AHRQ Safety Program for Surgery
Introduction
Problem Statement
Surgical skin preparation is an important strategy to prevent surgical site infection. Adequate surgical skin preparation reduces the burden of skin microorganisms prior to incision. Though it seems straightforward, surgical skin preparation is a complex process that requires the coordination and responsiveness of individuals and systems in the operating room. There are often many opportunities to improve the adequacy of surgical skin preparation.
Purpose of This Tool
This tool will help your safety program team understand how appropriately you are preparing the skin for incision. It can help your team identify practice patterns, so you can more easily pinpoint opportunities for intervention.
Please Adapt This Tool
A team of clinicians designed this tool to assess the adequacy and variability of surgical skin preparation in its operating room. Please modify this tool to best fit your team’s needs. The manufacturer’s product labeling should be consulted for directions for use of specific products, and may be helpful for developing audit questions.
How To Use This Tool
An observer who is not assisting with skin preparation passively watches the skin preparation procedure and documents observations on the data table below. We recommend that you collect data from 10 patients undergoing surgery, but there is no right or wrong number of patients to review. The more patients you review, the more likely you are to identify opportunities to improve the adequacy of surgical skin preparation. Your team can determine the approach that will work best in your perioperative area.
At the end of the month, tally your data in the Sensemaking Table and address any variability in practice.
How To Use Audit Data
Even if some team members are not part of the data collection process, the entire improvement team is responsible for creating a cohesive plan to address performance gaps. If the data reveal defects in surgical skin preparation, your team can design a quality improvement intervention to address them. You can use the AHRQ Safety Program for Surgery Toolkit to guide your team through the quality improvement intervention design process.
Data Table*
| QUESTION | DATA |
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| Observation Number | |
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Betadine ___ ChloraPrep ___ DuraPrep ___ Other ___ Name, if other: |
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Betadine ___ ChloraPrep ___ DuraPrep ___ Other ___ Name, if other: |
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Yes ___ No ___ Yes, after reminder ___ |
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Yes ___ No ___ Yes, after reminder ___ |
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Yes ___ No ___ Yes, after reminder ___ |
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1 ___ 2 ___ 3___ |
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Name: Role: |
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Trained: Yes ___ No ___ |
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* Use of brand names is for identification only and does not imply endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Sensemaking Table*
| QUESTION | DATA |
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| Count responses from Data Table to answer the following questions. | |
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* Use of brand names is for identification only and does not imply endorsement by the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
