Preoperative Skin Preparation Practices
Michael V. Smith
Western Governors University
Perioperative Skin Preparation Practices
A. Select a perioperative procedure (e.g., routine shaving of the surgical site) that you
would commonly find on a surgical floor.
1. Describe the process or procedure you have chosen and why you think it needs
Surgical site infection accounts for forty percent of all hospital-acquired infection (Griffin, 2005). The Association of Operating Room Nurses (AORN) recommendations provide guidelines for achieving skin preparation of the surgical site. These are practices are achievable and represent what is believed to be an optimal level of practice ...view middle of the document...
VII. Policies procedures on the skin preparation of patients should be written, reviewed
annually, and readily available within the practice setting.
The goals set forth by these recommendations are to be implemented in order to lower the risks of infections post-operatively. According to the new operating room department director that was interviewed for this research, “most of the guidelines are followed and there is always room for improvement” (B. Balliou, O.R. Supervisor, personal communication, December 12, 2011). It was conveyed that the efforts of this research would be to assist in the enhancement of prevention compliance regarding skin preparation preoperatively. Safeguarding the skin integrity by using clippers, instead of razors, has been implemented at this institution in most instances with the exception of the physician specifying the use of a razor. The Center for Disease Control and Prevention advises that if hair is to be removed, it should done immediately and before surgery with electric clippers (Pyrek, 2002). Observations of razors still being used in facility are occurring ‘despite a study published in 1971 reporting that patients whose hair was removed with depilatory or not removed at all had a 90% lower rate of infection than those shaved’(Griffin, 2005). Seemingly this would be an easy change for the physicians and staff, but some physicians are set in their ways and it is difficulty to change habits.
An observed area of additional concern for the patient is privacy, which will also be undertaken. Further patient advocacy is needed in order to maintain additional privacy during needed hair removal from the surgical sites. Currently, the preparations for all surgical sites are conducted in the holding area with only curtained partitions. While this has been standard procedure for this institution, recommendations for maintaining privacy will be made to reduce patients’ anxiety levels.
After review of the policies there are no recommendations for specific types of approved anti-microbial agents listed only the procedures (Memorial Hermann Southeast Hospital, 2009). This would be a possible area of interest that needs further clarification in the policy and procedure manual. Additionally, an addendum to illustrate the areas of skin preparation for each procedure would be a valuable reference for the staff to consult.
2. Based on your initial investigation of the situation, do the following:
a. Explain who determined the basis for the practice.
The current recommendations for policy for preoperative assessment and skin preparation for Memorial Hermann Southeast Hospital were established by the director of the department in 2009. These were then reviewed by the current director and communicated to the managers within the same department. This policy may be subject to change after review by the involved policy team in the department.
b. Explain the rationale for making the decision for the...