Maintaining a Sterile Field/OR Suite

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    My situation is a case had been opened but canceled the next scheduled patient was not due to be at the hospital for another 15 to 30 minutes then they would have to be processed through Outpatient Area. So that patient would not be ready for 30 to 45 minutes after they arrived. The staff planned to use the already opened case to save on supplies. The delay between cases was about 1 1/2 to 2 hours. AORN Recommended Practice V on Maitaining a Sterile Field states "A sterile field should be maintained and monitored constantly." It goes on to state "It is important to continuously monitor all sterile areas for possible contamination."
    How does your facility interpret this statement? What do your policies state to address this issue and how do you implement it?
    Thanks for your input!
    Hannah Rose
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    Hannah,

    You are exactly right in your reading of the AORN statement. A sterile field needs to be directly observed since this increases the liklihood that a break in sterility will be detected. So, someone should be in the room at all times. But, I have worked in places where the "unwritten" practice was to put tape on the door.

    But, even if observed,I believe our department policy is a 2-hour window. So, if the patient cannot be in the room within that 2 hours, then we would still break it down. As the standards also state," The potential for contamination increases with time because and other particles,can settle on horizontal services."

    Do you have a department policy regarding this? And, do you have an educator?


    K. Lynn
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    Yes, we have a policy which we are trying to reword to make more clear. Yes, we have an educator and I'm it. I'm new to my position and still learning every day. Thanks, Hannah Rose
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    Hannah,

    As the educator, it sounds as if you are well on the right track. Use the AORN Recommended Practices to help develop your policies. Remember, the Practices are really guidelines for facilities.

    If you do not participate yet on AORN's BB (membertalk) I would suggest signing up for that (it is free) and you will get a wealth of information! There is also another periop BB at www. periop.org/

    You get some info there also.

    Good luck with your new role.

    K. Lynn
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    aorn standards are guides not directives,at least everytime i called them .they felt it was up to the individual hosp. so ,with that in mind .lets be practical when you read this ? ask yourself some questions her. what type of case is it? what,s the condition of the or room?( being renovated or state of the art ) or even ask the dr. what he would prefer ? all points mentioned before are correct . if your decision still leaving concerns ? then ask yourself ,is it good enough if the pt. was yourself ?
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    We will put a sign on the OR suite doors indicating that there is a sterile set-up inside. We have a 2 hour window. This works well for us. No post-op infections etc....from this occasional practice.


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