17 Surgical Skin Preparation and Draping
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 17.1: The Surgical Preparation Process
- 1. Review the standards of practice for surgical prep and draping
- 2. Review the guidelines for patient hygiene before surgery
- 3. Discuss the guidelines for hair removal and skin marking in the surgical prep
- 4. List the FDA’s approved antiseptics for the surgical prep
Lesson 17.2: Guidelines of Skin Preparation
- 5. List the supplies needed for skin prep
- 6. Demonstrate the different procedures for skin prep
- 7. Discuss the elements of patient safety in regard to skin prep
- 8. Demonstrate skin prep on the standard prep sites
Lesson 17.3: Surgical Draping
- 9. Discuss the rationale and techniques for surgical draping
- 10. Discuss how to maintain asepsis during draping
- 11. Demonstrate draping techniques of the surgical site
- 12. Discuss how to remove drapes at the end of a procedure
1.
Classroom Preparation
Lesson 17.1: The Surgical Preparation Process
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Review the standards of practice for surgical prep and draping
- 2. Review the guidelines for patient hygiene before surgery
- 3. Discuss the guidelines for hair removal and skin marking in the surgical prep
- 4. List the FDA’s approved antiseptics for the surgical prep
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 17.1: The Surgical Preparation Process
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction • Principles of the Surgical Skin Prep • Skin Prep Safety Extreme Risk of Fire Using Alcohol Prepping Agents ANSWER – Textbook • Review Question 4 ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Purpose of the Surgical Skin Prep ANSWER – Textbook • Review Question 5 ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 3 | READ – Chapter Heading(s) • Hair Removal • Preoperative Skin Marking • Urinary Catheterization • Supplies • Procedure for Catheterization Patient Safety ANSWER – Textbook • Review Questions 1, 2, 3 ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Preoperative Prepping Agents 70% Alcohol Chlorhexidine Gluconate Iodophor ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 17.1: The Surgical Preparation Process
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | STANDARDS OF PRACTICE: SLIDES 4-5 | • Introduction • Principles of the Surgical Skin Prep • Skin Prep Safety Extreme Risk of Fire Using Alcohol Prepping Agents |
| 2 | PATIENT HYGIENE: SLIDES 6-7 | • Purpose of the Surgical Skin Prep |
| 3 | HAIR REMOVAL, SKIN MARKING, URINARY CATHETERIZATION: SLIDES 8-11 | • Hair Removal • Preoperative Skin Marking • Urinary Catheterization • Supplies • Procedure for Catheterization Patient Safety |
| 4 | ANTISEPTICS: SLIDE 12 | • Preoperative Prepping Agents 70% Alcohol Chlorhexidine Gluconate Iodophor |
Learning Activities (choose one or more to equal 50 min)
| 1 | DISCUSS (20 min) • Discuss the principles of skin prep, focusing on safety of the patient. Appropriate Settings: Traditional/online/flipped classroom |
| 2 | DISCUSS (30 min) • Discuss as a class the guidelines for patient hygiene before surgery. What supplies might the hospitalized patient need to be provided before the procedure? • Appropriate Settings: Traditional classroom |
| 3 | DISCUSS (30 min) • Divide the students into two groups, males and females, and have them discuss the process and safety guidelines for urinary catheterization of each sex. They can share their thoughts with the class. • Discuss why body hair management is an important part of surgical prep and review the steps for appropriate body hair management before surgery. Appropriate Settings: Traditional/online/flipped classroom DEMONSTRATE (50 min) • Demonstrate to the class the proper technique for hair removal and marking the skin in the surgical prep. Appropriate Settings: Traditional classroom INVITE (50 min) • Invite a guest speaker familiar with the urinary catheterization process. Have him or her show students the contents of a catheterization kit and describe how each piece is used. Appropriate Settings: Traditional/online/flipped classroom |
| 4 | ANALYZE (30 min) • Analyze as a class the FDA-approved antiseptics for surgical prep. Assign a scenario to the students and have the class critically think through the scenario. Appropriate Settings: Traditional/online/flipped classroom ROLE PLAY (50 min) • Divide the class into four groups. Assign each group one of the surgical skin preparation solutions (one group can take both triclosan and parachlorometaxylenol). Have each group discuss the following characteristics of their assigned preparation solution. While the groups are discussing, draw a chart on the board with the solutions down the side and the characteristics across the top. Fill in the chart with answers provided by each group. Give the students an opportunity to copy the completed chart if they wish. Characteristics to discuss include: • Organisms and situations in which this solution is highly effective • Organisms and situations in which this solution is less effective • Residual activity (yes or no) • Safety around eyes and mucous membranes • Other safety concerns • Flammability (low or high) Appropriate Settings: Traditional classroom |
Critical Thinking Question
If the person performing urinary catheterization has sterile gloves on both hands, why must one hand be nonsterile?
Discussion Guidelines: Explain that sterile gloves are needed on both hands in the beginning in order to prepare the sterile supplies needed for catheterization. After this preparation, one hand will need to be placed onto the male or female genitalia to keep the urethra visible, while the other hand remains sterile and is used to insert the catheter in a sterile fashion.
Classroom Preparation
Lesson 17.2: Guidelines of Skin Preparation
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 5. List the supplies needed for skin prep
- 6. Demonstrate the different procedures for skin prep
- 7. Discuss the elements of patient safety in regard to skin prep
- 8. Demonstrate skin prep on the standard prep sites
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 17.2: Guidelines of Skin Preparation
STUDENT PREPARATION (1 hr)
| 5 | READ – Chapter Heading(s) • Basic Skin Prep Supplies Preparation ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 6 | READ – Chapter Heading(s) • General Procedure for the Prep Single-Stage Prep ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 7 | READ – Chapter Heading(s) • Eye Supplies Technique • Ear Supplies Technique • Face Supplies Technique • Neck Technique • Breast Technique • Shoulder Technique • Arm Technique • Hand Supplies Technique • Abdomen Technique • Flank and Back Technique • Vulva, Perineum, and Vagina Technique • Male Genitalia Supplies Technique • Perianal Area Technique • Leg and Foot Technique • Trauma and Debridement Procedure • Autograft • Cardiovascular Prep ANSWER – Textbook • Case Study 1 ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 8 | READ – Chapter Heading(s) • Eye Supplies Technique • Ear Supplies Technique • Face Supplies Technique • Neck Technique • Breast Technique • Shoulder Technique • Arm Technique • Hand Supplies Technique • Abdomen Technique • Flank and Back Technique • Vulva, Perineum, and Vagina Technique • Male Genitalia Supplies Technique • Perianal Area Technique • Leg and Foot Technique • Trauma and Debridement Procedure • Autograft • Cardiovascular Prep ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 17.2: Guidelines of Skin Preparation
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 5 | SKIN PREP SUPPLIES: SLIDE 14 | • Basic Skin Prep Supplies Preparation |
| 6 | PROCEDURES: SLIDE 15 | • General Procedure for the Prep Single-Stage Prep |
| 7 | PATIENT SAFETY: SLIDES 16-17 | • Eye Supplies Technique • Ear Supplies Technique • Face Supplies Technique • Neck Technique • Breast Technique • Shoulder Technique • Arm Technique • Hand Supplies Technique • Abdomen Technique • Flank and Back Technique • Vulva, Perineum, and Vagina Technique • Male Genitalia Supplies Technique • Perianal Area Technique • Leg and Foot Technique • Trauma and Debridement Procedure • Autograft • Cardiovascular Prep |
| 8 | STANDARD PREP SITES: SLIDES 16-17 | • Eye Supplies Technique • Ear Supplies Technique • Face Supplies Technique • Neck Technique • Breast Technique • Shoulder Technique • Arm Technique • Hand Supplies Technique • Abdomen Technique • Flank and Back Technique • Vulva, Perineum, and Vagina Technique • Male Genitalia Supplies Technique • Perianal Area Technique • Leg and Foot Technique • Trauma and Debridement Procedure • Autograft • Cardiovascular Prep |
Learning Activities (choose one or more to equal 50 min)
| 5 | DISCUSS (30 min) • Discuss the materials needed for skin prep and the role each material plays in the process. Appropriate Settings: Traditional/online/flipped classroom |
| 6 | ROLE PLAY (50 min) • Ask two student volunteers to come to the front of the class; have one student play the “surgical technologist” and the other play the “circulator,” who has been using an improper technique. After a few minutes of dialog between the actors, discuss with the class how well the “surgical technologist” handled the situation. Discuss the ways in which a surgical technologist can approach a colleague firmly but professionally in such situations. • Appropriate Settings: Traditional classroom |
| 7 | DISCUSS (30 min) • Discuss the elements of patient safety in regard to skin prep with the students. Appropriate Settings: Traditional/online/flipped classroom |
| 8 | PRACTICE (50 min) • Have student practice skin prep on standard surgical sites. Have peers review students’ technique. • Appropriate Settings: Traditional classroom |
Critical Thinking Question
You are working on skin preparation for a patient and before you know it, you’ve run out of prep sponges. You see some surgical sponges nearby. Can you use those to finish the prep? Why or why not?
Discussion Guidelines: Students might discuss the difference between prep sponges and surgical sponges. Surgical sponges are treated with a radiopaque material to enable their detection by x-ray, if necessary. Surgical sponges are part of the sponge count, so one that is missing will be assumed to have been lost during surgery, causing unnecessary (and possibly dangerous) delay and concern.
Classroom Preparation
Lesson 17.3: Surgical Draping
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 9. Discuss the rationale and techniques for surgical draping
- 10. Discuss how to maintain asepsis during draping
- 11. Demonstrate draping techniques of the surgical site
- 12. Discuss how to remove drapes at the end of a procedure
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 17.3: Surgical Draping
STUDENT PREPARATION (1 hr)
| 9 | READ – Chapter Heading(s) • Principles • Learning to Drape • Draping Fabrics and Materials • Types of Drapes Surgical Towels Plain Sheet Fenestrated Drape Split and U-drape Incise Drape Laparotomy Drape Fluid Pouch Perineal Drape and Leggings Rolled Stockinet Shoulder Drape Thyroid Drape ENT Drape Eye or Ear Drape Craniotomy Drape • Techniques Used in Draping ANSWER – Textbook • Review Questions 6, 7 ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 10 | READ – Chapter Heading(s) • Techniques Used in Draping Guidelines for Handling Drapes ANSWER – Textbook • Review Questions 8, 9 ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 11 | READ – Chapter Heading(s) • Abdomen Drapes Required Technique • Lithotomy (Perineal) Draping Drapes Required Technique • Leg/Hip Drapes Required Technique • Knee • Hand Drapes Required Technique • Shoulder Drapes Required Technique • Face Drapes Required Technique • Eye Drapes Required Technique • Craniotomy Drapes Required Technique • Draping Equipment ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 12 | READ – Chapter Heading(s) • Removing Drapes ANSWER – Workbook • Chapter 17 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 17.3: Surgical Draping
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 9 | DRAPING TECHNIQUES: SLIDES 19-21 | • Principles • Learning to Drape • Draping Fabrics and Materials • Types of Drapes Surgical Towels Plain Sheet Fenestrated Drape Split and U-drape Incise Drape Laparotomy Drape Fluid Pouch Perineal Drape and Leggings Rolled Stockinet Shoulder Drape Thyroid Drape ENT Drape Eye or Ear Drape Craniotomy Drape • Techniques Used in Draping |
| 10 | ASEPSIS: SLIDES 22-23 | • Techniques Used in Draping Guidelines for Handling Drapes |
| 11 | DRAPING THE SURGICAL SITE: SLIDES 24-25 | • Abdomen Drapes Required Technique • Lithotomy (Perineal) Draping Drapes Required Technique • Leg/Hip Drapes Required Technique • Knee • Hand Drapes Required Technique • Shoulder Drapes Required Technique • Face Drapes Required Technique • Eye Drapes Required Technique • Craniotomy Drapes Required Technique • Draping Equipment |
| 12 | DRAPE REMOVAL: SLIDE 26 | • Removing Drapes |
Learning Activities (choose one or more to equal 50 min)
| 9 | DISCUSS (30 min) • Discuss the different types of drapes. What are special considerations with each type? Appropriate Settings: Traditional/online/flipped classroom |
| 10 | DISCUSS (30 min) • Discuss the different situations in which contamination can happen in the perioperative period. Have students suggest methods of maintaining asepsis in each situation. • Appropriate Settings: Traditional/online/flipped classroom |
| 11 | DEMONSTRATE (50 min) • Have students volunteer to demonstrate proper draping technique for each standard surgical site. Peers should evaluate technique and offer constructive criticism. Appropriate Settings: Traditional classroom DISCUSS (30 min) • Discuss with the class the rationale and techniques for draping. • Appropriate Settings: Traditional/online/flipped classroom |
| 12 | DISCUSS (30 min) • Discuss as a class the process of removing drapes after surgery. • Appropriate Settings: Traditional/online/flipped classroom |
Critical Thinking Question
During surgery, you notice that one of the drapes on the patient has become soaked through with blood. The patient was thoroughly prepped before placement of the drape, and the bleeding itself has been controlled by the surgeon. What, if anything, should be done about the drape at this point?
Discussion Guidelines: Students might discuss the fact that the patient’s body, though prepped, is not sterile, so a soaked drape represents strikethrough contamination. Another drape should be placed over the area to reestablish a sterile field.
Assessments
Chapter 17: Surgical Skin Preparation and Draping
ASSESSMENTS BY OBJECTIVE
| 1-12 | Workbook • Chapter 17 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 17 – Graded quizzes (Mastery Levels 1, 2, and 3) |
