Sterile Field anxiety!!!

[Carolanne]

This site is soooo helpful -- I'm new here, but already am feeling less anxious about returning to clinical and performing tasks. Thanks, JANLEB, for your advice on auto BP cuffs -- great suggestions, I'll keep in mind next time.

Anyway, I have big time sterile field anxiety. I'm really phobic about it, sounds silly probably. Goes back to a clinical experience I had when it was only my second time setting one up at a pt bedside and this instructor thought I was being way too pokey and slow and thought I should have been much more proficient at it. I've practiced in the school lab, even at home setting up a make shift one. I just keep flashing back to that episode I had with that particular clinical and always get so anxious when I have to do a dressing change, an irrigation, etc.

Just wanted to know if you have any tips for setting up sterile fields to help me get over this mental block I have. I know with time and experience it will come more naturally, but now being a student I feel all eyes are on me and it doesn't help!!

[janleb]

The main thing is to think ahead. Get all of your supplies together. Lets say a wet to dry dsg change. Usually the kardex will have what you need. If not look on the previous days bed side chart and see what was used. Get another set of hands to roll the pt if needed. You can use clean gloves to remove the old dsg. Lets say we have a decubitus on the medial aspect of the R buttock mesure the wound and approx the depth. I will have my saline soaked gauze already in the container soaking (sterile) and a couple 4x4 dry and abd pad and tape and my sterile gloves. So after removing the old dsg. with clean gloves and after I washed my hands I will put on my sterile gloves. (practice just putting on the gloves, over and over). Make sure your sterile field is in front of you. You can't reach across your sterile field. When packing a wound I use one of the large size Qtips as I unwind the packing I am using the qtip to pack it in. I gaged how much packing I am using with the previous day and in report I tell the oncoming nurse how much I used. With my sterile hand I put a sterile 4x4 over the packing and apply my abd pad and tape it.

Also really look at the wound before packing it. Is there any necrotic tissue in there. Is there any pink red granulation tissue. Is there any purulent drainage, Is there a bad odor. Is there any signs of infection?? Also look is the pt running a temp? What about WBC count?? Blood cultures are there any done if so what is the outcome??

With practice it gets easier. Go through it mentally as well as doing it. I hope this helps

[renerian, BSN, RN]

Just remember to gather supplies, like above, don't cross your sterile field, if you think you contaminated it, toss it.

renerian