September 4, 2002 Clinical Question
October 2002 Newsletter
18 Responses Participating Facilities: Summit, San Ramon, Washington, ValleyCare, Kaiser Pleasanton, Eden, Kaiser Oakland, Washington Outpatient.
1. You are circulating for a patient who is undergoing an abdominal hysterectomy. The surgeon has ordered an abdominal prep, a vaginal prep, and placement of a oley catheter. In what order do you perform these activities?
A. Abdominal prep, vaginal prep, foley insertion - 7
B. Abdominal prep, foley insertion, vaginal prep - 0
C. Vaginal prep, foley insertion, abdominal prep - 3
D. Vaginal prep, abdominal prep, foley insertion - 0
E. Foley insertion, abdominal prep, vaginal prep - 0
F. Foley insertion, vaginal prep, abdominal prep - 8
Rationale for "A" "Clean" to "Dirty"
Rationale for "C" Potential contamination of abdomen if vaginal prep and foley are done second. Bacterial count at urethral orifice will be decreased if vagina is prepped first.
Rationale for "F" Potential contamination of abdomen if vagina prep and foley are done second. Foley before vaginal prep because foley is going into "sterile" bladder. Prep for abdomen last because it should be "most sterile" at incision site.
Note: Practice varies between individuals at a particular facility.
2. Do you use one (1) prep set-up or two (2) to complete the activities listed above?
A. One - 6
B. Two - 12
3. Do you use one (1) pair of gloves for all three (3) activities or two (2) pair?
A. One - 1
B. Two - 16
4. Would you say that the majority of time, your facility removes hair at the incision site by:
A. Shaving with a razor before arriving in the OR - 2
B. Shaving with a razor in the OR -11
C. Clipping -5