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Positive impact on heat loss and patient experience of preheated skin disinfection: a randomised controlled trial
Örebro University, School of Health Sciences.
Örebro University, School of Medical Sciences.ORCID iD: 0000-0001-5939-2932
Örebro University, School of Health Sciences.ORCID iD: 0000-0001-5403-4183
2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 21-22, 3144-3151 p.Article in journal (Refereed) Published
Abstract [en]

Aims and objectives: The aim of this study was to compare the effect of preheated (36 °C) and room-temperature (20 °C) skin disinfectant solution on skin temperature and patients' experience of the skin disinfection process.

Background: To prevent surgical site infections, it is important to disinfect skin prior to invasive surgery. In clinical practice, conscious patients often comment on the coldness of the preoperative skin disinfection solution. Evidence is lacking, as to whether preheated skin disinfectant has any positive effects during preoperative skin disinfection.

Design: Randomised controlled trial.

Methods: A total of 220 patients undergoing pacemaker, implantable cardioverter-defibrillator, or cardiac resynchronisation therapy under local anaesthesia were included and randomly allocated to preheated or room-temperature skin disinfection. Skin temperature was assessed before and after skin disinfection at the planned incision site; in addition, three study-specific questions were used to assess how patients experienced the temperature.

Results: Patients experienced the skin disinfection process with preheated disinfectant as significantly more pleasant. They felt less cold and reported increased satisfaction with the temperature of the solution compared to patients who were disinfected with room-temperature solution. Skin disinfection with preheated solution also yielded a significantly higher mean skin temperature compared to room-temperature solution.

Conclusions: Preoperative skin disinfection with preheated disinfectant may prevent heat loss and contributes to a more pleasant experience for patients.

Relevance to clinical practice: Skin disinfection with preheated skin disinfectant is an easy and inexpensive nursing intervention that has a positive impact on heat loss and on patients' experience of the disinfection process.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2016. Vol. 25, no 21-22, 3144-3151 p.
Keyword [en]
Experience, intraoperative, perioperative, randomised controlled trial, skin disinfection, temperature
National Category
Dermatology and Venereal Diseases Nursing
Research subject
Caring sciences
Identifiers
URN: urn:nbn:se:oru:diva-50606DOI: 10.1111/jocn.13263ISI: 000388922700006PubMedID: 27256458Scopus ID: 2-s2.0-84973308967OAI: oai:DiVA.org:oru-50606DiVA: diva2:934327
Note

Funding Agency:

Örebro County Council

Available from: 2016-06-08 Created: 2016-06-08 Last updated: 2017-10-16Bibliographically approved
In thesis
1. Swedish operating room nurses preventive interventions to reduce bacterial growth, surgical site infections, and increase comfort in patients undergoing surgery
Open this publication in new window or tab >>Swedish operating room nurses preventive interventions to reduce bacterial growth, surgical site infections, and increase comfort in patients undergoing surgery
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Surgical site infection is a major postoperative complication that causes patient suffering and is costly for society. The general aim of this thesis was to test and describe interventions performed by operating room (OR) nurses to prevent bacterial growth in surgical patients, with the intent to prevent surgical site infections (SSIs) whilst increase patients comfort.

In studies I and II, 220 pacemaker patients were tested to compare pre-heated skin disinfection with room-temperature skin disinfection regard-ing bacterial growth, skin temperature and patient experience. Preheated skin disinfection was not less effective compared to room-temperature skin disinfection in reducing bacterial growth after skin disinfection and there were no differences regarding SSIs three month postoperatively. Preheated skin disinfection reduces skin heat loss and was perceived as more pleas-ant compared to room-temperature skin disinfection.

In study III, 12 OR nurses were examined regarding bacterial growth on their hands and at the sterile glove cuff end after surgical hand disinfec-tion and again after wearing sterile surgical gloves during surgery. They were compared with a control group of 13 non-health care workers. OR nurses’ hands had higher amounts of bacterial growth at two of three culture sites after surgical hand disinfection compared with the control group, and the bacterial growth increased in both groups with time during surgery. There seems to be a risk of bacterial growth at the glove cuff end during surgery, involving the same type of bacteria as isolated from the hands.

In study IV, 890 OR nurses answered an online questionnaire describ-ing OR nurses interventions guided by national guidelines to reduce SSIs, such as preparation of the patient skin, patient temperature, and OR ma-terials used. The proportion of the OR nurses who complied with the national guidelines preventive interventions was high: skin disinfection solution (93.5%), drapes (97.4%) and gowns (83.8%), and double gloves (73%). However, when guidelines were lacking the interventions differed.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2017. 90 p.
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 73
Keyword
skin disinfection, patient experience, skin temperature, intra-operative, surgical site infection, bacterial growth, recolonization
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-59394 (URN)978-91-7529-213-7 (ISBN)
Public defence
2017-11-10, Universitetssjukhuset i Örebro, Wilandersalen, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2017-08-25 Created: 2017-08-25 Last updated: 2017-10-16Bibliographically approved

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