5 Rules for a Sterile OR

5 Rules for a Sterile OR


Sterility is imperative in the operating room. One mistake can lead to a damaging infection or life-threatening infection. In the OR, patients are completely vulnerable to the actions of their nurses and surgeons, so it is important to take every precaution. I visited a group of nurses practicing operating room procedures in the Clinical Simulation Lab.

Did you know these important rules for staying sterile in the operating room?

  1. Cover up!
    Human skin is crawling with possible infectants. Dead skin cells, hairs: if anything enters the open incision during surgery, it could cause major problems. Every person in the room wears masks, gowns and hairnets to minimize the chance of infection, and tools are either steam cleaned and sterile or, increasingly, they are disposable.
  2. Don’t talk too much
    Even talking can disturb the air and move bacteria from your mouth into the room. Everyone wears masks to minimize the risk, and talking is important to communicate — but not too much. To cut down on talking, and to communicate quickly, surgeons might use hand signals to indicate a tool they need.
  3. Keep your hands where you can see them
    If you can’t see your hands, you don’t know what they have touched. The slightest brush of a non-sterile area, or a scratch at an itch on your cheek is contaminating. A few rules keep your hands clean: keep your hands in front of you, and don’t raise them above your head or lower them below the table. Your hands stay in a range between your waist and chin at all times.
  4. Make a list, check it twice
    Few things cause a nastier problem than leaving a sponge or surgical instrument inside a patient. That’s why nurses count, recount and check each others’ work before and after the procedure. This accounts for every object used during the surgery.
  5. Play it safe
    When in doubt, it’s best to do everything over: put on new gloves, exchange surgical instruments for sterile ones, grab a clean instrument table.

Sterility is hugely important in the lab. Some of the rules might seem nitpicky, or like extra work, but each one is important to a successful surgery and recovery.

PS: What is your operating room playlist? Some ORs play rock, others play hip-hop. The lab was in the holiday spirit, with “Rudolph the Red Nosed Reindeer” playing from a small stereo. There is only one rule for the playlist: surgeon’s choice.