Download Skin Antisepsis, Preoperative Patient – Team Member

[Insert Facility Name]
Competency Verification Tool—Perioperative Services
Practice: Skin Antisepsis, Preoperative Patient – Team Member
Name:
Date:
Competency Statement: The perioperative team member has completed facility- or health care organization-required education and competency
verification activities related to recommended preoperative patient skin antisepsis in the perioperative setting.1
1.
Guideline for preoperative patient skin antisepsis. In: Guidelines for Perioperative Practice. Denver, CO: AORN, Inc; 2015:43-66.
Outcome Statement: The patient is free from signs and symptoms of infection.2
2. Petersen C, ed. Infection. In: Perioperative Nursing Data Set. 3rd ed. Denver, CO: AORN, Inc; 2011:254-276.
Verification Method
[Select applicable code from legend at bottom of page]
DEM/
Competency Statements/Performance Criteria
DO/DA
S/SBT/
KAT
CS
RWM/
V
P&P
O
Not Met
(Explain why)
1. Verbalizes that preoperative patient bathing and skin antisepsis
products are approved by [facility-specific personnel].
2. Acknowledges that only bathing and skin antisepsis products
approved and provided by the health care organization will be used.
3. Leaves hair at the surgical site in place when feasible, and removes
only in select clinical situations.
4. Selects a safe, effective, facility-approved preoperative antiseptic for
the individual patient.
5. Applies the preoperative patient skin antiseptic in a safe and effective
manner.
6. Identifies location of safety data sheets for skin antiseptics in the
perioperative practice area.
7. Describes procedures for storage and disposal of flammable skin
antiseptics and recognizes that storage and disposal procedures are
based on local, state, and federal regulations.
8. If hair removal is necessary, removes hair at the surgical site by
clipping or depilatory methods in a manner that minimizes injury to
the skin.
9. Removes the patient’s hair in a manner that prevents hair dispersal
into the air by [facility-specific protocol (eg, wet clipping, use of
DEM/DO/DA
S/SBT/CS
RWM/P&P
=
=
=
Demonstration/Direct Observation/Documentation Audit
Skills Laboratory/Scenario-based Training/Controlled Simulation
Review of Written or Visual Materials/Policy/Procedure Review (Specify P&P #s _________________)
Copyright © 2015 AORN, Inc. All rights reserved. Used with permission.
KAT =
V
=
O
=
Knowledge Assessment Test
Verbalization
Other: ____________________________________________________
Page 1 of 5
[Insert Facility Name]
Competency Verification Tool—Perioperative Services
Practice: Skin Antisepsis, Preoperative Patient – Team Member
Verification Method
[Select applicable code from legend at bottom of page]
DEM/
Competency Statements/Performance Criteria
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
DO/DA
S/SBT/
KAT
CS
RWM/
V
P&P
O
Not Met
(Explain why)
suction)] when removing hair outside the operating or procedure
room is contraindicated.
Disinfects reusable clipper handles after each use, in accordance with
the manufacturer’s instructions for use.
Selects an effective, facility-approved preoperative antiseptic for the
individual patient based on the procedure type, and a review of the
manufacturer’s instructions for use and contraindications.
Prepares the skin for surgical antisepsis by washing skin at the
surgical site with a facility-approved product or soap
a. if the patient did not bathe or shower preoperatively or
b. when soil, debris, emollients, cosmetics, or alcohol-based
products are present at the surgical site.
Removes the patient’s jewelry at the surgical site before skin
antisepsis.
Cleans areas of greater contamination in the surgical field (eg,
umbilicus, foreskin, under nails, intestinal or urinary stoma) before
skin antisepsis.
Isolates highly contaminated areas (eg, anus, colostomy) that are near
the surgical site with a sterile barrier drape.
Recognizes that the skin antiseptic should be applied by a
nonscrubbed perioperative team member using sterile technique
according to the manufacturer’s instructions for use.
Wears surgical attire that covers the arms while performing skin
antisepsis.
Performs hand hygiene before performing skin antisepsis.
Wears sterile gloves and uses sterile supplies to apply the antiseptic.
Wears nonsterile gloves when the applicator is of sufficient length to
prevent contact of the gloved hand with the antiseptic solution and
the patient’s skin.
DEM/DO/DA
S/SBT/CS
RWM/P&P
=
=
=
Demonstration/Direct Observation/Documentation Audit
Skills Laboratory/Scenario-based Training/Controlled Simulation
Review of Written or Visual Materials/Policy/Procedure Review (Specify P&P #s _________________)
Copyright © 2015 AORN, Inc. All rights reserved. Used with permission.
KAT =
V
=
O
=
Knowledge Assessment Test
Verbalization
Other: ____________________________________________________
Page 2 of 5
[Insert Facility Name]
Competency Verification Tool—Perioperative Services
Practice: Skin Antisepsis, Preoperative Patient – Team Member
Verification Method
[Select applicable code from legend at bottom of page]
DEM/
Competency Statements/Performance Criteria
DO/DA
S/SBT/
KAT
CS
RWM/
V
P&P
O
Not Met
(Explain why)
21. Applies the antiseptic to an area large enough to accommodate
potential shifting of the surgical drapes, extension of the incision (eg,
during conversion of a minimally invasive procedure to an open
procedure), potential additional incisions, and all potential drain sites.
22. Applies the antiseptic starting at the incision site and moving toward
the periphery of the surgical site.
23. Preps the area with lower bacterial count first, followed by the area of
high contamination, as opposed to working from the incision toward
the periphery for incision site that is more contaminated than the
surrounding skin (eg, perineum).
24. Discards the applicator after contact with a peripheral or
contaminated area and uses another sterile applicator for additional
antiseptic applications.
25. Applies the antiseptic with care on fragile tissue, burns, open wounds,
or malignant areas.
26. Applies the antiseptic to all surfaces of the skin in the surgical field,
especially areas between fingers or toes.
27. Implements protective measures to prevent prolonged contact with
skin antiseptics including
a. protecting sheets, padding, positioning equipment, and adhesive
tape from dripping or pooling of the skin antiseptic beneath and
around the patient;
b. protecting electrodes (eg, electrocardiogram [ECG],
electrosurgical unit [ESU] dispersive electrode) and tourniquets
from contact with the skin antiseptic; and
c. placing a fluid-resistant pad under the patient’s buttocks during
skin antisepsis for the patient in lithotomy position.
28. Allows the antiseptic to dry for the full time recommended in the
manufacturer’s instructions for use before sterile drapes are applied.
DEM/DO/DA
S/SBT/CS
RWM/P&P
=
=
=
Demonstration/Direct Observation/Documentation Audit
Skills Laboratory/Scenario-based Training/Controlled Simulation
Review of Written or Visual Materials/Policy/Procedure Review (Specify P&P #s _________________)
Copyright © 2015 AORN, Inc. All rights reserved. Used with permission.
KAT =
V
=
O
=
Knowledge Assessment Test
Verbalization
Other: ____________________________________________________
Page 3 of 5
[Insert Facility Name]
Competency Verification Tool—Perioperative Services
Practice: Skin Antisepsis, Preoperative Patient – Team Member
Verification Method
[Select applicable code from legend at bottom of page]
DEM/
Competency Statements/Performance Criteria
DO/DA
S/SBT/
KAT
CS
RWM/
V
P&P
O
Not Met
(Explain why)
29. Implements protective measures to minimize the risk of fire when
flammable antiseptics are used.
30. Prevents antiseptics from pooling or soaking into linens for the
patient’s hair by use of
a. reusable or disposable sterile towels to absorb drips and excess
solution during application,
b. removing materials that are saturated with the skin antiseptic
before the patient is draped, and
c. wicking excess solution with a sterile towel to help dry the
surgical prep area completely.
31. Allows sufficient time for the antiseptic to dry completely and for any
fumes to dissipate before surgical drapes are applied or a potential
ignition source is used.
32. Does not heat flammable antiseptics.
33. Removes the skin antiseptic from the patient’s skin at the end of the
surgical procedure before application of an occlusive dressing or tape,
unless otherwise indicated by the manufacturer’s instructions for use.
34. Reviews and follows the skin antiseptic manufacturer’s instructions
for use and safety data sheets (SDSs) for handling, storing, and
disposing of skin antiseptics.
35. Stores skin antiseptics in the original, single-use container.
36. Discards skin antiseptics in single-use containers after each use and
does not refill.
37. Does not dilute skin antiseptics after opening.
38. Does not heat flammable skin antiseptics except in accordance with
the manufacturer’s instructions for use.
39. Does not warm skin antiseptics in a microwave oven or autoclave.
40. Verbalizes a review of facility or health care organization policies
and procedures related to preoperative patient skin antisepsis.
DEM/DO/DA
S/SBT/CS
RWM/P&P
=
=
=
Demonstration/Direct Observation/Documentation Audit
Skills Laboratory/Scenario-based Training/Controlled Simulation
Review of Written or Visual Materials/Policy/Procedure Review (Specify P&P #s _________________)
Copyright © 2015 AORN, Inc. All rights reserved. Used with permission.
KAT =
V
=
O
=
Knowledge Assessment Test
Verbalization
Other: ____________________________________________________
Page 4 of 5
[Insert Facility Name]
Competency Verification Tool—Perioperative Services
Practice: Skin Antisepsis, Preoperative Patient – Team Member
Verification Method
[Select applicable code from legend at bottom of page]
DEM/
Competency Statements/Performance Criteria
DO/DA
S/SBT/
KAT
CS
RWM/
V
P&P
O
Not Met
(Explain why)
41. Participates in assigned quality improvement activities related to
preoperative patient skin antisepsis.
Concurrent competency verification of the following is recommended
 additional competencies related to surgical attire as determined by the facility or
health care organization.

DEM/DO/DA
S/SBT/CS
RWM/P&P
=
=
=
Demonstration/Direct Observation/Documentation Audit
Skills Laboratory/Scenario-based Training/Controlled Simulation
Review of Written or Visual Materials/Policy/Procedure Review (Specify P&P #s _________________)
Copyright © 2015 AORN, Inc. All rights reserved. Used with permission.
KAT =
V
=
O
=
Knowledge Assessment Test
Verbalization
Other: ____________________________________________________
Page 5 of 5