Background: Surgical site infections (SSI) constitute a severe threat to surgery patients. The surgical environment must be as free of contaminating microorganisms as possible. Using sterile surgical instruments while performing surgery is an absolute necessity for ensuring quality of care in perioperative settings.

Aim: To compare bacterial contamination of agar plates after 15 h on set surgical instrument tables covered with a single- or double-layer drape.

Methods: An experimental design was used consisting of set instrument tables with six agar plates on each table: four instrument tables were covered with a single-layer drape and four instrument tables were covered with a double-layer drape. This set-up was repeated on nine occasions during the period of data collection, making 76 set instrument tables in total. As a control, one instrument table was uncovered on four of those occasions.

Results: The double-layer drape cover showed a significantly (P = 0.03) lower number of colony forming units (CFU) per agar plate than the single-layer drape covering. As expected, the uncovered instrument tables were highly contaminated.

Discussion: Our results indicate that it is good practice to cover instruments properly with at least a single-layer drape before a surgical procedure. If there is difficulty achieving optimal conditions while setting the instrument tables (e.g. positioning the patient for general anaesthesia), it is a better option to set the instrument tables earlier and cover them with a double-layer drape. These precautions will help protect the patient from harm and unnecessary SSI by lowering microbiological burden, a key factor in developing SSI.

Aim: This study examines how OR nurses experience intraoperative prevention of SSIs. Introduction: Infections related to surgical procedures create both great patient suffering and high costs for society. Therefore, prevention of Surgical Site Infections (SSIs) should be a high priority for all surgical settings. All details of intraoperative care need to be investigated and evaluated to ensure best practices are evidence-based. Methods: This study uses the Reflective Lifeworld Research (RLR) approach, which is grounded in phenomenology. Participants were OR nurses with at least one year of clinical experience. In total, 15 participants from seven hospitals made contact and were included in this interview study. Results: Prevention of SSIs takes both head and hand. It requires long-term, continuous, and systematic work in several parallel processes, both intellectually and organisationally. The hierarchical tradition of the operating room is often ambiguous, shielded by its safe structures but still restricted by traditional patterns. Confident relations and resolute communication within the team generate favorable conditions for preventing SSIs. Conclusions: By setting up mutual platforms and forums for quality development, increasing legitimacy for OR nurses and establishing fixed teams, prevention of SSIs will continue to improve, ensuring the patients' safety during intraoperative care.

The aim of the study was to describe patients' experiences with preoperative skin disinfection carried out in their home before elective hip replacement surgery with the aim of lowering the microbial burden and avoiding surgical site infections. The literature was reviewed for relevant studies. Optimal preparations before surgery depend on patients being able to assimilate preoperative information and instructions. The study was based on 14 interviews with patients who had undergone elective hip replacement surgery. Data were analysed with qualitative manifest content analysis according to Graneheim and Lundman (2004). The main categories of findings were: patients' experience of obstacles and limitations, the importance of supportive surroundings, and personal resources as strength when performing preoperative skin disinfection. The findings of this study agree with earlier studies showing a lack of compliance to preoperative skin disinfection. The findings also suggest reasons for non-compliance. Preoperative skin disinfection involves many important steps that need to be accomplished to ensure the maximum effect on microbial burden on skin surface. These steps can be difficult for some patient groups. Perioperative dialogue is one way to identify patients' individual needs and to help patients participate in the process. The study concludes that patients who carried out skin disinfection at home before surgery have a great responsibility to prepare themselves. The challenge for perioperative nurses who work with preoperative information is to identify and individually guide those patients who need extended support so that all patients with elective hip replacement surgery receive the same quality of care. Further research should focus on how caregivers discover individuals with extended needs and on identifying the kind of support that is effective to achieve optimal conditions for hip replacement surgery.