Safety Project of the Month


SALG has not been involved in the production of these projects, and as such, we cannot formally endorse them. However, the group is keen to support local safety projects and hopes that this page will help share ideas and promote discussion. The projects are not formally peer-reviewed. Safety initiatives can have unintended consequences, and those wishing to implement projects should be alert to this possibility.

September 2016


  • Surgical site infections (SSIs) can cause significant morbidity and mortality
  • As well as strict sterility, prophylactic antibiotics and glucose and temperature homeostasis, it seems intuitively obvious that simple infection control measures like ‘washing’ can make a real difference to infection control.
  • In addition, being clean can contribute to the patients feeling of well-being.
  • A project to educate patients and staff on washing before operations aims to make sure we cover the basics as well as the more complicated aspects of prevention of surgical site infections.

Clinical guidelines published by National Institute for Health and Care Excellence (NICE) in 2008 recommend ‘patients to shower or have a bath (or help patients to shower, bath or bed bath) using soap, either the day before, or on the day of, surgery.’

In June 2015, Queenie Lo and colleagues at Barts Health NHS Trust performed a snapshot audit regarding patient washing before surgery, after noting that patients were not reliably clean. A total of 47 questionnaires were completed. They found that 30% of the patients felt that they could have been cleaner in preparation for surgery, and 80% of the patients had not received any guidance on washing pre-operatively and felt that that more information on cleaning would be beneficial.

To respond to this, they produced a patient and staff information leaflet, after liaising with patients and the theatre governance and pre-operative assessment clinic (PAC) teams. The leaflet provides information about pre-operative cleaning to all patients admitted for surgery in a ‘Questions and Answers’ format for easy reading and understanding. These ‘Come Clean for Surgery’ leaflets are being now distributed to all patients scheduled for surgery at Barts Health, and patient cleaning now also features in new perioperative care plan being developed to meet the new National Safety Standards for Invasive Procedures.

For more information, please email Queenie Lo, anaesthetic registrar at Barts Health NHS Trust, using

Further reading

National Institute for Health and Clinical Excellence (NICE). Surgical site infections : prevention and treatment. 2008; NHS England.

National Safety Standards for Invasive Procedures ( NatSSIPs ). 2015;1–65