Breaking sterility: Dealing with procedural violations in healthcare
Lauren Simko BSN, RN, FNP

August 2012 
Volume 42  Number 8
Pages 22 - 26
  PDF Version Available!

EXAMPLES OF PROCEDURES requiring strict sterile technique include invasive procedures performed at the bedside, such as urinary catheter insertion, and surgery. A break in sterility can result in infection and seriously harm the patient. Each year 1.7 million patients acquire a healthcare-associated infection (HAI) and almost 100,000 of them die. At least one in five of these infections could have been prevented.1Healthcare workers can help prevent infections by performing strict hand hygiene, maintaining proper technique during diagnostic studies and procedures, and speaking up when they observe others violating standard policies and procedures.2This article discusses how any member of the healthcare team should intervene and advocate for patients when he or she witnesses a breach of sterile technique, even when doing so requires addressing a more senior staff member who's committed a procedural violation.Patient safety is the most important component of the nurse's daily role, and HAIs are among the most significant patient safety issues.3,4 HAIs, defined as infections "acquired as a consequence of a person's treatment by a healthcare provider" are considered to be one of the ten most common causes of death.5,6 Of these infections, 35% are attributed to catheter-associated urinary tract infections, 20% are the result of surgical site infections, and 15% are due to pneumonia and bloodstream infections.7Although not every infection is preventable, healthcare providers must recognize how to avoid or reduce the risk of infections in their patients as well as stay up to date on the continual changes in evidence-based practice. According to the World Health Organization, strict hand hygiene is important for reducing infection rates, with healthcare workers' adherence a key component.8 Another way to reduce infection rates is to follow strict sterile technique, not only in the OR but at the bedside and in the outpatient setting. Many procedures require sterile technique.

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