How to dress for success (and safety) in the OR and beyond

Given constant demands to deliver higher quality care at a lower cost, some hospital leaders feel the need to temporarily put safety improvement projects on the backburner. Although finding the time and money to invest in safety improvement is challenging, a safe work environment for front-line staff is essential for delivering efficient, high-quality care.

During a Jan. 23 webinar sponsored by Cardinal Health and hosted by Becker's Healthcare, Mary Cross, RN, MBA, a senior clinical operations consultant at Cardinal Health, and Leslie Petruzzelli, BSN, RN, MBA, CNOR, NE-BC, a director of perioperative services at HealthTrust, explored four safety improvements organizations can make to streamline overall efficiency of their facilities.

Here are the four improvements discussed in the webinar.

1. When it comes to isolation gowns, bad habits can become dangerous behaviors. Ms. Petruzzelli noted improper use of personal protective equipment, especially isolation gowns, is a common safety issue she observes in hospitals. Though fastening the neck on an isolation gown takes only a moment, nurses and physicians may overlook this step in a high-intensity clinical environment. This seemingly minor PPE infraction exposes front-line staff to dangerous cross-contamination. According to a simulation study at the University of Pittsburgh Medical Center, contamination occurred in 92.3 percent of simple set PPE donning and doffing instances, and human error was cited as an issue.

Ms. Petruzzelli said it is essential for clinicians to check one another to ensure they are complying with all safety protocol. Over-the-head isolation gowns are an easy way to avoid the problem altogether.

"Over-the-head gowns leave little room for donning error and remove risk entirely because there's only one way to wear it. They don't fall forward and there is no neck tie, so the clinician doesn't need to worry about tying the tab," Ms. Petruzzelli said. "These gowns increase compliance, reduce PPE protocol, and lead to reduced auditing and training time. They're very simple."

2. Ensure staff wear the appropriate surgical gowns in each procedure. Though 33 percent of nurses surveyed believed all surgical gowns offered the same level of protection, according to market research by Key Group, this is a dangerous misconception. The Association for the Advancement of Medical Instrumentation recognizes four possible safety-threat levels for different surgical procedures; each safety level determines which gowns clinicians should use for optimal protection. When deciding what kind of gown is necessary for a procedure, clinicians should ask themselves how much fluid they expect to be present during the procedure, how long the procedure will last and what their role in the procedure is.

Ms. Petruzzelli said it is necessary for organizations to educate their staff on AAMI levels and ensure compliance by including the proper gowns in procedure packs. She also encouraged organizations to bring in outside consultants to review the appropriateness of surgical gowns, which will ultimately help protect both staff and patients.

3. Protect against spilling and splashing infectious fluid waste. Some hospital leaders believe closed waste systems constitute best practice when it comes to fluid waste disposal. However, Ms. Cross points out, these systems don't account for dangerous spills, splashbacks or airborne particles and ignore fluid waste in other areas in the hospital, such as the ICU or emergency room. These risks are especially pronounced considering 24 percent of waste disposal handlers do not wear a gown and facial protection, according to market research from Key Group. She says utilizing solidifiers is an effective way to ensure liquid is safely disposed of throughout a hospital. Solidifiers may not yet be the industry standard, but Ms. Cross said integrating solidifiers is in the best interest of clinicians and patients.

"Just because something isn't standard practice today doesn't mean it shouldn't be," Ms. Cross said. "Think: Cars were originally made without seatbelts. Seatbelts weren't an option until the mid-1950s and weren't mandated until 1983. They weren't necessary until cars were faster, kind of like a faster clinical environment. Now we can't imagine not buckling up, and safer fluid waste disposal practices are the same."

4. Going latex-free in the OR matters to your staff today and tomorrow. Due to repeat exposure to latex products, healthcare workers are more likely than the rest of the population to develop latex sensitivities over time. Up to 17 percent of healthcare workers are affected by latex sensitivities, compared to less than 1 percent of the general population. Removing latex from the OR eliminates unnecessary and preventable costs stemming from paying for workers' compensation and pursuing and training new hires when clinicians lose work time due to latex sensitivities.

Synthetic, non-latex gloves have improved dramatically in recent years in terms of fit, feel and performance. By switching over from latex gloves, organizations can greatly improve standardization and reduce risk. Ms. Cross and Ms. Petruzzelli argue that people are an organization's best resources; if hospitals make safety decisions by looking at employees as their competitive advantage, the minor investment on the front end will pay dividends in the future.

To watch a recording of the webinar, click here.

To learn more about Cardinal Health, click here.

To learn more about HealthTrust, click here.

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