to do. It's up to you to figure out a way to make everything work in your specific setting. For us, that meant some trial and error. We knew we wanted to have the staff who did the actual prepping wear something that made them stand out from the rest of the team in the OR. After all, the Joint Commission requires you to have some way of signifying a critical process is taking place; a designated skin prep gown certainly checks that box. But it took a little while to settle on what we wanted them to wear.

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