Quality standard
Quality statement 1: Personal preparation for surgery
Quality statement 1: Personal preparation for surgery
Quality statement
People having surgery are advised not to remove hair from the surgical site and are advised to have (or are helped to have) a shower, bath or bed bath the day before or on the day of surgery.
Rationale
It is not necessary to remove hair routinely to reduce the risk of surgical site infection, and the use of razors for hair removal may increase the risk of infection. If hair needs to be removed, this should be done by healthcare staff using electric clippers with a single-use head on the day of surgery. Preoperative showering is likely to reduce the number of microorganisms on the skin surrounding the incision and may therefore reduce the risk of infection. Preoperative advice (and assistance if needed) on personal preparation for surgery will help to ensure that people having surgery have clean skin without unnecessary micro-abrasions (from shaving), which will reduce the risk of surgical site infection.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Structure
a) Evidence of local arrangements to ensure that people having surgery are advised not to remove hair from the surgical site.
Data source: Local data collection.
b) Evidence of local arrangements to ensure that people having surgery are advised to have (or are helped to have) a shower, bath or bed bath the day before or on the day of surgery.
Data source: Local data collection.
Process
a) Proportion of surgical procedures for which the person having surgery is advised not to remove hair from the surgical site.
Numerator – the number in the denominator for which the person having surgery is advised not to remove hair from the surgical site.
Denominator – the number of surgical procedures.
Data source: Local data collection.
b) Proportion of surgical procedures for which the person having surgery is advised to have (or is helped to have) a shower, bath or bed bath the day before or on the day of surgery.
Numerator – the number in the denominator for which the person having surgery is advised to have (or is helped to have) a shower, bath or bed bath the day before or on the day of surgery.
Denominator – the number of surgical procedures.
Data source: Local data collection.
What the quality statement means for different audiences
Service providers ensure that systems are in place for their staff to understand and act on the need to advise people having surgery not to remove hair from the surgical site and to advise them to have (or help them to have) a shower, bath or bed bath the day before or on the day of surgery.
Healthcare professionals advise people having surgery not to remove hair from the surgical site and advise them to have (or help them to have) a shower, bath or bed bath the day before or on the day of surgery.
Social care practitioners help people to have a shower, bath or bed bath the day before or on the day of surgery.
Commissioners ensure that they commission services from service providers that can demonstrate arrangements to ensure that people having surgery are advised not to remove hair from the surgical site and advised to have (or helped to have) a shower, bath or bed bath the day before or on the day of surgery.
People having an operation are advised not to remove hair from the area of the body where they are having the operation and are advised to have a shower or bath either the day before or on the day of the operation. If they are not able to wash themselves, they should be helped by health or social care staff.
Source guidance
Surgical site infections: prevention and treatment. NICE guideline NG125 (2019, updated 2020), recommendations 1.2.4, 1.2.5 and 1.2.1
Equality and diversity considerations
This quality statement applies to all people preparing for surgery, regardless of their ability to carry out personal preparations themselves. If people need help with washing before surgery or if hair removal is necessary, they should be treated with dignity at all times.
Advice should be both age-appropriate and culturally appropriate. It should also be accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. People having surgery and their carers or parents should have access to an interpreter or advocate if needed.