Preparing Patients Skin Prior to Arriving at Hospital for Surgery Must Improve; More than One-Third of Perioperative Nurses Say Hospital Doesnt Have a Protocol for Patients to Prepare Skin the Night Before, Morning of Surgery


CARY, Ill. -- In a recent nursing opinion poll, 37 percent of the perioperative nurses who responded said their hospital does not have a preoperative skin preparation protocol in place for patients to follow the night before and the morning of surgery to reduce microorganisms on the skin which can lead to infection. The poll was conducted at the Association of Perioperative Registered Nurses (AORN) annual conference in March by Sage Products Inc.

Research shows that five percent of patients develop surgical site infections (SSIs), the most common healthcare-associated infection in surgical patients. Bacteria, like methicillin-resistant Staphylococcus aureus (MRSA), community-acquired MRSA, Acinetobacter baumanii and Staphylococcus aureas, are increasingly prevalent. Consequently, decolonizing or preparing patients skin prior to entering the hospital for surgery is critical.

SSIs can increase hospital length of stay from 7 to 10 days and account for $25,546 in average treatment costs. As a growing number of patients are carrying harmful and potentially resistant bacteria on their skin, preparing skin with antiseptic agents, such as chlorhexidine gluconate (CHG), can help lower SSI risk.

CHG is the only preoperative skin prep agent that the Centers for Disease Control and Prevention (CDC) recognizes as having excellent activity against gram-positive bacteria as well as excellent residual activity. Despite the CDCs category 1B recommendation, 39.6 percent of respondents said they are not aware of CHGs persistent and cumulative affect on skin. CHG provides antimicrobial protection for several hours after application and immediately fights microorganisms upon application to the skin. In addition, each application of CHG better protects against infection risk.

The CDCs Hospital Infection Control Practices Committee (HICPAC) has set guidelines to aid in the prevention of SSIs and recommends preoperative antiseptic cleansing to reduce local bacteria at least the night before surgery. 34.7 percent of nurses polled said their facility urges patients to prepare skin the night before surgery. 34.7 percent said they ask patients to prepare both the night before and the morning of scheduled surgery, while 23.6 percent said they ask patients to prepare skin the morning of surgery. Those with a protocol reported (70.8 percent) that they ask their patients to prepare their whole body prior to surgery, and 26.4 percent ask patients to only prepare the surgical site.

The opinion poll also revealed that preoperative skin preparation occurs most often for orthopedic (41.3 percent) and cardiac (34.7 percent) procedures. Skin is less likely to be prepared for bariatric (8 percent) and labor and delivery (4 percent) cases.

Source: Sage Products, Inc.

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