Maintaining a Sterile Field
Why should health care practitioners double-glove during invasive procedures?
Why does a sterile field opened prior to a procedure need to be monitored continuously?
Does using a cell phone in the operating room pose a risk to patient safety?
Are there specific recommendations for gowning and gloving for clean-contaminated procedures (i.e. tonsillectomy, cystoscopy)?
Why should health care practitioners double-glove during invasive procedures?
Answer:
Health care practitioners should double glove (wear two pairs of gloves, one over the other) during invasive procedures to:
• reduce the risk of glove perforation,
• reduce the risk of surgical site infection for the patient,
• protect the wearer from exposure to bloodborne pathogens, and
• minimize the amount of blood exposure during needlestick injuries.
In addition, using perforation indicator systems as part of double gloving can assist the wearer to identify glove failure.
References
Recommended practices for prevention of transmissible infections in the perioperative practice setting. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:331-364.
Recommended practices for sterile technique. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:91-120.
Updated January 28, 2013
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Why does a sterile field opened prior to a procedure need to be monitored continuously?
Answer:
A sterile field established in advance of a procedure should be monitored continuously because sterility is event-related. The purpose of monitoring the sterile field is to observe for, or prevent, an event leading to contamination of the sterile field. These events may be caused by personnel, falling objects, or other means such as insects. Taping the door shut is not acceptable because it does not prevent all events from occurring or provide a means to observe the occurrence.
Reference
Recommended practices for sterile technique. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:91-120.
Updated January 28, 2013
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Does using a cell phone in the operating room pose a risk to patient safety?
Answer:
Monitoring equipment and other critical medical devices may be susceptible to electromagnetic interference (EMI) from cell phones. Because the operating room is considered a highly instrumented area, it is recommended that cell phones be in the off position when carried into the operating room.1 Perioperative nurses should work with their biomedical department personnel to establish safe procedures.
Aside from the concern of EMI, bacteria from the cell phone may be transferred via a practitioner's hands, leading to possible cross-contamination.2 Any of these instances could pose a risk to patient safety.
Reference
Cell phones and electromagnetic interference revisited. Health Devices. 2006;35(12):449-456. Brady RR, Wasson A, Stirling I, McAllister C, Damani NN. Is your phone bugged? The incidence of bacteria known to cause nosocomial infection on healthcare workers' mobile phones. J Hosp Infect. 2006;62(1):123-125.
Resources
Ogg M. Cell phone use in the OR [Clinical Issues]. AORN J. 2008;87(3):626-630.
Updated August 24, 2009
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Are there specific recommendations for gowning and gloving for clean-contaminated procedures (i.e. tonsillectomy, cystoscopy)
Answer:
There is no distinction between procedures types in the practice of gowning and gloving. The purpose of gowning and gloving, as well as wearing other appropriate surgical attire such as caps, masks, and eye protection is to prevent microbial transference to the sterile field, surgical site, and patient during the surgical procedure. As part of Standard Precautions, this practice also reduces the risk of occupational exposure to bloodborne pathogens and other potentially infectious materials.
Resources
Recommended practices for sterile technique. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:91-120.
Recommended practices for prevention of transmissible infections in the perioperative practice setting. In: Perioperative Standards and Recommended Practices. Denver, CO: AORN, Inc; 2013:331-364.
Updated January 28, 2013
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