If a Sterile Item Falls on the Floor
Re: "If a Sterile Item Falls on the Floor" (March, page 111). Recently I spent a day in the OR observing the sterile technique of the nurses for process improvement. I then prepared an in-service for the staff, and met with some new OR staff about how they could better their practice.

RMV->)One nurse handed me a copy of the article with this passage highlighted: "Stop following this mindless practice of discarding or recycling sterile items that fall on the floor." It just so happened that one of the things I offered constructive issues on was an item that fell on the floor, was later picked up by the circulator, opened to the sterile field and used inside the patient.

I have yet to meet the OR nurse who uses a mindless practice to judge whether an item dropped is still sterile or who believes that anything dropped on a floor at anytime then becomes unsterile. However, these nurses (because of this article) have questioned my credibility and opinion. The item they dropped was still intact and sterile (my judgment) or I would have insisted they not use it. I am disappointed that the OR nurse who highlighted the "mindless" quote apparently retained that statement. I would rather have her retain the mention that "all staff that handle sterile items should be trained to make a judgment in each case."

Sandra Gage, RN
Infection Control/Employee Health
Hill Regional Hospital, Hillsboro, Tex.
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Benchmarking Really Works
Re: "Which Benchmarking System Is Right for You?" (April, page 90). I would like to share our experience about how benchmarking can influence decisions to improve services and enhance goals. One of our staff nurses who attended last year's FASA conference brought back with her a performance measure study of the Institute for Quality Improvement on Diagnostic Colonoscopy. This study and CPT code were of interest to us because this is about one-third of the procedures that we perform. We decided to compare ourselves with the key performance measurements in the national study. After tedious days of chart review, additions and calculations, we came up with the result we thought we needed. As we compared and discussed our results, we also started looking at the "bigger picture" and the impact of our comparative numbers on our processes. We evaluated our performance and identified areas where we might adopt best practice, and improve our efficiency. This gave our CEO the data he needed to justify an expansion project of our post anesthesia care area that we're about to embark on very soon.

Flavel Rogers, MSHA, RN
Nurse Administrator
Glasgow Surgery Center, Newark, Del.
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