EBT Task 2

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A1. Procedure

The preoperative procedure of using with chlorhexidine-alcohol (CHG) before surgery has been proven to be more effective to reduce the number of surgical site infections (SSI) than the use of povidone iodine. By reducing the number of infections post surgery, it can lower patient morbidity and can reduce hospital stay time and eliminate further unnecessary costs.

A2a. Basis for Practice (who determined )
The basis for changing the method of using chlorhexidine-alcohol bath before all surgeries and not just the open heart patients.
In HCA facility, the infectious disease nurse (ID), wound care nurse and the operating room (OR) manager have collaborated to find an effort to reduce the rate of surgical site
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Infect Control Hosp Epidemol. 2012, 33(6): 608-617

4. Magalini, S., et al (2013) Observational Study on Pre-Operative Surgical Field Disinfection: Povidone- Iodine and Chlorhexidine- Alcohol. European Review for Medical and Pharmacological Sciences. (17): 3367-3375

5. Poulin,P., et al.(2014) Preoperative Skin Antiseptics for preventing surgical site infections: What to do? ORNA Journal Sept 2014:14-29

A4. Clinical Implications on patients
If all patients were bathed/showered preoperatively with an antiseptic, it would reduce the risk of SSIs. This would benefit the patient with shorter time spent on a critical care unit, would reduce the mortality rate and can reduce the readmission rate . Bathing/showering would mean an extra step for the patient and the nurse with added cost for the antiseptic chlorhexidine wash but it serves as added protection in the prevention of post surgical infection.
Before bathing/showering with soap and water prior to a procedure/surgery was accepted. It has been proven that antiseptic showering decreases skin microorganism count. Chlorhexidine gluconate products necessitate the need for several applications for the maximum antimicrobial benefit. Thus, each patient receives two preoperative antiseptic showers.
Patient will be instructed to shower/bathe at home and educated not to use any perfume and/or lotion after.
A5. Changes on practice setting

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