Ebt1 Task 3
Lauren
March 1, 2013
Evidence Based Practice
Task #3
Routine Perioperative Practice Research
Perioperative routine practices vary from state to state and even facility to facility. It is important for the surgical nurse to be well versed in perioperative procedures and constantly question the effectiveness and positive/negative outcomes related to each one. Several preoperative procedures take place on the surgical unit of my hospital, and after research and discussions with surgeons, I discovered a preoperative procedure that could be tweaked in order to improve post-op results.
A primary concern is post-operative infection. This is one of the most common complications of surgery and can have serious implications. Since post-operative infections account for one third of all nosocomial infections nationwide, this is an important issue to address. I believe that focusing on better ways to prevent possible post-operative infection would greatly improve surgical patients’ outcomes and experiences. As the procedure states now, the patient is required to take a shower/bath with normal bath soap excluding any lotions or powders prior to surgery and then once in the surgical site, is cleansed with Hibiclens and an intravenous antibiotic is initiated. This has been standard practice because past research suggested that as long as the patient bathed with normal soap and the site was scrubbed in surgery, post-operative infection has a decreased incidence. While this has proven to drastically reduce infection rate, there are more recent studies that have proven that bathing with normal soap alone is not sufficient enough to prevent a notable amount of nosocomial infections. Hibiclens is a prescription antimicrobial antiseptic skin cleanser used to cleanse a surgical site. It is an effective product; however, I have found that there are still post-operative infections occurring. For this reason, I decided to analyze the pre-operative procedure of surgical site
March 1, 2013
Evidence Based Practice
Task #3
Routine Perioperative Practice Research
Perioperative routine practices vary from state to state and even facility to facility. It is important for the surgical nurse to be well versed in perioperative procedures and constantly question the effectiveness and positive/negative outcomes related to each one. Several preoperative procedures take place on the surgical unit of my hospital, and after research and discussions with surgeons, I discovered a preoperative procedure that could be tweaked in order to improve post-op results.
A primary concern is post-operative infection. This is one of the most common complications of surgery and can have serious implications. Since post-operative infections account for one third of all nosocomial infections nationwide, this is an important issue to address. I believe that focusing on better ways to prevent possible post-operative infection would greatly improve surgical patients’ outcomes and experiences. As the procedure states now, the patient is required to take a shower/bath with normal bath soap excluding any lotions or powders prior to surgery and then once in the surgical site, is cleansed with Hibiclens and an intravenous antibiotic is initiated. This has been standard practice because past research suggested that as long as the patient bathed with normal soap and the site was scrubbed in surgery, post-operative infection has a decreased incidence. While this has proven to drastically reduce infection rate, there are more recent studies that have proven that bathing with normal soap alone is not sufficient enough to prevent a notable amount of nosocomial infections. Hibiclens is a prescription antimicrobial antiseptic skin cleanser used to cleanse a surgical site. It is an effective product; however, I have found that there are still post-operative infections occurring. For this reason, I decided to analyze the pre-operative procedure of surgical site
References: 1. Antibiotic resistant Staph infection MRSA fact sheet for patients, County of Orange. Accessed at: http://www.ochealhinfo.com/docs/public/epi/mrsa/MRSA-FactSheet.pdf 2. LaPrade, Robert, MD. PhD. The Steadman Clinic. Pre-Operative Bathing Instructions. Retrieved: March 2, 2013. Accessed at: http://drrobertlaprademd.com/pre-operative-bathing-instructions 3. Norton, Jeffrey. Surgery: Basic Science and Clinical Evidence. Pre-Operative Preparation. Accessed March 10, 2013 at: http://books.google.com/books?id=cs6O3QIwrKcC&pg=PA246&lpg=PA246&dq=is+a+shower+before+surgery+sufficient/&source=bl&ots=mbNqkSeYLO&sig=jdH_XwHjtVAywrCDuMow_h8Vfhc&hl=en&sa=X&ei=yFY9UfGmAerw0QHa9YHABg&ved=0CC0Q6AEwAA#v=onepage&q=is%20a%20shower%20before%20surgery%20sufficient%2F&f=false 4. Quaternary Ammonium Cation. Wikipedia, the free encyclopedia. Last accessed on March 2, 2013. Accessed at: http://en.wikipedia.org/wiki/Quaternary_ammonium_cation 5. Rao N, Cannella B, Crossett L, et al. A preoperative decolonization protocol for staphylococcus aureus prevents orthopaedic infections. Clin Orthop Relat Res (2008) 466: 1343-1348.