Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
[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