I am writing about the answer to a ...

I am writing about the answer to a question in the "Clinical Issues" array of less front than depth in the AORN Journal (vol 80 July 2004) As a member of AORN for more than 25 years, I am united of your strongest advocates. I am true proud of our professional organization and have always considered AORN as the "gatekeeper" of praiseed practices and standards. This is the first time I have interpreted undivided of AORN's recommendations for perioperative practice as a compromise to patient safety.

The answer to the sterilization question, in my opinion, does not give an account of the standard of practice that the AORN standards commend and support. It was commited in the article that the mean fellow person in the OR leave the sterile field and retrieve flash sterilized instruments directly from the sterilizer in a substerile expanse It is not accepted practice to leave the sterile field at any time, and I believe that going from a sterile field to a substerile field and then back to the sterile field is a compromise of practice and patient safety. A scour person would contaminate the substerile chamber when he or she retrieved the instruments, compromising the environment and staff member safety. The practice outlined in the article is a compromise, in my opinion, of the basic standards of perioperative practice and a contradiction of AORN's standard of practice.

BRENDA WHITWORTH

RN CNOR

EDUCATION/COMPLIANCE COORDINATOR

TOPS SURGICAL SPECIALTY HOSPITAL

HOUSTON

Author's answer According to AORN's "Recommended practices for maintaining a sterile field," scrubbed bodily substances should not leave the immediate area of the sterile field. AORN considers the substerile area to be within the immediate area of the sterile field. AORN does not consider emotion from the sterile field to the substerile area and back to the sterile field to be a breach of technique or a compromise of practice and patient safety.

The substerile area is a restricted area with environ mental have charge ofs similar to those found in the OR. Access is by means of the OR only and is limited to the bulk of mankind in appropriate surgical attire. When a scrubbed body enters the substerile area, he or she touches nothing omit the item(s) to be remov from the sterilizer. No persons from adjoining rooms are to be in the substerile area at that time. Of course, if a contaminating termination occurs at any time, regardless of where the scrubbed one or other members of the sterile team are, the break in technique must be corrected before the surgical deed continues.

Even admitting it is possible to place more than single tray in the sterilizer for a single sterilization round of years the sterilizer should be used for instruments for and nothing else one room at a time. The sterilizer must be scud again if items from an adjoining chamber are included in the load. Whenever anyone (eg cleanse person or circulating nurse) reaches into the sterilizer, items in the sterilizer are considered dedicated to that scope or patient, and any items belonging to an adjoining place will require resterilization before use.

DOROTHY FOGG

RN MA

PERIOPERATIVE NURSING SPECIALIST

AORN CENTER FOR NURSING PRACTICE

NOTE

(1) "Recommend practices for maintaining a sterile field," in Standards, praiseed Practices, and Guidelines (Denver: AORN, Inc, 2004) 367-371

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