Archive September 2007 VIII, No. 9

Infection Prevention

Can You Find What's Wrong With These Pictures?

Susan McCann, RN


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.

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