Ever since I started my exploration into EBP (evidence based practice) my professors stated that we should slay the sacred cows. The meaning behind this statement is that we should not practice because “that is the way we have always done this (or that)”. Our practice should be supported by “evidence“, that being supported by research, study and evaluation.
One practice that has bothered me is that of taping rings and jewelry with plastic transpore tape. Now why does this bother me?
1. IMHO, jewelry should be removed whenever possible.
2. The primary reason that I hear explained to patients is that this will protect from burns related to electrocautery. If that was the goal… electrical tape would be used not plastic tape with holes.
3. Another reason given is to prevent it from falling off. See #1, if it might fall off… take it off.
4. The rare, but only reasonable explanation I have heard, “is to decrease the likelihood of the jewelry from getting snagged. See #1.
In an old surgical text, from the days of drop ether (forgive me for not having the reference, read it years ago), I read a story of a patient refusing to pay her surgery and hospital bill because a gem stone was missing from her ring after surgery. The patient claimed that the gem was more than sufficient to cover the bill. (Again, see #1, this would not be an issue if removal was required).
As we have all experienced, policy often tends to be reactionary. Did the practice of taping rings come from the fear of non-payment? Tape the ring while patient is awake and then remove the tape when patient is awake to prove that the gem stones are still present? And this practice has continued without context for over 100 years?
What are your thoughts? Is this an example of a sacred cow that should be slaughtered?
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