Introduction
A pre-operative procedure in surgery is a step taken to prepare a patient for a procedure and their nature depends on the nature of disease or injury, the anatomical region involved, the urgency of the procedure, the general state of the patient among other factors (Hegner, 2004). There are some that, through research, I have determined need to change. My focus will be on the use of multiple anti-microbial agents to clean the surgical area instead of a single solution.
Incision region preparation procedure
Cleaning the incision region is an important process that begins with asking the patient to bathe, quite commonly using an antiseptic agent a night before the procedure. Afterwards, the area is then cleaned to remove gross contamination before applying the antiseptic. The area is then cleaned using the antiseptics. Apply the antiseptic in the selected area in concentric circles towards the periphery ensuring that the area covered is large enough to allow extension of the incision if necessary (Altman, 2003). The use of multiple antimicrobial agents to bathe, clean and scrub the site should change because the different antimicrobial agents used are among the many reasons for which anaphylactic reactions develop. This is when the body’s immune system responds to the drug by overreacting to it and producing immunoglobulin especially immunoglobulin E (Keim, 2011). Exposure to the drug again leads to the release of chemical mediators like histamine whose effects on cells and organs leads to symptoms like a rash. This also makes the entire process costly, because the patient has to undergo alternative treatment and use multiple antimicrobial agents used to prepare the surgical site.
The basis, rational and why we do incision and sterilization
According to my investigation of the process, we clean the surgical site because microorganisms present on the skin surface if introduced into the body, are capable of causing life threatening infections and more often than not, delay healing. We clean to avoid such complications. They base the decision they make on the site and the nature of disease of injury. Quite commonly, we clean most surgical sites, owing to presence of commensals which can cause disease if introduced in a different body environment (Aielo, 2005). We do surgical site cleaning in the above explained way to decrease infection and as a result improve the healing of the surgical site upon which we performed the procedure.
Clinical implications
The clinical implications of surgical site cleaning include reduced bacterial infections and faster healing. A reduction in the bacterial load on the skin through use of antiseptics sterilize the surgical site and if cared for properly will heal without complications. Also among the implications is development of anaphylactic reactions in some patients. Sometimes, these patients are allergic to one of the many multiple antimicrobial agents used in the cleansing process. Other complications related to the different drug profiles may occur, for instance, development of a rash or inflammatory reactions.
Proposed changes
Surgical site cleaning is now an already well entrenched preparative procedure and its effectiveness is universally accepted. However, slight changes could be made to make the process even more effective than it already is; for instance, the use of one solution instead of many antimicrobial agents and this will effectively eradicate the above mentioned complications. It will also make the entire preparatory process cost-effective. The use of a single agent is cheap and safer in the long run. In all other aspects such as the total area sterilized, the scrubbing before the procedure and the antiseptic bath a night before the procedure; the results seem acceptable and there’s no instant need for change.
Stakeholder involvement
Involving stakeholders to effect this proposed change is without doubt a daunting task. Knowing certain important points can help do this for instance, how they will measure the success of this change. The managerial importance of the stakeholders and how much influence they have determines their involvement. The first step in involving the stakeholders will be communicating to them. I’ll communicate effectively through the proper communication media with emphasis on the part of the procedure I wish to change. A presentation to stakeholders at a meeting is right, an avenue in which I can present my research and allow room for questions and any other important clarification.
Difficulties in research translation
There are certain difficulties that would be met in translating our findings into practice. First, the medical profession has established rules which took years to perfect and have thus been fully embraced. An example of this includes the cleaning of preparative sites. Changing the already preset minds will definitely be daunting, for example; many researchers think the use of a single antimicrobial agent encourages drug resistance through plasmids transmission in organisms like staphylococcus aureas. Instituting change to the procedure faces several barriers. First, financial challenges are a barrier in the sense that purchases for various antimicrobial agents have already been made. After selecting an appropriate one to use, sometimes, they discard the rest leading to wastage. Lack of leadership support also impedes the implementation process. This is because the skeptic leaders are unable to see the value in the change, making the process difficult to complete. Strategies to overcome these barriers need implementation. Firstly, when leadership support is lacking, I would contact peers who have been successful in implementing the method.
This would boost their confidence and prove that using one antimicrobial agent is practical and effective, with the extra property of being safe. Secondly, I would enlist outside help to drive the initiative and ease the change. Outside help could be acquired from research specialists or professors in the medical field who have had experience in dealing with preparative rules and are well-informed on the benefits and disadvantages of each, including surgical site sterilization (Pexton, 2011). My team would also run a focus group and this will aid in forming new ideas, aid and help people get engaged in the process of change, allow a representative group of people to share ideas and realize why embracing the use of a single antibiotic would be beneficial to the patient’s health. The application process involves determining how valid my research is and its findings. After that, I find its clinical significance and in this case, it would go a long way in preventing anaphylactic reactions. This would then be followed by assessing its feasibility in different clinical scenarios. These include accident victims in need of urgent surgical procedures, and patients in need of operations to remove tumors, cysts among other lesions.
Conclusion
In conclusion, preparative site cleaning using multiple antimicrobial agents is harmful to patients since they could develop anaphylactic shock; it is not costly and safe.
Reference List
Aielo, A. E., Marshal B., Stuart, B. L., Della-Latta, P., Lin, X. S., and Larson, E. (2005). Antibacterial Cleaning Products and Infectious Diseases. Emerging Infectious Diseases Vol. 11, No. 10. Web.
Altman, G. (2003). Delmar’s Fundamental and Advanced Nursing Skills (2nd Edition). Canada: Delmar Learning.
Hegner, B. R., Acello, B., Caldwell, E. (2004). Nursing assistant. A nursing process approach (9th Edition) Canada: Delmar Learning.
Keim, M. S. (2011). Drug allergy. E-medicine health. Web.
Pexton, C. (2011). Overcoming the barriers to change in healthcare system. Web.