Routine Shaving of Surgical Sites - Essay Example

? Perioperative Procedures. “Routine Shaving of Surgical Sites” Perioperative is the period of time which mainly covers from the time a patient goes to the doctor’s office for an operation procedure to the time when operation will end. The phases of operation process include patient in the room where guidance and counseling is administered to the patient before an operation is conducted, incision, dressing which covers the procedure time where actual operation takes place and finally the outpatient room where the patient rest and recuperates after operation (Evans, 1998). Besides, before an operation preoperative care should also be conducted to a patient because it usually allows many patients to have better results after surgery. The preoperative care includes psychological and physical preparation. Physical care preparations include studying and analyzing patient history like anesthesia history. Thus, laboratory tests like electrolytes, CBC, activated partial thromboplastin time and prothrombin are done (Keele, 2011). Psychological preparations like answering patient question before an operation usually decrease their anxiety. The perioperative procedure that will be analyzed in this essay is the routine shaving of surgical sites. Shaving of surgical sites is usually performed by surgeon assistant (Evans, 1998). The hospital administrator or chief surgeon determines the basis for practice after reviewing the patient history and approving the best procedure to be executed (Evans, 1998). The procedure is usually carried out by using depilatory creams, which dissolve the hair, and it is usually a slower process as the skin has to be in contact with cream for 15-30 minutes. Hair can also be removed by using clippers, with sharp edges to cut hair close to the patient skin leaving short stubble of about 0.04 inches long. Shaving is the most common method because it uses a sharp blade held within the head of the razor which is swapped over the patient skin to remove hair. Shaving, which is commonly used by many surgeons, has been implicated to cause higher risks of infections. Shaving result into microscopic cuts and abrasion, thus act as a block of the skin’s barrier defense against microorganism colonies (Hakim and Papalois, 2007). On the flip side, depilatory creams have a catastrophic disadvantage in that there could be an allergic reaction to the cream thus forcing nurses to conduct a patch test 24 hours prior to operation time thus leads to increased cost. The rationale for making the decision usually lies to the operation team and factors like allergy and health record due to SSIs infections determines the best method to be employed (Hakim and Papalois, 2007). Besides, shaving of surgical sites before any operation is usually carried out in a specific manner to reduce the spread of SSI and avoid health catastrophe that a patient may suffer due to poor administration of safety procedure during shavings (Fisher et al, 2007). Preparation of surgery of years has included the removal of body hair form the intended surgical wound site. Hair is mainly removed as its presence can impede with the exposure of the incision and subsequent wound. Besides, hair is also alleged to be associated with lack of cleanliness thus hair removal has shown too led to reduction of surgical site infections. A surgical site infection (SSIs) contributes tremendously to surgical morbidity and mortality every year. SSIs accounts for15% of all nosocomial infections experienced by patients after surgery. There are three types of SSIs defined by Centers for Disease Control and Prevention and they include incisional or organ infection, which is further subdivided as superficial (it mainly involves only the skin and subcutaneous tissue) and versus deep which infects the underlying soft tissue beneath the skin. Most of the SSI cases, the pathogen source, is the native flora of the patient’s skin, mucous membranes or hallow viscera. When a patient skin is incised, the underlying skin tissue is uncovered to the overlying endogenous flora. Due to the exposure, aerobic gram positive cocci like Staphylococcus serve as contaminant. Ingress into hollow viscera exposes neighboring tissue to gram negative bacilli like such as Escherichia coli. When such pathogen forms colonies in fresh wounds, it usually results into a catastrophe (Fisher et al, 2007) and results into SSIs. Besides, on the financial part of view, SSIs have led to an increased cost of health bills due to prolonged hospitalization due to infections involved, extra diagnostic cost, therapeutic antibiotic treatment and jeopardized health outcome of many patient. In 2009, it was estimated by researchers that SSIs extended period of hospital stay by 9.7 days and increased cost by 20,842 dollars per admission. The data above led to additional 700 million dollars health spending and health cost had to be pumped higher to $900 million. On the other hand, a recent study by 16 different departments examining the cost of SSIs has revealed a mean increase of 115% for the cost of care of a patient with an SSI compared other non infected control subjects (Hakim and Papalois, 2007). Different methods have been proposed on shaving of surgical sites so as to reduce the spread of SSI caused by poor methods of removing the hair. According to randomized controlled trials (RCT) comparing hair removed by shaving, clipping and depilatory creams compared with no hair removed and second procedure will compare hair removed by one method compared with hair removed by a different method. The first procedure was a control and showed the dangers of not removing hair before operation because of SSIs encountered by patients who decide to volunteer. In a study conducted on 1980 adults undergoing cardiopulmonary by pass surgery, (Hakim and Papalois, 2007) it was reported that manually shaven patients had a higher SSI of (13/990 1.3%) compared to electrical clipping, which had an infection of (4/990, 0.4%). A study also showed that (Hakim and Papalois, 2007) the use of depilatory creams and clippers was more effective than wet shaving and dry shaving thus, shaving, which is commonly used should abandoned because of the increased SSIs associated with it. Besides, when a patient is shaved, there are consequences of razor burn, which could further lead to attack by pathogens thus increased SSIs and skin rushes. Skin shaved by electrical clippers, stubble of hair is usually left on the surface thus the absences of skin burns hence reduced SSIs infections (Hakim and Papalois, 2007). The use of electrical clippers allowed easy application of antiseptic solutions on the skin compared to depilatory creams and shaving. Besides, the antiseptic solutions like Iodine-based preparations, which are 90% water, 8.5% PI and 1% Iodine, chlorohexadine-based preparations and alcohol based preparation were very effective on electrically clipped skin, thus help in removal of soil and transient organisms on the skin surface (Fisher et al, 2007). The best way to involve main stakeholders in adopting the way of removing hair from surgical sites is by conducting a seminar, where the results obtained from different methods, and their outcome is projected to stakeholders so that they can visualize the effectiveness of adopting electronic clippers. With such scientific evidence, most surgeons will adopt the cheap, friendly and effective method of hair removal, which will reduce the risk of SSIs after operations (Fisher et al, 2007). The main stumbling block of reflecting what has been outline from a research into practice is trial steps involved before approval by health authorities and cost to be incurred. This can be compared to introducing a new drug into the market. Before adopting a new discovery in the field of medicine, the procedures have to be tasted for safety to humans and ways of improving its potency employed. The process of approval by different authorities usually takes time and consumes a lot of money before it is adopted by the general public. The main barriers one can encounter when attempting to institute a change is the research part where one should outline the side effects of the new change, potency and potency index of the new drug or procedure. Besides, the procedure should meet certain standards set by relevant authorities (Hakim and Papalois, 2007). Conducting seminars with perioperative nurses so as to convince and assure them of the reliability and safety of new procedures. This will help in cutting the cost of meeting standards set by different regulatory bodies because the nurses will endorse your proposals. The other strategy of overcoming the barriers is by conducting your project with the help of major pharmaceutical firms like Pfizer and GSK. The multinationals has a positive reputation thus any of their projects can easily be adopted by different Healthcares. The third strategy of overcoming barriers is by coordinating with different universities, research and medical colleges within the country to introduce modules in their respective health courses which recognize the new methods of perioperative procedure (Fisher et al, 2007). The best way to apply research finding so that it can guide the realization of a procedure is by writing a proposal to different stakeholders who include surgeons and departments of health; hence this will enable one to have meetings and seminars where the idea can be adopted. Besides, holding symposiums among colleges where the better ways of shaving surgical sites can be introduced (Fisher et al, 2007). Such meetings and symposium will enable scientific exchanges and formulate better ways and improvement on perioperative methods and apply the changes. Websites that contain the information containing the proposed information should be formed to allow scientist and researchers proposed changes all over the globe. References: Evans, A. S. (1998). Bacterial infections of humans: Epidemiology and control. New York [u.a.: Plenum Med. Books. Fischer, J. E., Bland, K. I., & Callery, M. P. (2007). Mastery of surgery: Vol. 1 / ed. Joseph E. Fischer ; assoc. ed. Kirby I. Bland ; sect. ed. Mark P. Callery [et al.]. Philadelphia [etc.: Wolters Kluwer/Lippincott Williams & Wilkins. Hakim, N. S., & Papalois, V. E. (2007). Surgical complications: Diagnosis and treatment. London: Imperial College Press. Jeffrey, A (2008). Surgery Basic Science and Clinical Evidence. New York: Springer Keele, R. (2011). Nursing research and evidence-based practice: Ten steps to success. Sudbury, MA: Jones & Bartlett Learning. Read More