Does anybody use sterile technique anymore?

Morainey, BSN, RN · Mar 17, 2012

I'm a new grad, the only thing done using sterile gloves and a drape that I have seen thus far has been foley catheter insertion. We also have this whole big procedure for drawing blood from a central line, but I personally have never done it.

MN-Nurse, ASN, RN · Mar 17, 2012

A quick internet literature review is returning, "More research is needed" on this topic. A little browsing in the research databases in definitely in order.

PetsToPeople · Mar 17, 2012

We're taught to use sterile technique if it's a new wound (ex. a fresh stoma, trach, etc.), but to use clean technique for most/old wound dressing changes because it's assumed there's already bacteria residing in the wound by that point.

I am sure you had to take microbiology in order to graduate from a nursing program, so you I would hope you could re-read this and understand what you are saying. Yes, the wound will have microorganisms, but everytime someone touches it without using sterile techique, or even using improper clean technique, they are introducing NEW and DIFFERENT microorganisms that may not be as nice (lol) as the ones they already have, like oh I don't know, MRSA...

I think it is simply a matter of laziness...or a matter of "all the other nurses do it that way", but it could also be that the facility does not like the higher cost associated with using sterile materials. It should be sterile technique everytime, even if it is dripping with pus...you are there to clean and heal the wound over time, not slow the healing time, or make it worse

PetsToPeople · Mar 17, 2012

In reality.. we simply do not have time to use sterile technique , after that.
Clean technique would then apply .

Of course there is time! The only difference between sterile and clean technique is sterile gloves and what you touch and don't touch so there is no time difference, just a matter of technique, and if you use that techniqe all the time, you should be quick and efficient.

PetsToPeople · Mar 17, 2012

In most cases, it's cost prohibitive to use sterile technique, especially on something like a knee or hip incision (we see a lot of ortho) that gets exposed to patient's clothing anyways.

This makes no sense...it the wound/incision has a dressing on it, how does it come into contact with their clothes? And ortho infections are a big deal, not just head and spinal...or even just a skin infection, ask someone with MRSA

PetsToPeople · Mar 17, 2012

Tell me the name of the MAN who said catheterizing a woman could be a sterile technique.

Probably didn't come from a man, but from the WOMAN who got tired of having UTI's

PediLove2147, BSN, RN · Mar 17, 2012

I work on post-surgical floor (mostly neurosurgery) and the doctors like to do their own dressings so we don't touch them.

When it comes to wounds and saturated dressings though. I always though it was a sterile procedure but I saw nurses on my floor using clean technique so I went to the expert, our wound/ostomy nurse. She laughed, said there was absolutely no reason to use sterile technique. She said exactly what Lexirunner said. I don't know but if the WOUND nurse isn't using sterile technique, I don't see why I should.

Cuddleswithpuddles · Mar 17, 2012

A super specific situation:

I used to work in home health. At home, plenty of procedures that are normally thought of as sterile are performed with clean technique. If supplies were available to me, I will always choose to do sterile technique. If not, clean technique. There were some very sad and unfortunate instances wherein a patient only had X amount of urine catheters or suction catheters to last them until the end of the month. I fought tooth and nail to get such patients more but, in the meantime, I reused those suckers until a better solution comes. When it comes to tracheostomy patients or patients who go into autonomic dysreflexia, a grody, reused catheter is better than none.

dirtyhippiegirl, BSN, RN · Mar 17, 2012

I work on a burn unit.

We do a LOT of dressing changes.

"Sterile technique" is just lip service. We start out sterile but - esp. for a one to two hour dressing change - it's just not feasible to STAY sterile.

Also with cuddles (lol) here that I've also done home health (ppd) -- sterile goes out the window, and even in some cases "clean" due to financial constraints that insurance companies simply won't be changing any time soon.

allnurses Guide · Mar 17, 2012

Had surgeon sneer at us for doing "sterile technique" on a wound, saying there wasn't a way to be sterile outside the OR. But I've seen clean gloves fall out and get stuffed back into the box (not from the floor, but when a whole bunch comes out while grabbing gloves). Using sterile gloves, and a sterile field, heck yes!

I caught a tech setting up a suture tray set up using clean gloves instead of the sterile ones in ou protocol; and told her to do it the right way. She said she was told we only do clean now, it didn't make a difference according to the doctor. The doc about blew up when I asked if that had been said; and believe me, "clean" wasn't good enough.

hiddencatRN, BSN, RN · Mar 17, 2012

I was taught to use clean technique for wounds because a wound is not clean. The bacteria on the patient's skin has already had access to the wound, so as long as the HCP uses clean technique, we're ok.

I still use sterile technique for procedures where you could potentially introduce bacteria in to a clean area, such as caths or accessing central lines and ports (but even things like PIVs are done with clean technique- don't use sterile gloves for that, do we?).

I very clearly remember in nursing school, the first bandage change I witnesses, I asked the instructor if we needed to be sterile and she asked me how sterile I thought the patient's skin was.

nurseprnRN, BSN, RN · Mar 17, 2012

we aren't protecting the patient from his own bugs, but from the bugs in the hospital.

the wound nurse is talking about chronically open wounds (those ulcers and gaping wounds that won't heal), because they are already colonized. genuine clean technique is fine for them.