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Applying a skin preparation with concentric circles
is the best method.
False
There is no evidence that supports the concentric circular application methodology.1 Human skin varies markedly over different parts of the body. Because 80% of transient skin flora resides in the first five cell layers of skin, it is important to reach those lower layers and kill the potential pathogens dwelling further down. In addition to having multiple layers, the skin contains many cracks and crevices where organisms reside. Overall, these factors contribute to differential adherence and accessibility of microbes.(1-8) This suggests that in order to reach, properly dislodge, and kill potentially dangerous microbes, scrubbing, as opposed to uniformly, circular application, may be preferable.(1-2) The back-and-forth action creates friction and helps drive the solution into crevices and lower layers, killing more bacteria. Regardless of the cutaneous antiseptic used, allowing the preparation to dry completely is important to maximum effectiveness.
REFERENCES:
(1) AACN. 2005;22(10) (Available at aacn.org : click here)
(2) AORN. 2003; Standards, Recommended Practices, and Guidelines. pp. 338-341.
(3) Pfaff SJ Plast Surg Nurs. 2005;25(3):140-9; quiz 150-1.
(4) Keblish DJ et al. J Bone Joint Surg Am. 2005;87:986-992.
(5) Ryder M (Available at invectioncontroltoday.com: click here)
(6) Salvi M et al. Knee Surg Sports Traumatol Arthrosc. 2006;14(1):27-31. Epub 2005 Jul 30.
(7) Nielsen ML et al. J Clin Pathol. 1975;28(10):793-7.
(8) Brooks RA et al. Foot Ankle Int. 2001;22(4):347-50.
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Institute of Healthcare Improvement
5 million lives campaign
The 5 Million Lives Campaign is a voluntary initiative to protect patients from five million incidents of medical harm over the next two years (December 2006 – December 2008).
- IHI 5 Million Lives Website
- Overview
- Participants
- Implement the Central Line Bundle
- IHI Getting Started Kit: Prevent Ventilator-Associated Pneumonia How-to Guide
Center for Disease Control and Prevention (CDC)
Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee
