gowning off the back table

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Scrub nurses and techs at my facility gown and glove on the back table instead of gowning off a gown wrapper that is on an unsterile table. Should I tell my boss to forbid gowning off the back table?

Question: Is it acceptable for the first person to scrub for an orthopedic procedure to gown and glove at the sterile back table?

Answer: The scrub person should don a sterile gown and gloves from a separate sterile field other than the back table for all procedures, including orthopedic procedures.(4) When staff members don attire from the back table, they compromise the safe distance from the sterile field that is needed to maintain its integrity. Gowning and gloving from a separate sterile field prevents inadvertent contamination of the sterile back table. Gowning and gloving from the sterile back table compels the scrub person to enter the sterile field with wet hands to retrieve a sterile towel and gown. Subsequent scrub people can be gowned and gloved by the first scrub person before the start of the procedure.

http://findarticles.com/p/articles/mi_m0FSL/is_/ai_75562163

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Specializes in Operating Room.
No it isn't worth the so-called battle. Like I said, follow your policy. Also, if you are using the waterless prep properly and allow your arms to dry you WILL NOT have any dripping whatsoever. Period.

But, I wasn't talking about the waterless prep. I had mentioned that in my OR, we have to do a water based 5 minute scrub for the first scrub of the day, per policy. Subsequent scrubs can be with the waterless stuff. Also, we have a couple of people who always do the water based scrub(one nurse gets a rash from the waterless stuff) so in these cases, drippage does happen.

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Specializes in 2 years school nurse, 15 in the OR!.

I've seen it done both ways... At my current facility you will get struck down if u gown from the back table. However, I've worked where it's OK to gown from the back table. Please remember AORN is recommended practices...it's guidelines. What protects u are policies, not AORN and yes, I am CNOR.

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I've seen it done both ways... At my current facility you will get struck down if u gown from the back table. However, I've worked where it's OK to gown from the back table. Please remember AORN is recommended practices...it's guidelines. What protects u are policies, not AORN and yes, I am CNOR.

I respect your experience, but let me ask you this......

Do you have a problem with sales reps reaching over the back table to point at instruments?

During a total hip arthroplasty, would you have a problem with the circulator reaching over the back table to grab the acetabulum off the field without the scrub person giving it to her?

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Specializes in 2 years school nurse, 15 in the OR!.

Wow, not sure where I said anything about reps, or reaching across my table. Of course I don't let reps reach over my table... I personally do not like gowning from the back table. What I'm trying to say is to follow policy. I've done a deposition and what they are interested in is policy, not guidelines. That is what protects you...

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Wow, not sure where I said anything about reps, or reaching across my table. Of course I don't let reps reach over my table... I personally do not like gowning from the back table. What I'm trying to say is to follow policy. I've done a deposition and what they are interested in is policy, not guidelines. That is what protects you...

There are lots of nursing habits that are not mentioned in policy. Just because policy doesn't forbid something doesn't mean you should do it.

For example, there is no policy about wiping your own forehead with a sterile towel while scrubbed. That doesn't mean it's okay to do so.

Let me ask you this. If an operating room's policy book does NOT mention whether you should gown on the back table or on a separate table, and everyone at that operating room gowns off the back table, do you then think their practice is acceptable?

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Specializes in 2 years school nurse, 15 in the OR!.

I do not. If you choose to do it, make sure there is a policy to back you up. BTW, is everything in your facility in compliance with the 2008 guidelines??? I believe in the best care for my patients, unfortunately I can't make everything within AORN. If u want it stopped at your facility, help produce a policy! You asked how it was done at other facilities and I told u what I've seen. Personal attacks on nursing care is unwarranted.

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Personal attacks on nursing care is unwarranted.

You're being defensive. I have been civil. Debating technique is not attacking.

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Specializes in 2 years school nurse, 15 in the OR!.

Good luck with your "debate."

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Good luck with your "debate."

That was rude.

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Specializes in CST in general surgery, LDRs, & podiatry.
poor technique is exactly that. if you see nothing wrong with it, that is your choice.

the authors of all the books on the operating room, sterile technique, etc.. have made the articles using accepted principles and practices. nothing says that one has to agree with the facts or proven principles but it would be highly arguable that anything against the grain of proven and accepted technique would place the patient at a greater risk.

in saying that, one also has to pick their battles and is this one worth the fight?

all that being said - thank you ewattsjt - gowning off the back table is considered poor technique, as it requires you to approach, touch and remove an item from a sterile back table before you are gowned and gloved appropriately. (i've seen people attempt to do this before and accidentally drop the gown they just picked up and have it fall back on the table it came from = instant contamination.) basic technique states that sterile people should only touch sterile surfaces, and unsterile people should only touch unsterile surfaces. period. gowning off a special gown table, or off the mayo when setting up the field, is safer and does not expose the sterile back table to potential contamination from an ungowned, ungloved individual. when the scrub is gowning the rest of the team, it doesn't matter where the gowns come from, since the scrub hands the gowns to the team members in a manner used to avoid contamination, and then gloves them off the field.

those who are concerned with "drippage" can do the 5 minute water-based scrub with a brush at the beginning of the shift, before their first case begins, and dry off. then use the foam/alcohol based scrub just before entering the first case. nothing different about doing that than water-based scrubbing for the first case and using foam in subsequent cases.

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