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Understanding Differing Viewpoints on Preadmission Bathing and Cleansing: Soap vs CHG
AMBER WOOD, MSN, RN, CNOR, CIC; RAMONA CONNER, MSN, RN, CNOR; LISA SPRUCE, DNP, RN, CNS-CP, ACNS, ACNP, ANP, CNOR
The AORN evidence-based guidelines dene and advance the practice of safe perioperative nursing. AORN facilitates and encourages dialogue on practice guidelines among the perioperative community, within its online community of ORNurseLinkTM, through peer review for the AORN Journal, during the public comment period for draft AORN guidelines, and in continued discussion after publication. Promoting such dialogue strengthens the examination of issues that are important to perioperative practitioners and can inform the direction of future research and studies. These communication efforts are part of what make AORN the indispensable resource for perioperative practice.
In this issue of the Journal is an opinion article by Edmiston et al, To bathe or not to bathe with chlorhexidine gluconate: is it time to take a stand for preadmission bathing and cleansing?1 The opinion of Edmiston et al is that bathing with soap is not equivalent to bathing with the antiseptic product chlorhexidine gluconate (CHG). However, the evidence-based practice recommendation in the AORN Guideline for preoperative patient skin antisepsis2 is that either soap or an antiseptic can be used for preadmission bathing. We appreciate the opportunity to address the opinions of Edmiston et al by explaining how evidence reviews are conducted for AORN guidelines and discussing the differing viewpoints.
GUIDELINE EVIDENCE REVIEWS
AORN guidelines are based on a systematic review of the research and non-research evidence and an assessment of
benets and harms. Each guideline consists of practice recommendations based on the highest level of evidence available. Each reference is assessed for its individual level of strength and quality, and a rating is applied to the collective body of evidence supporting each recommendation. A detailed description of this evidence appraisal and rating model are presented in Table 3 of the introduction of 2015 edition of the AORN Guidelines for Perioperative Practice.3(p4) The systematic
literature search for the Guideline for preoperative patient skin antisepsis was conducted by a medical librarian and included peer-reviewed publications from January 2006 to December 2013, search alerts until February 2014, and additional requested articles that were discovered during the evidence appraisal process.2
REVIEWING AND INTERPRETING...