Any insight into this question would be appreciated

[001BondRN]

Hello to all; this is to help me gain some insight into a particular question I am reviewing as part of my studies for the NCLEX-RN. Maybe a "real-world" situation vs "by the book".

The gist of the question is that you are setting up a sterile field for dressing change when you immediately get a call to help a patient down the hall who fell.

Do you throw away the sterile field or do you use a sterile cover, leave it, then return to the patient?

Now I could be reading too much into this but we were told that once a sterile field is unattended it's immediately considered unsterile (or does that just apply to the OR). HOWEVER the rationale for covering it with a sterile cover (as deemed correct by this particular book) is because to discard it would be wasteful as it ignores the principles of resource management. My only guess is that because you actually covered it it is "technically" not considered unattended.

Either way I'm stumped, and any insight would be appreciated if anyone has an idea; not just for the NCLEX but because this could very well happen in the hospital.

[BloomNurseRN, ASN, BSN, RN]

I would love to know the actual answer but I would go with throwing it away if there's no other option of delegating the other work. We were taught explicitly that an unattended field is an unsterile field. The cover is a good intentioned idea and I can see that being appropriate in the OR but if it's a dressing change at the bedside there is no guarantee the patient or a visitor wouldn't get nosy and try to touch something. Those are my thoughts on the matter.

[jfb5143]

I don't think that that will be an answer on the actually NCLEX but just in case I would still go with the unsterile if left unattended rule

[bear14]

We had a true false question like that on a quiz when I was in med/surg 1 and I put false for the cover and got it wrong. Supposedly you can use one. I remember the nurse setting up the sterile field when I was in labor and putting a plastic cover over it and leaving the room. There should be something about that in your skills book.

[RLtinker, LPN]

you are not supposed to turn your back on a sterile field, so leaving it alone seems to be a no,no, covered or not. This seems like one of thought places were nclex world doesn't equal real world. but I maybe wrong.

sorry sent from my phone

[nurseprnRN, BSN, RN]

You could never be sure that someone hadn't come along and lifted up your cover to see what is in there, or spilled something wet on it that is dry by the time you return.

This is a patient safety question, patient safety being numbah one in NCLEX-land. Your only way to be sure the patient is safe when you go to use a sterile set-up is that you can personally vouch for its sterility.

In a controlled setting like the OR, there are people all around who recognize a covered sterile field, work with them all the time, and probably have protocols for what you do in a case like this to keep it sterile.

Anywhere else, not so much. You could never be sure that someone hadn't come along and lifted up your cover to see what is in there, or spilled something wet on it that is dry by the time you return. The housekeeping lady could brush up against it, the patient's junkie son-in-law could peek to see if there were anything worth stealing in there, or whatever, and you would never know.

Alas, if they question stem doesn't specifically say all of that (and it won't), you have nothing. Discard and come back and do it again later is the only possible answer.

[001BondRN]

Thanks to all that replied- thank God for the fundamentals