Paper
Wednesday, July 11, 2007
This presentation is part of : Models of the Nursing Workforce
A study in the observed practices of asepsis with perioperative nurses as scrub nurses in the operating room
Jeanette S. Adams, PhD, CRNI, APRN, Shool of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
Learning Objective #1: analyze three key principles of asepsis as it relates to the scrub role for perioperative nurses in the operating room.
Learning Objective #2: evaluate the assimilation process of practice standards as evidence base principles are identified and empirically supported.
Aseptic technique is the cornerstone for best practice and positive patient outcomes with the prevention of nosocomial infections from surgical procedures in the operating room. The Joint Commission on the Accreditation of Healthcare Organizations and its National Safety Goals consider health care infections a sentinel event and requires the facility to conduct a root cause analysis to find risk reduction strategies. Surgical site infections are the second most common cause of healthcare acquired infections in the United States. Perioperative nurses serve as the first line of defense for surgical patients and over 75% of perioperative practices are aimed at the prevention of surgical site infection. Thus, it is imperative that perioperative nurses maintain strict adherence to the standards of asepsis and monitor other operating room staff for strict aseptic practice. 

The purpose of this study was to investigate the standard practices of asepsis with perioperative nurses as scrub personnel in the operating room. An instrument was developed to ascertain the self-reported aseptic practices of care from scrub personnel. The same tool was used to observe and record the actual aseptic care practices of  scrub personnel during a surgical procedure in the operating room. The instrument demonstrated reliability and validity and inter rater-reliability was obtained. Data analysis using a t test revealed significant differences in the self-reported and observed results. Specific items related to asepsis standards of practice delineated from the Centers of Disease Control and Prevention, the Association of Professionals in Infection Control and Epidemiology and Association of Perioperative Registered Nurses are addressed. Based on the results of the study it was concluded that there is a difference in our cognitive understanding and our implementation of the principles of asepsis. Recommendations are presented to assimilate changes in standards of care as evidence base knowledge contributes to our empirical based profession.

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