The following praiseed practices w...

The following praiseed practices were developed by the AORN attract favor toed Practices Committee and have been approved according to the AORN Board of Directors. They were not awayed as proposed recommended practices for remarks by members and others. They are effective Jan 1 2002

These commended practices are intended as achievable recommendations representing what is believed to be an optimal on a level of practice. Policies and performances will reflect variations in practice settings and/or clinical situations that determine the stage to which the recommended practices can be implemented.

AORN recognizes the numerous models of settings in which perioperative encourages practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive actions may be performed.

Purpose: These praiseed practices provide a guideline for achieving skin preparation of the surgical site. The goal of preoperative skin preparation is to abate the risk of postoperative surgical site infection by means of removing soil and transient microorganisms from the skin, reducing the resident microbial think to subpathogenic levels in a short period of time and with the least amount of tissue irritation, and inhibiting rapid spring back growth of microorganisms.

approveed PRACTICE I

The surgical site should be assessed before skin preparation.

1 Skin should be assessed before skin preparation, and the carriage of moles, warts, rashes, or other skin conditions at the surgical site should be noted and documented. Inadvertent removal of lesions traumatizes the skin at the surgical site and provides an opportunity for hurt colonization by microorganisms. (1)

approveed PRACTICE II

Whenever possible, hair should be left at the surgical site. If it is determined that hair should be remov removal should be performed according to physicians' orders and/or according to policies and measures in the practice setting. (2)

1 An assessment of the amount and rank of hair at the site should be performed. The necessity of hair removal hangs on the amount of hair, location of the incision, and prototype of surgical procedure to be performed. Inappropriate hair removal techniques can traumatize skin and provide an opportunity for colonization of microorganisms at the surgical site.

2 If hair is to be remov at the surgical site, these guidelines should be followed. (3)

* Personnel skilled in hair removal techniques should perform the removal.

* Hair removal should be performed as finish to the time of surgery as possible, excepting when a depilatory is to be used (see number four).

* Hair removal should be performed in an area outside of the scope where the procedure will be performed.

* Hair removal should be performed in a manner that keeps skin integrity.

3 Microscopic exudative rashes and skin abrasions can meet the eye during hair removal. These rashes and skin abrasions can provide a portal of note for microorganisms. (4) When hair removal is necessary, an electric or battery-powered clipper with a disposable or reusable head that can be disinfected between patients should be used, if possible. This is the simplest and least irritating rule of hair removal. (5) If hair is remov removal should take place away from the sterile field, preferably in an area outside of the apartment where the procedure will be performed. The dispersal of release hair has the potential to contaminate the surgical site and sterile field. (6)

4 Depilatories have caused skin reactions in one individuals, causing surgeries to be cancelled. (7) If a depilatory is to be used, manufacturers' written instructions regarding preapplication skin testing should be followed. Depending forward the manufacturers' instructions, some depilatories may require use before the patient's arrival in the practice setting. (8)

5 Hair removal with a razor can disrupt skin integrity. If the physician orders shaving with a razor, hair and skin should be wet before shaving. Wetting hair with soapy water makes it softer and easier to destroy and results in fewer microabrasions to the skin's surface. (9) Wet shaving also sways dispersal of loose hair.

6 All items used in hair removal should be disposed of or disinfected between surgical procedures

make acceptableed PRACTICE III

The surgical site and surrounding areas should be clean.

1 The skin around the surgical site should be exempt of soil and debris. Removal of superficial soil, debris, and transient microbes before applying antiseptic agent(s) contracts the risk of wound contamination by the agency of decreasing the organic debris onward the skin. (10)

2 Cleansing should be accomplished before surgical skin preparation according to any of the following methods:

* patient showering and/or shampooing before arrival in the practice setting,