Going around in circles: is this the best practice for preparing the skin?

Hospital-acquired infections, which include bloodstream infections and surgical site infections, result in high rates of morbidity and mortality in the United States annually. Proper aseptic care of the skin prior to any skin breach is of paramount importance to reduce these outcomes. The application of the most appropriate skin preparation solution is significant but possibly not as important as the technique employed to apply the solution itself. Historically, concentric circles were the method of choice taught to nurses prior to any venipuncture. More recently, the back-and-forth friction method is being promoted. There is no evidence to support either method, yet effective reduction of infections is occurring. It is the intent of this article to address concerns for hospital-acquired infections and offer evidence-based suggestions to improve outcomes, as one method of skin preparation demonstrates greater efficacy.