What really caught my attention was the pre-hospital prep described for one hospital. Currently, (as most of my patients exhibit good hygiene) I haven’t begun anything more than taking a shower (with basic soap), washing their hair, and brushing their teeth pre-op. My SSI rate is less than 0.5% over 20 years. The bold is my emphasis.
As Beth Beck, director of infection prevention and control/employee health at Springhill Medical Center in Mobile, AL, explains, her facility follows specific steps in the prep process to help reduce infection risk.
“We ask the surgeons to have the patients bathe with chlorhexidine the night before,” she says.
“Then, once they arrive to the hospital, we wipe them down with a CHG-impregnated cloth and we instruct patients to brush their teeth twice. We have them rinse with a CHG oral rinse. Then, we give them skin and nasal antiseptic.”
Now remember this is a surgical products magazine, so the focus on the article may be to sell me the skin and nasal antiseptic product which the article mentions is marketed by 3M and is meant to reduce Staphylococcus aureus (Staph aureus) colonization, a leading cause of SSI.
The article quotes Joe Gillis, marketing manager for the skin and nasal antiseptic product at 3M:
According to Gillis, approximately thirty percent of surgical patients today are colonized with Staph aureus in the nares. In turn, a study published in The Lancet in 2004 revealed that eighty percent of Staph aureus infections are caused by the patient’s own nasal flora. Additionally, one percent of the surgical population carries methicillan-resistant Staphylococcus aureus (MRSA).
The article goes on to explain that Beck’s facility is in the trial phase of using the skin and nasal antiseptic product on orthopedic patients who are undergoing an operation involving implants. The hospital added the nasal antiseptic part of the routine after seeing an increase in surgical site infections in orthopedic patients.
What is your or your hospital’s routine “prep before the prep?”