Wednesday, September 15, 2010

Abdominal Perineal Surgical Skin Prep

Part 1: Perineal Prep

Perineal Prep Supplies
Plastic bag / waterproof sheet 
Gloves
Long sponge forcep ( female patient )
Prep set with povidone iodine unless contraindicated

Perineal Prep Boundaries
Mons pubis to buttocks bedline
Inner thigh across to other inner thigh

Step 1: Mons Pubis and External Genitalia
With a Povidone soaked sponge start at the top of the pubis
Side to side motion over pubis
Move downwards over external genitalia ( never going back up )
Stop prep before prepping over anus, discard sponge
Pour more prep over sponge if needed but NO double dipping from prep kit!
If the patient is male ensure foreskin is retracted, cleaned and returned to original position 

Step 2: Inner Thighs
With a Povidone soaked sponge start at inner groin of one thigh 
Moving in an up and down motion from perineum (proximal) to 1/2 way up the inner thigh (distal)
Discard sponge
Obtain a new sponge and proceed to the other thigh in the same fashion

Step 3: Vagina Prep
With a long sponge stick and a Povidone soaked sponge insert sponges directly in vagina
Move sponge stick in a circular motion ensuring all vaginal folds are prepped
Discard sponge
Repeat with a new sponge

Step 4: Second Prep of Pubis, Genitalia and Thighs
Repeat step 1 and 2

Step 5: Lower Buttocks and Anus
Take a Povidone sponge and prep buttocks touching bed from out to in 
Prep anus with one swipe and discard sponge


Part 2: The Abdominal Prep

Abdominal Prep Supplies
- Tape over electrodes
- Gloves ( personal protective wear )
- Cotton Swab ( umbilicus )
- Prep set with chlorhexidine prep unless contraindicated

Abdominal Prep Boundaries
- Bedline to bedline
- Xyphoid process to mons pubis / outer legs

Step 1:  Umbilicus
Using a chlorhexidine dipped cotton swab clean umbilicus of any lint or debris.  Source of surgical contamination 
Use several if needed

Step 2:  Abdomen
-Starting at the belly button clean in concentric circles 
-Clean upper thigh and up to bedline on your side
Obtain a new sponges, walk over to other side of patient and clean upper thigh and up to bed line

Step 3: Second paint of prep





Sunday, September 12, 2010

The start of something new!

This blog is being set up as a resource for OR nurses to learn about best practice and surgery.  The great thing about this is that it is accessible from work and home allowing for the flexibility nurses need when preparing for a slate.  Feel free to submit your feedback and suggestions as to what would be most useful for you!