Hi all... just a few quick questions.... I have seen some questionable practice of late and was just curious as to what happens at your place of work....
At your facility do ALL staff in theatre wear masks?
Also, with ortho cases... do staff have to wear a balaclava?
Are staff other than the scout nurses allowed in and out of theatre throughout an ortho case?
Does anyone have any links to articles that have studied the correlation between the wearing of masks by all staff in the OR versus post op infection and/or other complications?
I have just started working casually at a number of facilities and the norm differs immensly....
May 22, '04
A lot of places where I have worked don't use "total joint protocol" anymore. The hoods hang in a storeroom, gathering dust. We do try to keep excess traffic down, just like in any other case--we are not fanatical about it. The circulator gets a break and lunch just like in any other room. There is no outside circulator these days. If we have laminar flow, we always use it; that is, it's on for any case, not just total joints. Masks, yes we wear as long is surgery is underway or preparing to get underway (with a patient and/or sterile instuments in the room) and when opening sterile instruments--but to go in and out of empty rooms to restock or whatever; no, we don't wear masks.
I think that the recognizance that pre-op antibiotics, delivered within a certain time frame, was far more important than all these "sacred cows" is what led to these changes. About time, I'd say.
I could never, ever support waiting until a patient was in the room to start opening. I was taught that all unnecessary noise be stopped or at least controlled during induction of anesthesia, and particularly during the danger and excitement phases. I always ask my scrub to stop banging instruments around, or to try to be just a bit quieter, when I bring my patient to the room. I also ask the rest of the team to either keep their voices down, or take their loud conversations outside.
Also, the circulator's place during induction is up at the head of the bed, assisting anesthesia. I also don't think it is fair to the scrub or the surgical team to make them rush to open, scrub and set up, then have to count--it makes the whole room feel stressed out.
What if they opened and found that a sterile indicator had not turned, and had to tear down the entire set up and start anew? That would be really unacceptable with a patient already under anesthesia. Better to catch that far in advance of the patient's entry into the room, and act accordingly.
Last edit by stevierae on May 22, '04