CMS produced a list of four risk-reduction techniques intended to improve safe use of skin preparations in anesthetizing locations in hospitals and ambulatory surgery centers.
Alcohol-based skin preparations are considered to be the most effective and rapid-acting skin antiseptic, but the flammable nature of such products can contribute to the risk of surgical fires and result in patient harm. According to CMS, approximately 100 surgical fires occur each year, resulting in roughly 20 serious patient injuries.
A review of the following recommendations by expert healthcare organizations indicates a general consensus that the risk-reduction measures are appropriate:
• Use skin prep solutions that are packaged to ensure controlled delivery to the patient in unit dose applicators, swabs or other similar applicators. The solutions should also provide clear and explicit manufacturer/supplier instructions and warnings. These instructions for use should be carefully followed.
• Ensure that the alcohol-based skin prep solution does not soak into the patient's hair or linens. Sterile towels should be placed to absorb drips and runs during application and should then be removed from the anesthetizing location prior to draping the patient.
• Ensure that the alcohol-based skin prep solution is completely dry prior to draping. This may take a few minutes or more, depending on the amount and location of the solution. The prepped area should be inspected to confirm it is dry prior to draping.
• Verify that all of the above has occurred prior to initiating the surgical procedure. This can be done, for example, as part of a standardized pre-operative "time out" used to verify other essential information to minimize the risk of medical errors during the procedure.
Alcohol-based skin preparations are considered to be the most effective and rapid-acting skin antiseptic, but the flammable nature of such products can contribute to the risk of surgical fires and result in patient harm. According to CMS, approximately 100 surgical fires occur each year, resulting in roughly 20 serious patient injuries.
A review of the following recommendations by expert healthcare organizations indicates a general consensus that the risk-reduction measures are appropriate:
• Use skin prep solutions that are packaged to ensure controlled delivery to the patient in unit dose applicators, swabs or other similar applicators. The solutions should also provide clear and explicit manufacturer/supplier instructions and warnings. These instructions for use should be carefully followed.
• Ensure that the alcohol-based skin prep solution does not soak into the patient's hair or linens. Sterile towels should be placed to absorb drips and runs during application and should then be removed from the anesthetizing location prior to draping the patient.
• Ensure that the alcohol-based skin prep solution is completely dry prior to draping. This may take a few minutes or more, depending on the amount and location of the solution. The prepped area should be inspected to confirm it is dry prior to draping.
• Verify that all of the above has occurred prior to initiating the surgical procedure. This can be done, for example, as part of a standardized pre-operative "time out" used to verify other essential information to minimize the risk of medical errors during the procedure.
Related Articles on Surgical Fires:
ECRI Institute Provides Tips on Avoiding Surgical Fires
ECRI Institute Lists Top 10 Health Technology Hazards for 2012
FDA Initiative Designed to Help Prevent Surgical Fires