The Patient Prep Plan
Strong patient prep protocols
can make the difference between
a successful procedure and one
bedeviled by complications.
To learn more, Surgical Products
interviewed Kimberley S. Prinsen, RN,
MSN, technical service specialist with
3M’s infection prevention division.
How important is it for healthcare
facilities to establish specific
protocols around patient prep?
Protocols help remove variation
in practice. In general, variation
in practice can mean variation in
outcomes, whereas standardization in
practice can standardize outcomes.
The main purpose of standardizing on
specific protocols is to ensure safety
and welfare of patients and staff.
Research has shown that variation
in processes of care is problematic
because it can lead to increased
rates of error and potential negative
patient outcomes. Establishing
protocols for staff to follow around
patient prep aligns with best
practices to ensure patients receive
consistent, high-quality care.
What methods should healthcare
facilities use in developing their
patient prep protocols?
Methods that employ elimination of
variation in process is the foundation
of quality improvement and reliability.
We first saw these methods in
manufacturing in the 1930s. In the
1990s, these methodologies were
adapted for the healthcare environment.
Establishing prep protocols that
limit the number of variabilities can
in standardization and subsequent
training.
Step 2: Educate and train
regarding the appropriate prep
selection and application of the
surgical prep. This is essential as it
ensures the patient benefits from the
full efficacy of the product.
Step 3: Assess staff competency
initially and annually, or as dictated by
the facility’s auditing process.
Is it important for everyone to
understand the full protocol,
or do individual staff members
only need to know their specific
responsibilities?
Anyone who applies the surgical
prep to the patient should have a
full understanding of the protocol
and any product that is used for
prepping in the facility. The training
for those individuals should include:
• Antiseptic prep selection:
Clinicians should ask themselves,
“Which prep should I use for
each individual patient?” Basic
considerations include: patient
concerns — age, allergies/
sensitivities, type of procedure,
intact skin vs. open wound.
• Application method: Once a
prep is chosen, clinicians should
determine the correct application
method, such as scrub and
paint, paint only, and back and
forth. They should also be done
in a way to avoid dripping and
pooling. The amount of time the
prep needs to be in contact with
the skin is also critically important
in order for the prep to achieve
efficacy.
By Daniel Seeger, Editor
Getting patients ready for surgery requires consistent protocols.
Kimberley S. Prinsen, RN, MSN
Technical Service Specialist
3M’s Infection Prevention Division
play a part in reducing the risk of a
surgical site infection.
Preoperative Surgical Skin
Antisepsis is a critical step in
managing the risk of surgical site
infection.
What are the best strategies for
introducing new patient prep
protocols to staff?
Step 1: Decide on the surgical skin
preps to be used by the facility.
It should be a collaborative effort
among surgical services, infection
prevention professionals, and
surgeons. We know that no single
prep can meet all the prepping needs
because of patient and procedure
variability. However, the prep or
product choices can be limited to aid