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Background
The hospital was successful in reducing deep and organ space skin contaminant-related
surgical site infections (SSI) by using a progressive skin cleansing regimen to reduce
the concentration of transient and resident bacteria on the patient's skin. The adjunct
procedure limits the risk of surgical site contamination of endogenous skin microbial
pathogens.
Methods
An extensive review determined that the majority of primary organisms cultured from
the Hospital Acquired Infections (HAI) were skin contaminate-related. Based on the
review and surgeon recommendations, a task force implemented an adjunct cleansing
regimen of 4% CHG surgical scrub sponge used PRIOR to 2% CHG “paint”. The combined
cleansing regimen is used in addition to the traditional pre-surgical skin prep. The
adjunct process reduces the concentration of transient and resident bacteria on the
patient's skin, thereby limiting the risk of wound contamination. Further, the O.R.
staff's skin preparation competencies were validated through return-demonstration.
Just-in-Time education occurred if deviation from evidence-based practice occurred.
Results
The hospital saw a 68% decrease in the number of skin contaminant-related deep and
organ space surgical site infections during the first six months following the initiation
of the progressive skin cleansing regimen. Additionally, it was observed that the
occurrence of HAIs deviated from the suggested 4% CHG soap and 2% CHG paint skin prep
regimen, resulting in skin contaminant-related SSIs.
Conclusions
Implementing a comprehensive skin prep regimen eliminates the exposures that place
patients at higher SSI risk. The goal to reduce/eliminate preventable skin contaminate-related
infections and decrease the likelihood of hospital re-admissions following surgery
was achieved.
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Article Info
Identification
Copyright
© 2020 Published by Elsevier Inc.
