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Infection Prevention
Can You Find What's Wrong With These Pictures?
Susan McCann
Publish Date: October 27, 2008   |  Tags:   Infection Prevention

Personal protective equipment is a lot like a car seat belt: You're only protected if you're wearing it. Even though there are constant reminders, too many people who make their livings in operating rooms simply don't do it. Just as with buckling up, you're likely to forget how important the protective equipment is until there's an incident.

It's easy for you to develop a protocol for PPE protection, but implementing it means keeping it accessible as well as reminding staff about the need for such equipment. Scenes such as these, in which everything in the following five photographs may appear to be in order until you take a closer look, are all too common in today's ORs.

There are so many varieties of eye protection available, ranging from goggles to face shields, that it's unacceptable to enter a procedure without them as the assistant on the right apparently did. It's also hard to explain on an incident report, compensation form or OSHA statement that there was an eye splash simply because someone wasn't wearing the right equipment.

After the operation, everyone helping with disposal should also take steps to protect their hands. But notice in this picture that the woman holding the bag open isn't wearing gloves. She's also wearing excessive jewelry, which is another problem. AORN recommended practice states that watches, earrings, bracelets, necklaces and piercings should be removed or totally confined within the scrub attire. Although there is no evidence to demonstrate that jewelry increases bacterial shedding, there is a concern that it could fall onto the sterile field or into the wound if not contained.

On a less visible level, it's essential for anyone handling OR equipment to wear gloves. Note the anesthesia provider at the head of the table is not wearing any.

A mask that's not tied properly can (and will) contaminate your field, and dangling masks could contaminate your scrub top, your food and your next patient. This is especially important to staff who operate machinery, because a dangling mask can get caught in the equipment's moving parts.

Masks are the best barriers against airborne transmission of bacteria, nasopharyngeal shedding and moist minute droplets. You should remove your mask before leaving the OR and wash your hands after touching it. According to some studies the standard tieback mask loses its effectiveness after 90 minutes, so be sure to change your mask at intervals during the day.

Worth a thousand words each
These pictures will hopefully serve as helpful reminders to keep you, your patient and possibly your family from any harmful infections. It's up to all of us in health care to assist one another with PPEs because the safety of both our patients and our staff is at stake.

So remember: Don't get into a car without clicking your seat belt and don't enter your next procedure without wearing the suitable PPEs. In both cases, devoting a moment to safety can go a long way towards preventing a potentially fatal incident.