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Speaking up: Breaking Sterility

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Speaking up: Breaking Sterility

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breaking sterilityThe cover story of the August 2012 Nursing 2012 journal is on breaking sterility. The article does not advocate a lessening of the strictness of sterility. Instead, it discusses what a nurse should do when he or she sees a surgeon break sterile technique. In this case, the surgeon reached behind him to touch the back of the chair he was sitting on during surgery. The chair was not sterile. The nurse was a nurse intern early in her employment.

Hospital acquired infections can have devastating effects on patients. They are one of the ten most common causes of death. Each year, 1.7 million patients acquire a healthcare associated infection and almost 100,000 of them die. At least one in five of these infections could have been prevented. (1) Hospital acquired infections are difficult for plaintiff attorneys to litigate because it is often hard if not impossible to prove who broke technique and introduced the organisms into the patient.

One of the methods of infection prevention is speaking up when a staffer sees another person contaminating or about to contaminate the patient. What are the risks of speaking up? When a person who is lower in the hierarchy of power speaks up to a person of higher rank, the risks include ostracism, hostility, being ignored, and being chastised. Medical malpractice attorneys are all too familiar with cases that would have never been filed if a staff member had spoken up – challenged authority, done the right thing, the ethical and appropriate thing.

The article presents a solution. The nurse intern asked the surgeon, “Doctor, what size gloves do you wear?” Clearly this is not a casual question in the midst of surgery. The surgeon asked, “Why?” The nurse responded, “I saw you touch your chair with your hand so I wanted to get you a new pair of gloves before you proceeded.” He paused, and said, “Size nine, and thank you.” She received looks of approval from the other members of the operating room team. Deftly and diplomatically handled.

(1) Lauren Simko, Breaking sterility, Nursing 2012, August 2012

Med League provides expert witnesses with expertise in evaluating operating room malpractice cases. Call us for assistance.

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