[Hypnopompic]

I aplogize, if this dosent turn out right--I have not used a bulletin board before.... Anyhow, I would like to pose a question for a inquiry paper I am writing. Does anyone have any backgroud on post op washes, other than they are hospital policy? And/or where I could find literature around this topic.

[sunnygirl272]

your post turned out ok..but what do you mean by post-op washes?

[Hypnopompic]

Thanks for the reply. What I mean is that when the patients get on to the floor after surgery they always get a bed bath (post operative wash). I was wondering why this is, is it because of policy, hygiene, ect.--I had a situation where a RN almost forced a patient to let her wash him because that it is called a post op wash and that is just what they do. I just want to know the rational behind washing this guy's groin when he had knee surgery. What is the history/rational behind post op washes, and it is out of date? ty

[shannonRN]

i haven't heard of this practice. at least they don't do it at my hospital. then again i have only worked med-surg for 1 1/2 years. it might have been a common post op procedure before my time. sorry that i couldn't be of much help. good luck with researching the topic. let us know what you find out!!

[meownsmile]

I have never heard or seen someone require a post-op wash. I can see that sometimes there is pre-op wash left in the area of the incision and it may need to be cleaned to watch for hemotoma or something, but just to give a bath because they came back from surgery i dont understand.

It could be that this person didnt get a full pre-op bath if it was an emergency surgery and there was something said when the patient returned to the floor about them having some overly offensive BO or crusting that needed cleaned up.

[aus nurse]

Post-op washes are common practice here, at least in the hospitals I have worked in. It is aimed at bed bound patients rather than ones able to mobilise. They can get to the bathroom and shower or wash as preferred. Here we use Betadine (iodine)
in OR as a skin antibacterial (or antimicrobial, whatever it is!) and it can cover a wide area around the operative site. It becomes quite sticky and uncomfortable. So as far as I have always believed it is for the patient's comfort that we do these washes not for any infection control purpose. Sorry I can't provide you with any policies or anything to back this up...it is just accepted as common practice where I have worked. If any of my patient's refused a post-op I would never insist. It is their decision.
Hope this helped

[Hypnopompic]

Thank you very much for your input. It is common practice he as well, I was just trying to research the history behind it (it's purpose). I think we do it here for patient comfort as well but if it is uncomfortable for the patient then why do??? I just think sometimes we do things just because we always have and I feel it is thinks like this that waste nurse's valuable time and if we can cut some of the unnecessary stuff out then time would be less of an issue. Thanks again for a different perspective.

[LydiaGreen]

I am a nursing student who will graduate in May. I have done the vast majority of my clinical placements in Med/Surg. We perform post-op washes WITHOUT EXCEPTION. The betadine solution and other antiseptic washes used prior to surgery to ensure sterile field for surgery can BURN the skin. The longer they are left on, the more they can burn. When the post-op wash is done (preferably while the surgical client is still feeling the effects of general anesthesia, epidural, or pain meds) you must perform an assessment not just of the surgical wounds, etc, but of the skin. We have standardized forms to report ANY reaction to the antiseptic solutions. These are tracked - if a certain percentage of burns occur, then the solution used may be changed.

If the client doesn't feel like a post-op wash, we do client teaching about the possible effects of the betadine, that the risk of these possible effects increases directly in proportion to the amount of time that passes. That makes them WANT the post-op wash.

A little advice? The antiseptic solution pools under the body. Even if the surgery was performed on the abdomen, there will be a pool of betadine under their back. One patient had a really strong reaction - wasn't my patient, I was assisting an RN - resulted in second degree chemical burns. NOT NICE. The post-op wash is important and should be done ASAP.

[jnette]

Interesting ! Must say, I have never heard of this before...ever.

Thanks for the input... will have to ask around now, and see what our perspective is on this topic !

[Sarah, RNBScN]

In the OR, the scrub nurse attempts to wash the patient as thoroughly as possible prior to applying a sterile drsg. since the patients wake up rather quickly and we like to transfer them while they are still sleepy.

On the floor, when a patient returns from the OR a post op bath is usually performed once the patient is sedated. This allows the nurse to assess the pt, and drsg. while the bath is being done. It is true from "Lydia Green" post that the betadine solution is very irritating to the skin and must be washed off as soon as possible.

Most post bath that I have done, pt. seem more settled and relaxed with sedation of course.

Hope this helps.

Sarah