A multidisciplinary team tackled low compliance in preoperative bathing, showing that standardization—not product choice—drives surgical site infection prevention and patient safety outcomes.
At Sinai Hospital and the University of Maryland Medical Center, a team of clinical leaders, Annet Adegboyega, DNP, MSN, BSN, RN, CNOR; Mihyun "Rose" Jang, MSN, MPH, BSN, RN, CNOR; and Renilda Tijones, MSN, BSN, RN, CNOR, identified an issue with low compliance in preoperative bathing among surgical patients. Recognizing the connection between preop hygiene and surgical site infections (SSIs), they launched an initiative to evaluate and improve the process across multiple departments.
To learn more about this study, “Rethinking Preoperative Washing: Necessity and Effectiveness,” which was presented as a poster at the AORN Global Surgical Conference & Expo held April 5 through 8, 2025, in Boston, Massachusetts.
The project began with a literature review comparing the effectiveness of chlorhexidine gluconate (CHG) and antimicrobial soap. Surprisingly, the evidence revealed no significant difference between the two products in reducing SSIs. The team concluded that what mattered most was not which product was used but how consistently and correctly it was applied.
One of the early findings was the absence of standardized protocols. Each unit approached preoperative bathing differently, leading to confusion and gaps in patient care. In response, the clinical outcomes team developed and implemented clear, evidence-based protocols. These were distributed hospital-wide and supported with training to ensure both outpatient and inpatient staff understood the procedures.
“We started doing a literature review on how we can improve our compliance for preoperative, bathing, and surgical patients,” Jang said. “After the literature review, we found that either antimicrobial soap or CSG fat has no significant differences in effectiveness in surgical site infections. So, our evidence-based recommendations are first having standardized protocols.”
To measure success, compliance dashboards were created using Tableau, allowing real-time tracking across units. Monitoring not only highlighted areas of improvement but also reinforced accountability. Equally important was educating nurses about the clinical rationale behind pre-op hygiene. Many inpatient nurses lacked familiarity with its role in infection prevention, and targeted education helped increase engagement.
A core insight from the project was that CHG wipes alone are not the answer. If patients didn’t understand how to use them—or couldn’t afford them—the protocol failed. By recognizing that a regular bath could be just as effective when properly completed, the team emphasized accessibility and patient-centered care.
“So the main takeaway is that it's not really about whether CHG is more significant in reducing SSI, or whether it's a regular path,” Tijones said. “There aren't enough studies out there that provide a direct relationship between CHG and SSI. SSI is always seen as a multifaceted effect of a certain bundle, and CHG is just one of them. So that's really an opportunity there. What we are looking at in this project is really compliance.”
Ultimately, the initiative succeeded through teamwork, communication, and practical solutions—demonstrating that sustainable change in infection prevention depends as much on collaboration as it does on clinical science.
“This was really great working on because we are a team,” Adegboyega said. “One of the main points I want to put out there, or the main point, is that always working as a team. You cannot do it a lot, and change cannot happen with just one person. It's always a team effort, which also includes other patients.”
Stay prepared and protected with Infection Control Today's newsletter, delivering essential updates, best practices, and expert insights for infection preventionists.
Pathogen Pulse: Facilities Need the SPD, Yersinia Enterocolitica Outbreak, and More
July 22nd 2025From unsterilized surgical tools in Colorado to a years-long methicillin-resistant Staphylococcus aureus (MRSA) outbreak in Virginia and a surging measles crisis in Canada, recent headlines reveal the fragile front lines of infection prevention and the high stakes when systems fail.
Telemedicine's Transformative Role in PPE Distribution and Sterile Equipment Management
July 22nd 2025In an era defined by digital transformation and post-pandemic urgency, telemedicine has evolved beyond virtual visits to become a vital infrastructure for delivering personal protective equipment (PPE) and managing sterile supplies. By enabling real-time forecasting, remote quality control, and equitable distribution, telemedicine is revolutionizing how health care systems protect both patients and providers.
Reducing Hidden Risks: Why Sharps Injuries Still Go Unreported
July 18th 2025Despite being a well-known occupational hazard, sharps injuries continue to occur in health care facilities and are often underreported, underestimated, and inadequately addressed. A recent interview with sharps safety advocate Amanda Heitman, BSN, RN, CNOR, a perioperative educational consultant, reveals why change is overdue and what new tools and guidance can help.
New Study Explores Oral Vancomycin to Prevent C difficile Recurrence, But Questions Remain
July 17th 2025A new clinical trial explores the use of low-dose oral vancomycin to prevent Clostridioides difficile recurrence in high-risk patients taking antibiotics. While the data suggest a possible benefit, the findings stop short of statistical significance and raise red flags about vancomycin-resistant Enterococcus (VRE), underscoring the delicate balance between prevention and antimicrobial stewardship.
What Lies Beneath: Why Borescopes Are Essential for Verifying Surgical Instrument Cleanliness
July 16th 2025Despite their smooth, polished exteriors, surgical instruments often harbor dangerous contaminants deep inside their lumens. At the HSPA25 and APIC25 conferences, Cori L. Ofstead, MSPH, and her colleagues revealed why borescopes are an indispensable tool for sterile processing teams, offering the only reliable way to verify internal cleanliness and improve sterile processing effectiveness to prevent patient harm.
The Next Frontier in Infection Control: AI-Driven Operating Rooms
Published: July 15th 2025 | Updated: July 15th 2025Discover how AI-powered sensors, smart surveillance, and advanced analytics are revolutionizing infection prevention in the OR. Herman DeBoard, PhD, discusses how these technologies safeguard sterile fields, reduce SSIs, and help hospitals balance operational efficiency with patient safety.