skin prep for c-section

[newgrad2005]

I did a search for this question, but didn't come up with anything. Here's my situation: I am a new L&D nurse and I have spent three days (with three different preceptors) in the OR circlulating c-sections. Each of them did the skin prep differently. We use gel prep and sterile sponges. Some go over the incision site several times and then up the belly, some go over the site only once and then go up and around and down the leg with one sponge before turning it over. When the sponge is turned over, doesn't this contaminate when the used side touches the sterile glove? I am all confused and I have had three different doctors tell me that I broke technique while doing my prep. Now I am nervous to have to do it again. What is the right way???

[webbiedebbie]

When I learned in the 80's, we used a kit that had sponges dipped in betadine scrub that were divided in the middle so you basically had a "handle" and we started at the incision line and worked our way up to the umbilicus. Then we tossed those sponges and got a fresh one and did the perineum and down. Then we used sponges on sticks dipped in betadine and did the same thing. Then we draped a paper over top of what we had done and patted and lifted it starting at the side opposite of us and pulled it toward us.

When I moved to Ohio, the nurses were horrified at the way I was doing my scrub and prep. They told me the "right way" was to start in the middle of the abd and make circles, gradually getting bigger and working your way around to the sides of the body and closer to the perineum.

I guess every place is different. "Is there a right way?" The gel is new to me, but then again, I no longer work L&D.

I responded to this thread because of the way I felt when I was treated like I didn't know what I was doing.

[JenTheRN]

We use alcohol on all our c/s. Then we apply a sticky drape impregnanted with betadine right on the belly. The way that we prep is starting at the incision, working in a big circle, and never going over the same area twice with one sponge.

[Marie_LPN, RN, LPN, RN]

When the sponge is turned over, doesn't this contaminate when the used side touches the sterile glove?

I would certainly think so.

[Marie_LPN, RN, LPN, RN]

And we use the scrub prep kits, that comes with packs of the handle sponges, and packs of betadine sponge sticks

[gypsyatheart]

I have seen many different kits, and many different techniques, but I still maintain, go from incision site out and do not go back over an area...then you will have contaminated it. It doesn't matter if you do circles, side to side, from the belly button out, etc. Just don't repeat the motion back over the clean area.

I would go to the Clinical Nurse Educator or your primary preceptor and tell them you need clarification on the way this institution does their preps.

[JaneyW]

You are not alone!!! We use the gel and it comes in a bottle with a sponge attached. We don't even use sterile gloves as we aren't coming into contact with the part of the applicator that touches the patient. I can't even count the ways I have been shown to prep. I cringe when people go back and forth over the incision site and they yell at me for not doing it! All I can say is get a method that is within sterile and safe technique and stick with it. Just because a nurse with 20 years of experience tells you it is the right way because she has always done it that way doesn't make it OK. It sounds like you have a good head on your shoulders. I have done this for 3 years and still run into the same issues.

[midwife2b]

We use DuraPrep... one swipe across the incision site, then up the abdomen to the ribs, then the lower part of the pelvic area. The scrub nurse will make us redo it if it isn't properly done!

Used to do the "scrub and paint" procedure but it was a lot more time consuming... some of the "older" OR nurses HATE the duraprep but it really is simple...