Prepping for Prevention: An Intervention to Optimize Skin Antisepsis and Peri-Operative Antibiotic Prophylaxis

Area of Science:

• Infection Control
• Surgical Safety
• Public Health

Background:

• Surgical site infections (SSIs) are a significant concern in healthcare settings, leading to increased morbidity and mortality.
• The U.S. Centers for Disease Control and Prevention (CDC) outlines several recommendations to prevent SSIs, including proper skin antisepsis and peri-operative antibiotic administration.
• Standardization of these preventive measures is crucial for consistent and effective infection control in surgical procedures.

Purpose of the Study:

• To evaluate the effectiveness of interventions designed to standardize surgical skin antisepsis procedures.
• To assess the impact of interventions aimed at standardizing peri-operative antibiotic administration.
• To determine the success of these combined interventions in improving compliance with infection prevention guidelines.

Main Methods:

• A cross-sectional study design was employed to observe surgical skin antisepsis practices before and after intervention implementation.
• Compliance with specific antisepsis steps, including hand hygiene, use of sleeves, cleansing time, drying time, and cleansing motion, was recorded.
• Peri-operative antibiotic administration, including order placement, selection, and dosage, was evaluated across a cohort of surgical procedures.

Main Results:

• Significant improvements were observed in surgical skin antisepsis compliance, notably in hand hygiene (1% to 48%), wearing sleeves (1% to 67%), correct cleansing time (47% to 85%), adequate drying time (67% to 87%), and cleansing motion (78% to 95%).
• Peri-operative antibiotic administration also showed significant improvements, with correct antibiotic selection rising from 52% to 95% and order placement increasing from 59% to 70%.
• The interventions successfully standardized surgical skin antisepsis and encouraged earlier ordering of peri-operative antibiotics.

Conclusions:

• The implemented interventions were successful in standardizing surgical skin antisepsis and improving peri-operative antibiotic administration.
• These standardized processes are critical for reducing the incidence of surgical site infections.
• The findings support the adoption of such interventions in healthcare settings to enhance surgical safety and patient outcomes.