3 0
S U P P L E M E N T T O O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | M AY 2 0 1 4
years later, AORN recommended against covering setups under any circum-
stances. The rationale: Air currents are created when covers are removed, which
threatens the sterile field. Of course, that meant that when cases were cancelled
or bumped, everything had to be set up again and this led to considerable waste
.
But new AORN standards reflect recent research showing that it's actually safer
to cover under certain circumstances — if, for example, there's going to be a lot of
activity in the room as the patient arrives. After all, the more people coming in and
out of the room, the more likely it is that contaminants from the floor and else-
where are going to become airborne and fall on the instruments.
Studies have found that covering for up to 4 hours can be safe, as long as the
covers are both put on and taken off correctly. Since the edges of the table serve
as a demarcation line between sterile and non-sterile, covers must be peeled
back in a way that doesn't raise the
unsterile part of the cover — the part
that hangs below the table — above the
sterile field.
Of course, this is a significant change
for perioperative nurses who've been
taught over the last 20 years not to
cover, but it's a great option. The key:
Make sure the procedure is standard-
ized and that ongoing staff education
includes a demonstration on how to
place and remove covers correctly.
2. Should we double-glove?
Also emerging as a recommended practice is double-gloving. Calling on evi-
dence gained from recent studies, AORN provides 4 good reasons to do it. In
short, double-gloving:
• reduces the risks related to glove perforation, including small perforations
P E R S O N A L P R O T E C T I O N
IT ALL ADDS UP
Adequate barrier pro-
tection involves a
large number of vari-
ables, all of which
require constant
attention.
Pamela
Bevelhymer,
RN,
BSN
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