Is an unmonitored sterile field considered sterile?

[buck70]

I know what the recommended practice (AORN) is. I also know what I was taught in tech school. Most textbooks say to keep the sterile field under constant surveillance. My question: how many of you guys follow this practice to the letter? We are having a debate in my OR. :argue: Like I said, I know what the texts all say, but "what is everybody else doing?" Thanks for replying. I just want to see how many folks are really doing it by the book.

[shodobe]

Always do what you feel comfortable doing. There are always different opinions on how things should be done. I just know that in all of my years there hasn't been an issue with this. Not saying there aren't times where you have this feeling something is wrong. I trust the people I work with explicitly and can be assured that an unmonitored room is the way I left it. Reading your posts shows me the dedication you have and you have to remember that older OR nurses, including me, are sometimes set in their ways. Neither way is really wrong, just different.

[olygurl98502]

In our hospital it has depended who our manager was. One temp manager made us tear it down if we could not have someone sitting in there watching the field. Now that she has gone, we have gone back to posting the red on hold, do not enter signs.

[cdsga]

If the unmonitored sterile is as you said "unmonitored", how can you defend your basic nursing duty by maintaining sterility and aseptic technique, which is the responsibility of a prudent OR nurse?

Sounds like a oxymoron to me.

The answer is NO--no debate on that one.:imbar

[shodobe]

After 30 years of straight OR experience, I can say I have nor anyone I have worked with has had a problem or an issue with this. I consider myself a very prudent OR nurse who doesn't have to justify my actions to anyone but myself. I feel extremey confident in the ways I do things and as I have said before, there are too many people out there that are just to darn anal. Come on people, get a grip! Everywhere I have worked this is an exceptable practice and it's never been up for debate because it isn't written in stone. Some posters that have just a few years experience seem to know it all. Come work for me and see if that is true.

[GadgetRN71, ASN, RN]

I try to avoid this by waiting as long as decently possible to open a case..It takes us very little time to open even a big case(good teamwork). However, have we left the room unmonitored at times? It has happened and in this hospital, we don't tear it down because it may have been unattended for a few minutes. I take each situation as it comes.

I learned that when you work in a level one trauma center, things aren't always cut and dried. We've had patients crashing through the doors, chest open, doctor in street clothes with his/her arm in the chest doing heart massage. At that point, sterility is the least of the pts worries!

Another doctor did missionary work in other countries in ORs where they had dirt floors, and windows with no glass in them(open to the air). He said the infection rate was lower than you'd think. Now, I'm not advocating operating in these conditions ideally, but it kind of makes you wonder.

[cdsga]

Let me clarify. After many years in the OR, trauma and nontrauma, city and rural, there are many ways to do things, and for the most part everything works out fine. But when things do go wrong and you are out there feeling like lone wolf mcQuade, doing things in an individual and isolated manner, with nothing to defend or justify about your practice because you feel it's ok....guess where you will be...out there like a lone wolf. These entries tell me alot, and individual practice issues that cover the basics like sterility are judged harshly. Been there. Done that and you alone will pay the price for going your own way. It's just a matter of time. Lucky mine was survivable, but it took a while. A word to the wise...

Know your standards, don't count on doctors friends collegues others to be there when you have a mess up. They will be long gone. You may even save a life...doesn't matter. Don't work for an institution or a manager that condones and encourages cutting corners.

Do the right thing. And as long as I educate nurses in my OR I am going to encourage and expect that they do the same.

If I get the chance to work for some of you--I 'll show you how it can be done.

[Fun2, BSN, RN]

I think if the sterile field needs to be unmonitored, it should be covered up with sterile drapes or towels, the doors closed, and notices put on the door to alarm any upcoming occupants of the sterile field.