How many really use STERILE technique? - page 2

I am having problems passing my sterile technique in lab. I want to know how often you use sterile technique to change a surgical dressing? I have done dressing changes and NEVER used sterile... Read More

  1. by   Baby Catcher
    I realize that it is a required skill but I just can't seem to get it right!!


    Get a buddy to practice with you and give you some pointers. You'll catch on.
  2. by   Speculating
    Quote from orrnlori
    I agree with everyone. It's vitally important. But wait until you get your first patient with a huge surgical wound, or maybe even one of those nice juicy open wounds and the doctors round at 5:30 am (while you are in another room drawing labs) and take down all the dressings to "look" and then just leave the room and leave the nasty dressings strewn around the bed, in the mean time the patient is poking around in there as well. It drove me nuts when I worked in trauma. Somebody needs to teach physicians septic technique as well. :angryfire

    I'm confused! I think the Drs all ready know septic technique.
  3. by   tonchitoRN
    when i was in school we were tested on sterile technique. it was a do or die test. that means if you broke sterility, even the tiniest bit, you were flunked from the program. you bet your booty i learned how to do it perfectly. it is difficult but with practice it can be done. :stone
  4. by   moia
    Sterile technique should be a habit like how you wash,dry and put away your dishes.
    When you begin a dressing change you have to think logically. Try not to get concerned about all the reasons WHY you are doing it and think of it more as a technical skill,like learning to drive.
    I brought an open kit home with me and used everyone as a patient. Practice is the only way to get good at this and to give you confidence.
    Not every nurse does a dressing change the same way but we all abide by certain rules.
    The most important part of any dressing change is preparation and organization. You need to think out every step of the change and collect every thing you will need for each step. You must organize your bedside with everything you need lined up in the order you will need it.

    Plan the whole thing out in your head and plan it out again when you get your supplies and finally plan it out once more when you organize the bedside.
    By the time you are ready to start you will feel pretty comfortable because you have already done it three times.

    Dirty to dirty..soiled dressing means regular gloves so you don't get dirty.
    Assess the wound..look for colour and drainage and holes in the incision
    Then clean the wound..this can be awkward until you can handle doing things with one hand
    Remember you don't need to use the tweezers and all that crap, you are wearing sterile gloves so you can go ahead and grab anything that is sterile..clean to clean
    Clean from the inside out..so you don't bring any contaminants toward the wound.
    Then dress the wound.
    Don't freak yourself out and make this any bigger than it needs to be. If you get nervous remember dirty to dirty,clean to clean..never break that rule and you will be fine.
  5. by   oldgray08090
    Nearly all of your respondents so far have reinforced the importance of using sterile technique whe changing dressings. They're all right, of course, but I thought it might be helpful to go a step further. As an old (and I mean OLD) OR tech-now-RN, sterile technique is second nature, but it was a skill that came with some effort. My advice is to practice, practice, practice with a person who has a sharp eye for breaches in technique, so that you have the opportunity to do run-through after run-through (in a lab setting, of course), until you get it right. Stay with it; it is not beyond your reach.
    -Rick

    Quote from kwagner_51
    I am having problems passing my sterile technique in lab. I want to know how often you use sterile technique to change a surgical dressing?

    I have done dressing changes and NEVER used sterile technique!! I understand the importance of using sterile technique in urinary cath.

    I realize that it is a required skill but I just can't seem to get it right!!


    Thanks for your input!!
  6. by   kwagner_51
    Quote from suzanne4
    Sterile technique for dressing changes always!!
    If you haven't been doing them, what has been the technique that you are using?
    We have been using clean technique. I do realize that Sterile technique is very important. I work on a Medical surical floor right now and we use clean techinque ONLY.

    When I worked in OB we, used clean except when we went to the OR, but even then we didn't scrub and I wasn't wearing gloves, just a hat, the booties and a mask.

    When you set up to do sterile technique, do you drape the bedside table, ot do you just place all the supplies , in their containers, on the table and go from there? The second senario is how I am doing, and can't pass] sterile technique.

    Thanks!

    Edited to add: When you have the sterile field laid out, how do you keep from reaching across the field to get your supplies?
    Last edit by kwagner_51 on Mar 31, '04
  7. by   suzanne4
    KWagner51,
    What exactly do you mean by "clean technique" to make sure that we are thinking the same as you. Are you using sterile gloves to apply the new dressing and are you changing gloves after removing the old dressing?
    I think we need to better understand exactly what you are doing to better help you........................

    We are here to help.................................
  8. by   kwagner_51
    Quote from suzanne4
    KWagner51,
    What exactly do you mean by "clean technique" to make sure that we are thinking the same as you. Are you using sterile gloves to apply the new dressing and are you changing gloves after removing the old dressing?
    I think we need to better understand exactly what you are doing to better help you........................

    We are here to help.................................
    No we don't use sterile gloves we use clean gloves. To protect us from the pt. I think though that the pt. is post op day 2 and so the skin is closed.

    I KNOW that sterile techique is extremely important. I must learn this so I can go on. I can not believe that I am having so much trouble with this.

    Thanks!!
  9. by   suzanne4
    Most wounds, if they are closed, do not even require dressings after the first two days IF it is a surgical dressing. However, if the dressing is on because of drainage, then the wound is not closed, therefore sterile technique is required. But what types of dressings are you changing? Surgical wounds or central lines? Also, are you using the clean gloves to remove the dressing, AND put on a new pair of gloves or are you using the same ones?
  10. by   nursepenny
    Remember, you need to use sterile technique when suctioning trachs, also. It is a good idea to practice with someone and have them explain what you are doing right or wrong. This is one skill you will need to utilize frequently.
  11. by   gwenith
    I think Kwanger is getting herself/himself mixed between surgically clean, sterile and aseptic techniques. Like everyone I beleive that sterile technique is an absolute must to master but sometimes the problem is as simple as this primary confusion.
  12. by   kwagner_51
    The only thing I have done that requires sterile technique is a urinary cath. and that was in the lab on a dummy. The only thing I did wrong was putting the gloves on wrong.

    This time, I put clean gloves on to change the dressing, kept them on to wash the surgical wound, and put on the betadine. I took them off and put on the sterile gloves BEFORE opening the packages.

    Ok now some questions please? :

    1.] When you do sterile technique do you use soap and water to clean the surgical wound, 1 day Post op?

    2.] When do you apply the betadine?

    3.] How do you keep from reaching across the sterile field?

    4.] Do you drape the bedside table?

    My aim is to do this right so that I can keep my pts. free of infection.

    Thanks!!
  13. by   Lanegirl
    This happened to me at my clinicals last friday..........

    My patient was 104 yo with an infected Stage IV pressure ulcer on her coccyx. I was told to do the irrigation and dressing change. No problem. I start to gather up my sterile dessings and I am looking for sterile gloves when the nurse comes and asks me what I am doing. So I tell her I am looking for sterile gloves to do the dressing change. She say's "oh you don't need those" and also takes the sterile 2x2s from me and hands me a pack or regular 2x2s. Now I am confused. She tells me just to use regular gloves for the dressing change, to include packing the wound and applying new dressing. I was taught sterile technique in class but that all went out the window with this dressing change. I take of the soiled dressing with clean gloves, take off those gloves and don a new pair of clean gloves and do the irrigation and wound packing and apply dry 2x2 dressing. I just get done and Dr. shows up, off comes the dressing. He tells the nurse she needs to pick out some of the dead tissue in there and redress it. So, again, she comes in, using clean gloves, picks out wound, irrigates it, packs it (using the same dirty gloves) and reapplys dressing. I was very surprised to say the least. I felt very awkward as far as saying anything to her. Who am I to question her, I am a lowly student who has only been to 3 clinicals..........but I do feel this was very wrong. If it would have been just myself doing this I would have followed sterile technique.........and maybe I should have just said, No, this is what I was taught.......

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