Sterile field monitored constantly? Define please

  1. 0
    Does anyone have a policy that defines who to monitor constantly a sterile field when a case is delayed? With staffing being so tight how can you balance using staff to monitor a room with the need for them to help in some other duty? Is securing a room with tape an appropriate and acceptable technique that qualifies as monitoring constantly? What are you doing to follow this practice guideline.
    Hannah Rose

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  2. 12 Comments...

  3. 0
    cover the trolley with pieces of sterile towel and
    if u have the authority to seal the doors, it is a good idea.
  4. 0
    Sealing the door with a piece of tape is very common practice, I don't know however how it would stand up in court.
    What I do know is, that covering a trolley, set up or whatever you call it in your hospital, is not recommended practice. Research is showing that it is almost impossible to remove the drapes used, without contaminating your sterile field.

    Marijke
  5. 0
    AORN standards are the recognized authority for periop nursing. They prescribe that someone must be in any room that has been opened for a procedure to ensure that no contamination has occurred. This can be someone who remains sterile or not. Use this standard as a reason to support your request for more help! You will be held liable if an infection occurs and it is proven that you covered a table and/or left a room unsupervised.
  6. 0
    Jeepers, you mean that AORN does not trust it's member to see a room is set up and have the sense not to disturb it? It's not like they have members of the public walking around the OR suite who wouldn't know better.

    If they are concerned about monitering a table before the procedure it stands to reason in my mind that they should have someone watching the table during the procedure as the same people have a greater risk of inadvertently touching a sterile table with nonsterile items when they are working in the room.

    The number of moniters could get ridiculous. Sometimes the patients benefit from putting that $ to better use elsewhere.
  7. 0
    Never cover a sterile set-up!!! It is near impossible, as already mentioned, to remove a drape without contaminating it.
  8. 0
    How can a non-sterile person monitor a sterile room without containmenating it? In my opinion, that person would have to "scrub-in" (I think that is the right word) and be wearing gloves, mask, and the whole works in order to keep the room sterile.

    Nick
  9. 0
    NRW,
    They aren't talking about keeping the room sterile. The entire room isn't sterile. They are talking about the instruments and things of that nature that are sterile. Not everybody in the OR Scrubs-in. Only the person scrubbing for the case, the first assistant if there is one, and the MD. Anesthesia doesn't scrub, and the circulator doesn't scrub.

    Brett
  10. 0
    hmm, why dont they scrub in too? I mean they are working in the OR with patient too. I know they at least have to wash their hands and all. Also, what exactly is involved in "scrubbing-in"?

    Thanks.

    Nick
  11. 0
    nick, as brett explained, the whole room is not sterile. There is a sterile "field" that must be maintained, and cannot be touched by the circulator, anesthesia, or any other person not scrubbed in. Part of the circulator's job is to take care of the needs of their scrub. (sterile person who is asisting the doctor) This includes going into the core (room which contains all the sterile instruments) and retrieving them as needed, and opening them up to the sterile field. The circ only touches the outside of the container, and if she inadvertantly touches anything inside, the item is contaminated.

    Scrubbing in is only done by the persons who will be in physical contact with the open part of the patient. The area around the incision is draped off (with sterile drapes). All non-scrubbed in personel are very careful not to contaminate these areas. The tables with the instuments and supplies that are opened and set up are also sterile, and cannot be touched by anyone who hasn't scubbed in.

    So as you see, there are only certain areas around a patient and the equiptment that are considered sterile. There is no way ( to my knowlege) to completely sterilize an entire room. If there was, it would be unnessecary, as well as unpractical.


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