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Running head: EVIDENCE-BASED LITERATURE REVIEW 1Evidence-Based Literature Review regarding the Benefits of Preoperative ShowersDeloris MerrittWestern Governors University
EVIDENCE-BASED LITERATURE REVIEW2Evidence-Based Literature Review regarding the Benefits of Preoperative ShowersSurgical Site Infection (SSI) rates are among a leading concern of healthcare consumers, healthcare practitioners, and healthcare institutions in the United States. Complications from such infections can be costly and life altering. By identifying improvements in nursing practice an impact on SSI rates can be affected. Although there are various components involved in this healthcare issue nurses play a vital role in healthcare practices. With the appropriate tools, evidence-based education and institutional support to patient and healthcare personnel the future of SSI will see a decrease in rates.Professional Practice DescriptionThe focus of this review is to evaluate if utilizing Chlorhexidine Gluconate (CHG) showers is effective in decreasing surgical site infection rates for scheduled induction who result in an unscheduled cesarean section. According to the CDC, an SSI is an infection that occurs at or in the proximity of the surgical site within the first thirty days post-op (Akhter, Hamid, & Ali, 2016). The data obtained focuses on the benefits of CHG showers, but more specifically if they should be routinely performed for scheduled induction of labor patients. All patients who presentto a Labor and Delivery unit could potentially have an unscheduled or emergency cesarean section.Current Nursing Practice at Cox Health SystemsCurrently, at Cox Health Systems only scheduled cesarean sections are instructed to take a preoperative CHG shower. Instructions are given to patients in preadmission prior to their scheduled surgical date, and in some cases in the healthcare provider’s office. Patient are instructed to take a CHG shower the night before and the morning of surgery. The morning of thepatient’s scheduled cesarean section it is verified by the Labor and Delivery nurse if the patient
EVIDENCE-BASED LITERATURE REVIEW3did take their preoperative shower. The patient is not asked if directions on taking a CHG showerwere explained to them or if they performed the shower correctly. If the patient did not take at least one preoperative shower, then they are required to take one prior to changing into their hospital gown. Whereas, the scheduled induction of labor patient is not instructed to shower priorto arrival.The Need for Current Nursing Practice ChangeThe use of a CHG shower the night before and the morning of a scheduled cesarean section is believed to decrease bacterial counts significantly versus other cleaning methods (Edmiston Jr & Spence, 2014). An important statistic to consider is greater than one in every fivepregnant women delivered via primary cesarean section in 2016; equally 21.8% (Martin et al., 2018). The need to change the current nursing practice of educating our patients of the