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Nursing: The Significance of Evidence-Based Practice and Ethical Principles in Perioperative Procedures

Nursing: The Significance of Evidence-Based Practice and Ethical Principles in Perioperative Procedures

Nursing is a dignified profession, which entails the provision of medical aid through pertinent procedural measures for the daily physical, mental and nutritional healthcare needs of admitted patients and outgoing convalescents. There is a need for recognition of the overall significance of applied research and integration in evidence-based practice with fundamental ethical principles. Such a requirement requires a greater understanding of existent barriers to evidence-based practice with the promotion of safe and reliable healthcare. Appropriate perioperative procedural measures are fundamental to greater effectiveness in the medical sphere. The routine shaving of the surgical procedure is pertinent in various occasions and prevailing conditions related to surgery.

Outcome Evaluation: Basis for Practice

The conduct of the perioperative procedure traditionally entails the removal of hair from an existent surgical site. The aim directs toward a reduction of surgical site infection risks. There are three main methods of performing, such as the utility of clippers, shaving through the usage of razors and hair-dissolving creams. The background behind the practice in the medical fraternity is based on the belief that it significantly decreases the risks of infection. In addition, it increases overall exposure of the incision site and facilitates wound closure and dressing processes. Strong evidence suggests that creams, particularly depilatory creams, are better for procedure accomplishment.

Moreover, the procedure is supported and justified based on humanitarian reasons. The presence of hair makes a surgeon’s task difficult, on his clear viewpoint of the surgical site’s incision points. When there is need to apply adhesive leads increases, hair removal is requisite to enable better skin binding. With the above ideas in the medical sphere, an ongoing controversy over the demand for procedure conduction exists. Modern researches show a scenario where infection rates are more viewed through the utility of razors. Despite the benefits of infection control procedures, surgical infections remain an essential cause of mortality and morbidity among hospitalized patients. Systemic and procession changes that promote compliance with established standards and guidelines can diminish infectious morbidity. For example, adequate preoperative control of antibiotics effectively prevents infection and reduces mortality and morbidity. Here is a clear vision that the evidence-based procedure requires transformation.

The Rationale Behind the Procedure

The outcome evaluation of such an important procedural measure demanded changes in perception in the modern medical sphere. There is a notion that shaving is a fundamental procedure for the reduction of surgical site infection. The collected data indicates that most surgeons believe the procedure’s benefits in reducing infection rates. In addition, it enables easier access to surgical incision points on the surgical site. It has also been associated with the resultant occurrence of small cuts and abrasions, often providing ideal places for bacterial growth and resultant infestation. While hair removal used to be practiced, shaving the night before surgery before the operation is mentioned as inappropriate. It is preferential to use electric clippers. Hospitals should educate the medical staff and purchasing personnel on the raised infection rates related to preoperative shaving. All the razors should be removed from the surgical prep kits and stock carts. The surgical staff can purchase heavy-duty clippers for hair removal.

Explanation of Practice Procedure

As experience shows, fewer infection rates occur when the latter depilatory creams are used, compared to the other two methods. Moreover, findings indicate that the procedure may be immediately completed before surgery or a day before, with preference. Such an aspect helps to reduce the overall rates of bacterial infection. The potential threats have been affirmed to increase the duration between shaving and surgery. There is a fact that shaving often alters the skin flora’s composition with implications of increased bacterial infestation. Consequently, such high bacterial growth rates lead to higher chances of infection.

Typically, the shaving procedure continues to be used because of its effectiveness in reducing the infection rate: thus, it reduces the incidents of post-operative wounds. Unlike other clinical methods that can be used to reduce infection rates, the shaving procedure has been established as a cost-effective technique for reducing the incidences of infection in a surgical area.

Clinical Implications of Procedure

A modern literature review strongly opposes shaving patients to reduce surgical site infection. According to Griffin, patients with hair had a 90% lower rate of surgical area infection than patients whose hair had been shaved. Recent studies have shown that shaving increases the risk of surgical site infection. Notably, it has long been associated with small cuts and abrasions, often providing ideal places for bacterial growth and resultant infestation. According to Alexander et al., shaving should not be used to reduce infection rates in a surgical area. However, the procedure can only be used when it is unavoidable.

Even though there is much opposition to the practice of using razors to shave patients, there are several hospitals that still practice this procedure. In this regard, educating the hospital staff on the clinical implications of shaving patients is important. They need to be educated on the importance of not shaving and advised to use clippers to remove hair if necessary.

In modern surgery, the period of hospitalization after and before the surgery is diminishing rapidly. According to Gilmour, most patients are admitted less than twenty-four hours before surgery. Therefore, it is important to consider all these aspects in order to effectively reduce the infection rates in a surgical area.

Procedural Changes Requisite in the Medical Fraternity

The dynamic reviews propose strong evidential foundations for enhanced clinical decision-making capabilities of nursing workers in various situations. However, the implementation of such an evidence-based practice could be improved. There is a need for institutional changes in individual and group autonomy related to nursing workers. Despite the clinical implications, it is still possible to have a cost-effective and efficient procedure for removing hair to reduce the infection rate of the surgical site area. In this case, the nurses must use clippers to remove hair. Besides, they need to be trained on the proper use of the clippers in order not to damage the skin.

Furthermore, razors should be discouraged and completely removed from hospitals. This challenge will mainly lay with the purchasing department to ensure that there will be no supply of razors to the hospital. It is possible to have a cost-effective and efficient procedure.

Stakeholders’ Involvement towards Overall Transformation

The cooperation between the major stakeholders is crucial for improved transformational processes, including policymakers, clinicians, nurses, and surgeons. The implementation of specific processes may be possible. There is a need for the involvement and efforts of key stakeholders toward obtaining requisite staff compliance. Furthermore, the stakeholders will play a key part in the decision-making process of changing the shaving procedure. For example, the purchasing department should ensure the hospital purchases no new razors.

Translation of Research: Difficulties Encountered

The existing economic conditions significantly influence the enactment of research findings in a practical setting. This evidence-based practice shows that constant knowledge renewal is required. The procedural dynamics exist with better procedural options discovered and promoted.

There are certain difficulties in implementing research findings in a practical setting. The main difficulty is financial constraints since the process will require substantial funds to educate the nurses and purchase new medical equipment. This may call for cost-saving measures that affect the overall utility of evidence-based practice.

Barriers to Institutional Change

Barriers exist to the enhanced transformation of existing practices, such as the perioperative shaving process. Such an aspect may be related to existent resistance towards transformational changes, the inability to critical appraisal of research findings, the lack of time for staff education, poor support from administration, data unavailability, workload pressures, competing professional priorities as well as limited timeframes which are crucial aspects to enhance the utility of evidence-based practice.

Strategies to Counter Barriers

Strategies are essential for overcoming such barriers and enhancing overall work safety and patient health. A key strategy would be to educate medical professionals and nurses on the importance of not shaving. Another strategy would be to remove razors from the precincts of the hospitals through a ‘razor-roundup’ exercise and encourage clippers to remove hair from the skin. Lastly, patients must be enlightened on the significance of not shaving near the surgical area.

Application of Findings

The American Department of Health and Social Security issued the Bridge Report with evidence-based nursing recommendations. It served as a basis for the first model of research utilization with the nursing profession towards incorporating the pertinent aspect of evidence-based practice. ANNA Research Committee investigated various nursing organizations in 2004. The Committee mentioned that evidence-based practice remains a challenge of concern. It appears to be the resultant struggle of incorporating and guiding organizations towards evidence-based practice.

The findings from recent research studies about the adverse effects of shaving on the surgical area could be implemented by medical practitioners and other stakeholders in the healthcare industry. For example, they should discourage the use of razors to shave patients. Besides, they should advocate for using clippers to remove hair to reduce the infection rate in the surgical area.

Through the implementation of the research findings, the risk of infections, among other complications, will be greatly diminished and lead to better healthcare and patient recovery. Significant elements for the success of this institutional change involve a clear vision and well-defined norms and skills regarding the process of organizational change.

In conclusion, a valuable aspect is an increasing awareness of the need for shifting decisions and activity through the transformational utility of evidence-based practice related to clinical care. It is connected with considering the best evidence and learning processes related to the feasibility of evidence-based practice initiatives.

📎 References:

1. Alexander, J. W., Fischer, J. E., Boyajian, M., Palmquist, J., & Morris, M. J. (January 01, 1983). The influence of hair-removal methods on wound infections. Archives of Surgery (chicago, Ill.: 1960), 118(3), 347-52.
2. Garber, J. S., Gross, M., & Slonim, A. D. (2010). Avoiding common nursing errors. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
3. Gilmour, D. (2012). Perioperative care. Manual of Perioperative: An Essential Guide.
4. Griffin, F. A. (November 01, 2005). Best-practice protocols: Preventing surgical site infection. Nursing Management (springhouse), 36 (11), 20-26.
5. Hamlin, L., Davies, M., & Richardson-Tench, M. (2009). Perioperative nursing: An introductory text. Chatswood, N.S.W: Elsevier Australia.
6. Impact of Surgical Care Complications. (2013). Medscape Education. Retrieved from https://www.medscape.org/viewarticle/531895_2
7. Melnyk, B. M., & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing and Healthcare: A Guide to Best Practice. Philadelphia, PA.: Lippincott Williams & Wilkins.
8. Meyer, G. M. R. N. B. S. N. (October 12, 2005). Recommendation for Surgical Skin Preparation. The Online Journal of Knowledge Synthesis for Nursing, 2 (1)