What is the most appropriate intervention when a nurse witnesses a colleague using non-sterile technique during a wound dressing change, increasing the risk of infection, with the patient's surgical site appearing erythematous?

Immediate Intervention is Necessary When Witnessing Non-Sterile Wound Dressing Technique

Option A: Immediately intervening during the procedure to correct the technique safely is the most appropriate intervention when witnessing a colleague using non-sterile technique during wound dressing changes, especially with an erythematous surgical site.

Scientific and Medical Rationale

Infection Prevention Priority

• Immediate intervention is essential when patient safety is at risk 1
• The erythematous appearance of the surgical site indicates potential early infection that could be exacerbated by improper technique
• Guidelines strongly emphasize that proper sterile technique is critical in preventing surgical site infections (SSIs) 1

Professional Responsibility

• Healthcare professionals have an ethical obligation to intervene when witnessing practices that increase infection risk
• The 2020 World Journal of Emergency Surgery guidelines emphasize that SSIs significantly increase morbidity, mortality, length of stay, and healthcare costs 1
• Safe intervention during the procedure prevents immediate harm while maintaining professional standards

Evidence-Based Approach

• Surgical site infections are associated with increased morbidity and mortality 1
• The 2022 AAOS Clinical Practice Guidelines emphasize that prevention of SSI after trauma is critical to patient outcomes 1
• Proper sterile technique during dressing changes is a fundamental infection control measure 1

Why Option A is Correct

• Patient safety takes immediate precedence over colleague comfort
• Timely correction prevents contamination from continuing and potentially causing infection
• Professional intervention can be done respectfully while maintaining sterile field
• Preventing harm is the primary ethical obligation in healthcare

This makes option A: Immediately intervening during the procedure to correct the technique safely the correct answer.

Why Other Options are Incorrect

Option B: Recording the event secretly for later use in a performance review

• Secret recording violates professional ethics and trust
• Delayed action allows potential harm to continue when it could be prevented
• Undermines collegial relationships and professional communication
• Documentation should be transparent and focused on improvement, not punishment

Option C: Discussing concerns privately post-shift to avoid public embarrassment

• Delayed intervention allows improper technique to continue, risking patient harm
• While privacy is important, patient safety takes priority over colleague embarrassment
• Post-shift discussion does not address the immediate risk to the current patient
• Educational opportunity is missed at the critical moment when technique could be corrected

Option D: Requesting transfer of the patient to another nurse's care permanently

• Avoids addressing the underlying issue of improper technique
• Does not prevent harm to other patients under this nurse's care
• Fails to provide education or opportunity for improvement
• Undermines teamwork and professional development

What the Examiner is Testing

• Knowledge of infection control priorities in wound care
• Understanding of professional responsibility to intervene when patient safety is at risk
• Ability to balance professional courtesy with patient safety concerns
• Knowledge of appropriate intervention timing when witnessing improper clinical technique
• Understanding of ethical obligations to both patients and colleagues