Conversion to Chlorhexidine Gluconate for Perioperative Vaginal Preparation: An Evidence-Based Process Improvement Project

Surgical site infections (SSIs) occur during the postoperative period and involve the operative site. To lower the occurrence of SSIs in their patient population, the gynecology SSI prevention committee at a large academic medical institution initiated a process improvement project examining vaginal antiseptic skin prep solutions. Some studies indicate that chlorhexidine gluconate (CHG) is superior to povidone-iodine in the reduction of microbial skin counts and SSIs. After reviewing the available literature, the committee members determined there was an opportunity to make an evidence-based practice change and realize significant cost savings by converting povidone-iodine prepping kits to CHG prepping kits for vaginal procedures. The committee members worked with perioperative and facility leaders to revise the vaginal preparation policy, provide staff member education, and convert to CHG prepping kits. Facility leaders supported this cost-saving conversion for all perioperative units, and the project led to a successful, large-scale, evidence-based process improvement.