Hi Everyone,
I need some help please. At our Hospital we have been using the Navigator for several years. We presently place it on the bottom of our sterile fields and pick it up with a sterile towel to wave over the patient's chest to find the tip of PICC. I am the only one on our team that places a sterile probe cover over it and places that on my sterile field. My concern is this. I see the nurses I work with touching the cone of the navigator to the sterile drape over the patient's chest to find the tip. I feels this contaminates our sterile field. I would like to see this practice changed to using the sterile probe covers over the Navigator. My problem is I can't find anything to reference this change. What does everyone else that uses the Navigator do? I Thank you in advance, Vickey
The principles of surgical asepsis do not change because you have gained access. I'm not very familiar with the Navigator, but could you still use it if you placed it on the patient's chest prior to establishing your sterile field? If you only handle it through the drape you could roll the drape back from the top side to see it, if needed, and still not be placing it on your sterile field. Otherwise if it is not sterile, it cannot be placed on a sterile field because it makes the sterile field contaminated.
Daniel Juckette RN, CCRN, VA-BC
I ALWAYS use a sterile probe cover 5 in x 48 in. Putting it underneath the sterile drape would not work because you have to see the arrow. Many times there is the problem of it sliding off the chest/abdomen. And how are they keeping everything sterile when they plug the wire into the black box? I have a tip for everyone: before you thread the PICC, place the Navigator on the pts chest, abdomen, or lean it up against the pts side with nose of device pointing toward the heart. You will know you are heading toward the SVC as the pitch continues to get higher and higher. :-)
Ann Armstrong, RN
PICC Lines
MidMichigan Medical Center, Midland
One of the AORN principles state that "All items used within a sterile field must be sterile". This is reviewed in an article in the Infection Control Today Journal titled Asepsis and Aseptic Principles in the Operating Room by Cathy Osman, RN, BSN, CNOR. Although written in 2000 it is still pertinent to today. Basically it reviews that sterile and nonsterile should not be mixed. The rationale is that nonsterile contaminates sterile. AORN standards may be a great resource for advocating change. Below is a link to this article. Kathy
http://www.infectioncontroltoday.com/articles/2000/07/asepsis-and-aseptic-practices-in-the-operating-ro.aspx
K Fritch, IV Therapy Charge Nurse