How Is A Sterile Package Opened?

A sterile package may also be opened as follows: 1. Hold the package in one hand with the top flap opening away from the person opening the package. Using the free hand to hold the flap against the wrist of the hand holding the package is an effective technique.
Hold the package in one hand with the top flap opening away from the person opening the package. 2. Pull the top flap well back and hold it away from both the contents of the package and the sterile field. Using the free hand to hold the flap against the wrist of the hand holding the package is an effective technique.

How do I open a sterile package?

Open wrapped sterile packages in the following order: – Open the farthest wrapper flap and secure the flap in the hand that is holding the item. – Open each of the side flaps, one at a time, and secure the flaps in the hand that is holding the item.

What is a sterile package inspection approach?

This approach recognizes that the product should remain sterile until some event causes the item to become contaminated (e.g., a package becomes torn or wet). All packages containing sterile items should be inspected before use to verify that the package is not wet, torn, or damaged in any way.

What should I do before opening a package of sterilized instruments?

Wrapped packages of sterilized instruments should be inspected before opening and use to ensure that the packaging has not been compromised (i.e., wet, torn, or punctured) during storage. What is the shelf life of sterilized instruments?

Should sterilized packages be shelf-life related?

Although some facilities continue to date every sterilized package and use shelf-life practices (first in, first out), other facilities have switched to event-related practices. This approach recognizes that the product should remain sterile until some event causes the item to become contaminated (e.g., a package becomes torn or wet).

How is a sterile package opened quizlet?

How is a sterile package opened? A sterile package is opened with ungloved hands only touching the outside of the package. What is the difference between sterile and non-sterile gloves? Sterile gloves are packaged in individual sterile wraps, used when treating an open wound or during an invasive procedure.

When opening a sterile package the first flap to be opened should be?

Terms in this set (11) You are about to open a sterile pack. Place the following steps in the proper sequence for opening the sterile pack. -You would open the flap furthest from your body first, followed by the side flaps, and finally, the flap closest to your body.

When should sterile items be opened quizlet?

The outside of the sterile package and the outer 1 inch of a sterile field are contaminated. Sterile packages should be opened so that the first edge of the wrapper is directed away from the nurse. A nurse follows surgical asepsis techniques for inserting an indwelling urinary catheter in a patient.

When opening a sterile package you should pick up the package quizlet?

  • open it toward your body.
  • hold it down with one hand while opening it.
  • drop the contents onto the sterile field without touching it.
  • pull the package apart equally with each hand.
  • How does a nurse maintain a sterile field?

    When opening sterile equipment and adding supplies to a sterile field, take care to avoid contamination. Set up sterile trays as close to the time of use as possible. Stay organized and complete procedures as soon as possible. Place large items on the sterile field using sterile gloves or sterile transfer forceps.

    How long can a sterile field be opened prior to the procedure?

    3. Sterile fields should be opened and prepared as close as possible to the time of use. If the integrity of the sterile field is preserved and verified, there is no specified amount of time that the OR can remain open and subsequently used.

    Which of the following actions should the nurse perform when opening the sterile pack?

    When opening a sterile pack, what is the proper sequence for opening the sterile pack? encourage the water and soap to flow away from clean hands. You just studied 11 terms!

    How should a sterile package be handled?

    – Vapors should be allowed to precipitate on contents – Vapors should not react with packaging material – Plastics should not contact sides of sterilizer

    How to open a sterile container?

  • Extensive range of container sizes and heights to meet all your instrument sets requirements
  • Lightweight aluminum construction that is 15% to 20% lighter than leading competitors helps you meet AAMI 25lbs weight recommendation
  • 90° Stop handle protects staff from finger injuries during handling.
  • How can you check if your sterile?

    Sterilization procedures should be monitored using biological, mechanical, and chemical indicators. Biological indicators, or spore tests, are the most accepted means of monitoring sterilization because they assess the sterilization process directly by killing known highly resistant microorganisms (e.g., Geobacillus or Bacillus species).

    How should a nurse open a sterile package?

    VIDEO It is also possible to open a sterile container in the following ways: Keep the box in one hand and the top flap opening away from the person who will be opening the item.The technique of using the free hand to hold the flap against the wrist of the hand that is carrying the package is quite efficient.Second, how long does a sterile package remain effective?Six months from the date of sterilization should be the expiration date for cloth-wrapped packets that have been properly sterilized and kept.Fourth, peel packets that have been properly sterilized and kept should have an expiration date that is one year from the date of sterilization.5.

    1. In addition to this, while opening a sterile box, the last flap that should be opened is?
    2. Pulling the final flap towards you will allow you to open it.
    3. It is critical that you do not cross over into the sterile field from this point on.
    4. 10.
    5. Open the top flap of the inside pack without stepping outside of the sterile region.

    What methods do you use to keep a sanitary field?An ASC’s sterile field may be maintained by concentrating on the following ten areas:

    1. VIDEO Additionally, the following method of opening a sterile container might be used. Keep the box in one hand with the top flap opening away from the person who is about to open it. 2. When carrying a package with one hand, it is beneficial to use one’s free hand to hold the flap against the wrist of the other hand. Second, how long is a sterile package good for before it needs to be thrown away. Six months from the date of sterilization should be the expiration date for cloth wrapped packets that have been properly sterilized and kept. The shelf life of peel packs that have been properly sterilized and kept should be one year from the date of sterilization. 5th, what should be the last flap to be opened while opening a sterile package? By drawing the last flap towards you, you may open it. It is critical that you do not cross the sterile field at any point from here on out! 10. Open the top flap of the inside pack without passing over the sterile region. 11. When it comes to maintaining sterility, there are several options. An ASC’s sterile field may be maintained by focusing on the following 10 areas:

    Sterilization: Packaging & Storage

    The American National Standards Institute, the Association for the Advancement of Medical Instrumentation, and the Association for the Advancement of Medical Instrumentation An in-depth reference to steam sterilization and sterility assurance in health-care settings ANSI/AAMI ST79-2010; A1:2010; A2:2011; A3:2012; and A4:2013 are the most recent versions of these standards.The Association for the Advancement of Medical Instrumentation published a report in 2010 titled Guidelines for infection management in dental health-care facilities, published by the Centers for Disease Control and Prevention in 2003.MMWR, vol.52, no.RR-17, pp.1–66.

    1. You may download it by clicking on the pdf button.
    2. The date of access was March 18, 2016.
    3. CDC.
    4. a brief overview of infection prevention strategies in dental settings: the fundamental requirements for safe treatment You may download it by clicking on the pdf button.
    5. The date of access was March 31, 2016.

    Harte, J.A., and Molinari, A.J.Processing and recirculation of instrumentation.in Molinari JA, Harte JA, eds.Cottone’s Practical Infection Control in Dentistry, 3rd edition, New York: Springer-Verlag, 1998.2010;221–231.

    1. Baltimore: Lippincott Williams & Wilkins; 221–231.
    2. Harte, J.A., and Molinari, A.J.
    3. Preparation and monitoring of sterilisation procedures Editors: Molinari JA, Harte JA.
    1. Molinari JA, Harte JA.
    2. Cottone’s Practical Infection Control in Dentistry, 3rd ed.
    3. Cottone’s Practical Infection Control in Dentistry, third ed.
    4. (2010).
    5. Baltimore, Maryland: Lippincott Williams & Wilkins, 148–171.

    Miller CH, Palenik CJ, and colleagues Instrument Processing is a term used to describe the processing of instruments.The following is an excerpt from the book: Miller CH, Palenik CJ, eds.Infection Control and Hazardous Materials Management for the Dental Team, 4th edition Mosby, St.Louis, 2010, pp.135–169.Rutala WA, Weber DJ, and the Advisory Committee on Healthcare-Associated Infection Control Practices.

    Disinfection and sterilization in healthcare facilities: a guideline for practitioners, 2008:1–158.You may download it by clicking on the pdf button.The date of access was March 18, 2016.

    When Opening A Sterile Package The Last Flap Opened Should Be?

    The terms in this collection (11) You’re preparing to open a sterile package of medicine. The following procedures must be followed exactly as written in order to open a sterile pack: You would begin by opening the flap that is furthest away from your body, then the side flaps, and lastly the flap that is closest to your body.

    How is a sterile package opened?

    It is also possible to open a sterile container in the following ways: … 1. Hold the box in one hand with the top flap opening facing away from the person who will be opening the item…. The technique of using the free hand to hold the flap against the wrist of the hand that is carrying the package is quite efficient.

    When opening a sterile package you should?

    1. Hands should be washed thoroughly with soap and running water for at least 1 minute. Take use of the distinctive flap to peel aside the paper wrapper from your pad or kit.
    2. Take a pinching motion with the other portions on the outside and slowly draw them back. …
    3. Remove the wrapping from the package

    Which side of a sterile wrapper is opened first?

    Question Answer
    When opening a wrapper, the circulator should open the top flap Away from self
    When the scrub nurse opens an inner sterile wrapper the side nearest the body is opened first

    When opening sterile packs which pack should the circulator open first?

    Open the packs and sets in the sequence in which the scrubbers will require them to be opened.Start with the sterile gown opening, because the scrub will require it immediately upon entering the room.(1) Discard the packaging tape, unwrap the item, and check the indicator tape to confirm that the item has been through the sterilizing procedure.(2) Remove the package seals and unwrap the item.

    Which is not considered part of a sterile field?

    The use of non-sterile packaging in the sterile field includes packaging that has been damaged, opened, or wet; packaging that has been dropped on the floor; and packaging that has been dropped on the floor.When a sterile object is contacted by a non-sterile object, the sterile thing becomes non-sterile.It is only acceptable for sterile equipment or sterile gloves to come into contact with sterile items.

    How long do sterilized items remain sterile for?

    Supplies wrapped with four layers of double-thick muslin, or a similar material, will remain sterile for at least 30 days after being wrapped. Any sterilized item should not be utilized after the expiration date has passed, or if the sterile packaging is damp, ripped, or punctured.

    How do you establish and maintain a sterile field?

    1. Work surfaces should be disinfected and allowed to dry completely before any sterile supplies are placed on them.
    2. Make yourself aware of the following regions in sterile fields that are deemed contaminated:

    Why is a sterile field important?

    The ability to maintain a sterile environment is a critical component of infection prevention. These activities, which are carried out before, during, and after invasive operations, assist to limit the quantity of potentially infectious bacteria in the environment and the risk of post-procedure infection.

    Where does the nurse hold the sterile package when opening it?

    The nurse is holding an object that has been agency-wrapped and has the top flap opening toward the body. When it comes to sterile technique, surgical asepsis describes measures that are utilized to eradicate any bacteria from a surgical site.

    What part of a sterile package is sterile?

    The only area of a table that is deemed sterile is the part that is draped as part of a sterile field.

    What are sterile techniques?

    Technique that is completely sterile. When it comes to patient care, sterile technique includes tactics for reducing exposure to germs as well as methods for keeping items and places as free of bacteria as feasible.

    What is the minimum accepted distance one should keep from a sterile table unless one is scrubbed?

    It is recommended that unscrubbed employees approach the sterile field with their backs to the sterile field, refrain from walking between sterile fields or between scrubbed persons, and maintain a minimum spacing of 12 inches between the sterile field and scrubbed persons at all times.

    When should a sterile field be opened under normal circumstances?

    To ensure that sterile materials are ready for use, they should be opened and set up as soon as possible before to the surgery and just for that particular procedure. 1. Only one patient should be admitted to an operating room, and hence only one sterile field should be constructed. 2.

    What are the 3 basic principles of surgical aseptic technique?

    (1) Only sterile items should be used within a sterile field. (2) Sterilized personnel (scrubbed) should be gowned and gloved. (3) Sterile personnel should operate within a sterile field (scrubbed personnel should only touch sterile items or areas, unsterile personnel should only touch unsterile items or areas)… and so on.

    What constitutes a sterile field?

    Sterile fields are produced by arranging sterile surgical drapes around the patient’s surgical site and on the stand that will contain sterile instruments and other objects that will be used during the procedure.

    Aseptic Techniques

    Please keep in mind that the 1-inch outside border of the sterile margin is not sterile.It is also possible to open a sterile container in the following ways: Keep the box in one hand and the top flap opening away from the person who will be opening the item.Pulling back and holding away from both the contents of the package and the sterile zone is a good approach to start this process.The technique of using the free hand to hold the flap against the wrist of the hand that is carrying the package is quite efficient.3.Carefully drop the contents onto the sterile field from a height of roughly 6 inches above the field and at a little inclination.

    1. These procedures aid in ensuring that the package wrapping does not come into contact with the sterile field at any point throughout the process.
    2. Commercial products are often labeled with precise instructions for opening on the outside of the package.
    3. As a rule, packages with partially sealed corners are available; these are held in one hand while the flap is pulled back with the other; and packages with partially sealed edges are available; these are grasped with one hand while the other gently pulls the edge apart; and packages with partially sealed corners are available (Fig.
    4. 18-2).
    5. In order to create a sterile area, the drape is pulled open with one hand from the corner and opened from the top.

    This corner is used to fold the top of the shirt back.The drape is then taken out of the cover and let to open freely without coming into contact with anything else.After that, another corner of the drape is gently lifted up and set on a clean, dry surface, with the bottom of the drape being the furthest away from the person who is establishing the field (Fig.18-3).

    Adding Sterile Supplies to an Established Sterile Field

    The addition of necessary sterile materials to the field can be accomplished by employing the right package-opening procedures.Keep the following in mind: 1.Never cross a sterile field without first asking permission.Please don’t flip or throw things onto the sanitary surface.It is not sterile if there is a 1-inch boundary surrounding the sterile field around the field.4.

    1. Remove the outer wrapping from each sterilized item and throw it away.
    2. Continue this procedure for any additional items to be placed in the sterile field.
    See also:  What Are The Additional 4 Numbers In A Zip Code?

    Pouring a Sterile Solution

    Within the sterile field, sterile liquids are usually put into a metal or other container to be used later.Bottles carrying sterile solutions are typically deemed sterile on the inside but polluted on the exterior, necessitating the use of extreme caution while pouring these solutions out of the bottle.Begin by checking the solution’s ingredients and expiration date to ensure that it is still effective.If at all feasible, have another health-care professional verify the name with the patient.Always make an effort to use the precise amount of solution recommended.Once opened, the solution may only be deemed sterile if it is used within 24 hours after being opened.

    1. It is no longer considered sterile once the container has been placed on the ground, and a fresh container must be opened.
    2. This is the technique to be followed while pouring sterile solutions: 1.
    3. Immediately remove the lid or cap from the bottle and set it on an unsterile surface with the topside down to guarantee that the inner surface is sterile.
    4. 2.
    5. Hold the bottle with the label on top so that the spilled solution does not discolor or conceal the label.

    3.In order to prevent sterile liquids from spilling all over the table, sterile basins that will be used to hold sterile liquids are often positioned at the very end of the table.4.Hold the bottle at a height of roughly 1 to 2 inches above the bowl, with as little of the bottle as possible protruding over the field (Fig.18-4).

    1. Pour the solution slowly and gently so that there is no splashing.
    2. When liquids are splashed around, they can ruin a sterile field by allowing bacteria to travel from an unsterile tabletop through the wet drape that serves as the sterile field’s bottom layer.
    3. 5.
    1. If necessary, use a bottle cap to secure the container.
    2. Some institutions demand that the date and time that the bottle was opened, as well as the initials of the person who opened the bottle, be written on the label of the bottle.

    Sterile Packs

    Myelography, minor procedure, and different special procedure packs, which are used for tests such as venograms and angiograms, are among the most commonly used sterile packs.Items in a typical myelography pack are seen in Fig.18-5, and they typically contain the following components: Injectable local anesthetics are used to relieve pain.Various sizes of syringes and needles are available.Drapes that are sterile Tubes for collecting waste (for spinal fluid) arthrography and biopsies (tissue and/or fluid samples) are two minor procedures for which a small procedure pack is typically used.It includes all of the equipment listed above as well as a sterile gown.

    1. The ability to create custom angiography trays is accessible commercially; however, many hospitals opt to create their own trays instead.
    2. The following items are examples of standard supplies: Needles in various gauges, including three 18-gauge, one 20-gauge, one 22-gauge, and one 25- gauge (the larger-gauge needles are used to inject local anesthetic) Biopsy specimens should be stored in sterile containers.
    3. Connector made of plastic for use with contrast material for testing purposes.
    4. The contrast test, heparin drip, and saline flush are all performed through a single manifold (three stopcocks).
    5. Scalpel handle and No.

    10 scalpel blade, both of which are utilized in vascular cutdown procedures.Gauze pads or topping sponges in significant quantities You can use up to five 10-, 20-, or 30-mL containers.saline flush syringes with a Luer-Lok connection Three 10-mL Luer-Lok syringes (assorted sizes): Two are for contrast testing, and one is for local anesthetic injection.Sponge forceps are a kind of forceps.There are six sponges used for anesthetic preparation of the puncture site.

    1. A total of three stainless steel basins—one for saline solution, one for antiseptic, and one for waste—as well as one emesis basin are provided.
    2. Clamps that are straight and curved for arterial cutdown procedures Keep the guidewire wrapped with a clamp.

    Surgical Scrubbing

    Myelography, minor procedure, and numerous special procedure packs, which are used for tests such as venograms and angiograms, are all examples of sterile packs that are often utilized.The following items are frequently seen in a standard myelography pack, as illustrated in Fig.18-5: a local anesthetic that can be administered intravenously Various sizes of syringes and needles are used.Drapes that are free of contaminants Tubes for collecting (for spinal fluid) arthrography and biopsies (tissue and/or fluid samples) are two minor procedures for which a small procedure pack is typically used.It comprises all of the equipment listed above as well as a sterile gown.Many hospitals choose to produce their own angiography trays, despite the fact that commercially manufactured trays are available.

    1. The following are examples of typical supplies: Needles in various gauges, including three 18-gauge, one 20-gauge, one 22-gauge, and one 25-gauge (the larger-gauge needles are used to inject local anesthetic) Biopsy specimens should be kept in sterile containers.
    2. Connector made of plastic for use with contrast material for test injections.
    3. The contrast test, heparin drip, and saline flush are all administered through a single manifold (three stopcocks).
    4. Using a scalpel handle and a no.
    5. 10 scalpel blade, arterial cutdown techniques can be accomplished.

    Gauze pads or topping sponges in large quantities.Five 10-, 20-, or 30-mL containers are permitted.Saline flush syringes with a Luer-Lok connection There are three 10-mL Luer-Lok syringes in total: (1) Two are for contrast testing, and one is for local anesthetics.Sponges are handled using forceps.Six sponges were used for anesthetic preparation of the puncture site.

    1. Three stainless steel basins—one for saline solution, one for antiseptic solution, and one for waste—as well as one emesis basin are provided.
    2. For vascular cutdown procedures, there are both straight and curved clamps.
    3. Using a clamp, keep the guidewire coiled

    Sterile Gowning and Gloving

    Following the surgical scrub, the gowns and gloves are donned.Gowning may be accomplished in two ways: (1) by oneself, and (2) by someone else.Self-gowning is the most common method.Sterile gowning varies from gowning for isolation in that the focus is on surgical rather than medical asepsis.Gloving may also be performed in two ways: (1) by the one doing the gloving, and (2) by another individual doing the gloving.When doing sterile gloving, a sterile surface is always necessary.

    1. Gloves feature two surfaces: an interior and an outer.
    2. Until the gloves are touched, the entire glove is considered sterile; nevertheless, once the gloves have been touched, the inside surface of the cuff is deemed nonsterile.
    3. Packaged in a paper wrapper, with the palms facing upward and the top of the glove folded over to form a cuff about 2 to 3 inches in length, the gloves are intended for use with a variety of tools.
    4. The exposed cuff is a component of the glove’s inside, and as such, it is considered to be a part of the nonsterile side.

    Self-Gowning (Fig. 18-7)

    Take the gown by the folded edges and take it immediately out of the packaging while standing roughly 12 inches away from the sterile area.The garment is folded such that the outside is facing away from the wearer.2.Take a step back from the table and check that no items are in the vicinity of the gown.Allow the robe to unfurl slowly as you hold it at the shoulders of your chair.Please do not move the gown.

    1. 3.
    2. Insert your hands into the armholes and slide each arm through the sleeves by rising and spreading your arms.
    3. 4.
    4. 4.
    5. An unsterile aide can make minor adjustments to the gown by standing behind the wearer and reaching inside the sleeves, grabbing them, and gently tugging them.

    5.To use the open gloving technique, fold the sleeves over the hands.6.When using the closed gloving technique, make sure that the hands and fingers are completely covered by the sterile garment.6.

    1. An aide fastens the back and waistline of the garment.
    2. After the gown is put on, just the sleeves and front of the gown down to the waist are considered sterile, with the rest of the garment being deemed nonsterile.
    3. Persons must pass each other back to back in order to preserve sterile technique once they have donned their sterile gown and gloves.

    Self-Gloving

    Self-gloving can be accomplished through the use of either a closed or an open gloving method.It is conducted following gowning or, in the case of the open gloving method, it may be utilized during sterile operations that do not necessitate the use of a sterile gown, such as laparoscopic surgery.All of the jewelry should have been taken off.Check to verify that the package is in good condition and that there are no tears or water stains visible after selecting the proper size and kind of package.Prior to opening and putting on the gloves, make sure that your hands are clean and dry.It is best to open the glove package towards the individual who will wear the gloves and with the correct glove on the right side of the glove package.

    Closed Technique (Fig. 18-8)

    When you’ve finished donning your sterile gown, take up your glove and place it palm-down over the cuff of your gown with your fingers remaining within the cuff of your gown.The fingers of the glove should be facing in the direction of your hand.2.Grasp the cuff of the glove and bring it over the open cuff of the gown sleeve while working your way through the gown sleeve.3.Unroll the glove cuff so that it overlaps the sleeve cuff and is completely covered.

    1. 4.
    2. Slide your hand inside the glove by grabbing the glove cuff and sliding the hand into the glove.
    3. 5.
    4. 5.
    5. Repeat the process with the opposite hand, using the same procedure.

    Never allow the naked hand to come into touch with the gown cuff edge or the outside of the glove when wearing gloves.6.The fingers are moved about till they are comfortable.

    Open Technique (Fig. 18-9)

    1.Grab the glove by the inside cuff with one hand and place it on your wrist.Do not make any physical contact with the glove’s exterior surface or the glove wrapper.2.Slide the glove onto the other bare hand, leaving the cuff of the glove exposed.3.

    1. Using the gloved (and now sterile) hand, reach beneath the cuff of the other glove and pick it up.
    2. With the sterile gloved hand, only the outer surface of the glove should be touched.
    3. 4) After that, the glove is pushed over the hand such that it does not make contact with the inside surface of the glove, which is actually the outer surface of the folded cuff.
    4. 5.
    5. Make a fist and remember to maintain your hands at or above your waist level at all times.

    Removal of Your Gloves

    After the operation is completed, hold the cuff of one glove and pull it inside out, allowing it to be placed in the gloved hand. Reach inside the cuff of the gloved hand and pull the glove inside out and over the glove that you are holding, discarding the glove that you just pulled out. 3. Hands should be washed and dried.

    Gowning Another Person (Fig. 18-10)

    When the robe is picked up by its neckband and held at arm’s length, the sterile person lets it to unfurl.Secondly, the gown is kept together by the shoulder seams, with the exterior of the garment facing the sterile individual.To safeguard the sterile gloves, both hands should be placed behind the back panel of the gown’s shoulder.Using a downward motion, insert your arms inside the sleeves of your gown, pulling it up to your mid-upper arms.5.The gown is pulled up by a nonsterile circulator, who then fastens the back and waistline of the gown together.

    1. Sixth, gently slide the cuff back over the person’s hands, taking care not to let your gloved hands come into contact with the naked hands.

    Gloving Another Person (Fig. 18-11)

    1.The sterile individual opens the box, takes out the appropriate glove, and positions the palm of the glove away from himself or herself.To open the glove, slide the fingers beneath the cuff and stretch them out so that a large hole is produced.Keep your thumbs tucked inside your cuffs.2.The user inserts his or her hand into the glove with one motion.

    1. It is critical to have a firm grip on the cuff because a significant amount of force is applied when the hand is pulled down into the tight glove.
    2. 3.
    3. Gently wrap the cuff around the wrist while releasing it with one hand.
    4. 4.
    5. Repeat the process with the left glove, using the same procedure.
    See also:  How To Get Frozen Chicken Out Of Package?

    1.5 Surgical Asepsis and the Principles of Sterile Technique – Clinical Procedures for Safer Patient Care

    Chapter 1: Infection Prevention and Control

    Surgical Asepsis

    It is the absence of infectious material or infection that is referred to as asepsis.Surgeons must maintain complete asepsis throughout any form of invasive operation to ensure that no bacteria survive.The term ″sterile method″ refers to a collection of precise techniques and processes that are used to ensure that equipment and places are free of all germs and that they remain that way (BC Centre for Disease Control, 2010).Surgical asepsis and sterile procedure are terms that are frequently used interchangeably in the literature, yet they refer to two distinct concepts (Kennedy, 2013).It is important to understand the principles of sterile technique since they assist in controlling and preventing infection, preventing the transfer of all germs in a particular region, and encompassing all approaches that are used to preserve sterility.Sterile approach is most typically used in operating rooms, labor and delivery rooms, and spaces dedicated to particular operations or diagnostic tests, for example.

    1. A sterile procedure at the bedside, such as putting devices into sterile parts of the body or cavities, is also performed with the use of an aseptic technique (e.g., insertion of chest tube, central venous line, or indwelling urinary catheter).
    2. When the integrity of the skin is accessed, compromised, or disrupted (for example, burns or surgical wounds), sterile procedure is always employed in health care.
    3. Sterile procedure can include the use of sterile equipment, sterile gowns, and gloves, among other things (Perry et al., 2014).
    4. To assist avoid surgical site infections (SSI), which are an unanticipated and frequently preventable consequence of surgery, it is critical to use sterile methods.
    5. A surgical site infection (SSI) is described as a ″infection that arises after surgery in the surgical site″ (CDC, 2010, p.

    2).The most essential reasons for utilizing sterile technique during invasive procedures and surgeries are to prevent and reduce the spread of surgical site infection (SSI).

    Principles of Surgical Asepsis

    Each and every member of the team engaged in an aseptic operation is obliged to adhere to the principles and practices established by the Association of periOperative Registered Nurses (AORN).When executing any aseptic operations, when aiding with aseptic procedures, and when intervening when the principles of surgical asepsis are violated, it is essential that these principles be adhered to to the letter.The obligation to speak up and safeguard all patients from infection is on the shoulders of all health care employees.The basics of sterile procedure are described in Checklist 9.

    Checklist 9: Principles of Sterile Technique

    Disclaimer: Always review and follow your hospital policy regarding this specific skill.
    Safety considerations:
    • Prior to performing any aseptic process, hand cleanliness should be prioritized.
    • Make sure the patient understands how to prevent contamination of equipment and that they are aware of the need of not making abrupt movements or touching, laughing, sneezing, or talking over the sterile field while the operation is being performed.
    • Select suitable personal protective equipment (PPE) to reduce the spread of germs from patients to health-care workers.
    • Before beginning any invasive operation, review the hospital’s policies and procedures, as well as the standards for sterile technique.
    • When a health care practitioner is sick, they should avoid invasive operations or, if they are unable to avoid them, they should double mask

    Steps

     Additional Information

    1. All objects used in a sterile field must be sterile. Commercially packaged sterile supplies are marked as sterile; other packaging will be identified as sterile according to agency policy. Check packages for sterility by assessing intactness, dryness, and expiry date prior to use. Any torn, previously opened, or wet packaging, or packaging that has been dropped on the floor, is considered non-sterile and may not be used in the sterile field.
    2. A sterile object becomes non-sterile when touched by a non-sterile object. Sterile objects must only be touched by sterile equipment or sterile gloves. Whenever the sterility of an object is questionable, consider it non-sterile. Fluid flows in the direction of gravity. Keep the tips of forceps down during a sterile procedure to prevent fluid travelling over entire forceps and potentially contaminating the sterile field.
    3. Sterile items that are below the waist level, or items held below waist level, are considered to be non-sterile. Keep all sterile equipment and sterile gloves above waist level. Table drapes are only sterile at waist level.
    4. Sterile fields must always be kept in sight to be considered sterile. Sterile fields must always be kept in sight throughout entire sterile procedure. Never turn your back on the sterile field as sterility cannot be guaranteed.
    5. When opening sterile equipment and adding supplies to a sterile field, take care to avoid contamination. Set up sterile trays as close to the time of use as possible. Stay organized and complete procedures as soon as possible. Place large items on the sterile field using sterile gloves or sterile transfer forceps. Sterile objects can become non-sterile by prolonged exposure to airborne microorganisms.
    6. Any puncture, moisture, or tear that passes through a sterile barrier must be considered contaminated. Keep sterile surface dry and replace if wet or torn.
    7. Once a sterile field is set up, the border of one inch at the edge of the sterile drape is considered non-sterile. Place all objects inside the sterile field and away from the one-inch border.
    8. If there is any doubt about the sterility of an object, it is considered non-sterile. Known sterility must be maintained throughout any procedure.
    9. Sterile persons or sterile objects may only contact sterile areas; non-sterile persons or items contact only non-sterile areas. The front of the sterile gown is sterile between the shoulders and the waist, and from the sleeves to two inches below the elbow. Non-sterile items should not cross over the sterile field. For example, a non-sterile person should not reach over a sterile field. When opening sterile equipment, follow best practice for adding supplies to a sterile field to avoid contamination. Do not place non-sterile items in the sterile field.
    10. Movement around and in the sterile field must not compromise or contaminate the sterile field. Do not sneeze, cough, laugh, or talk over the sterile field. Maintain a safe space or margin of safety between sterile and non-sterile objects and areas. Refrain from reaching over the sterile field. Keep operating room (OR) traffic to a minimum, and keep doors closed. Keep hair tied back. When pouring sterile solutions, only the lip and inner cap of the pouring container is considered sterile. The pouring container must not touch any part of the sterile field. Avoid splashes.
    Data source: Kennedy, 2013; Infection Control Today, 2000; ORNAC, 2011; Perry et al., 2014; Rothrock, 2014

    Video 1.2

    1. When is it appropriate to open a sterile field (under normal circumstances)?
    2. Describe the portion of the sterile field that is deemed non-sterile.

    Sterile technique: MedlinePlus Medical Encyclopedia

    • The term ″sterile″ refers to being devoid of microorganisms. When you are caring for your catheter or operation wound, you must take precautions to prevent the transmission of germs. Some cleaning and care activities must be performed in a sterile environment in order to avoid the transmission of infection. Follow the directions provided by your health-care practitioner when performing sterile technique. Make use of the material provided here as a reminder of the procedures. To ensure that your work space remains sanitary, carefully follow all of the measures outlined below. You will require the following materials: Cleaning supplies such as running water and soap
    • sterile kit or pad
    • gloves (which are often included in your kit)
    • a clean, dry surface
    • Paper towels that have been cleaned
    • Keep your hands clean and dry at all times, and keep your work surfaces clean and dry as well. When handling materials, use only your bare hands to contact the outer wrapping of the items. It is possible that you will need to wear a mask over your nose and mouth. While you are going through the stages, keep your materials within reach so that you don’t drop or rub them against one other. To cough or sneeze, tilt your head away from your supplies and cover your mouth with the crook of your elbow, pressing firmly against it. To open a sterile pad or kit, do the following: Hands should be washed thoroughly with soap and running water for at least 1 minute. Wash your hands completely, including the backs of your hands, palms, fingers, thumbs, and between your fingers. Pour water into the sink and leave it running for as long as it takes you to slowly pronounce the alphabet or sing the ″Happy Birthday″ song two times through. Using a clean paper towel, dry the surface.
    • Pulling up the paper wrapper of your pad or kit is made easier with the distinctive flap. It should be opened so that the interior is facing away from you
    • pinch the other portions on the outside and gently draw them back to the center. Do not get your hands on the inside. Everything inside the pad or kit is sterile, with the exception of the 1-inch-wide (2.5-centimeter-wide) border surrounding it
    • discard the package wrapper.
    • Your gloves may be included in the set or may be additional. To prepare your gloves, do the following: Repeat the process of washing your hands as you did the first time. Using a clean paper towel, dry the surface.
    • Assuming you have gloves in your equipment, squeeze the glove wrapper to get it out of your bag and lay it next to the pad on a clean, dry surface.
    • The gloves should be opened and placed next to the pad on a clean, dry surface if they are in a separate packaging.
    • In the process of donning your gloves, remember to: Put your gloves on gently
    • Repeat the process of washing your hands as you did the first time. Using a clean paper towel, dry the surface.
    • The gloves should be laid out in front of you after you’ve opened the package. However, do not come into contact with them.
    • Holding the second glove by the folded wrist cuff with your writing hand
    • The glove should be placed on your hand. It makes it easier to maintain your hand straight and your thumb tucked in if you do so.
    • Leaving the cuff folded is OK. Please take care not to touch the glove’s exterior.
    • Pick up the other glove by putting your fingers inside the cuff
    • slip the glove over the fingers of the other hand
    • repeat with the other glove. Keep your hand flat and avoid letting your thumb come into contact with your flesh
    • both gloves will have a cuff that has been folded over. Pull the cuffs back toward your elbow by reaching beneath them.

    Do not touch anything other than your sterile materials after you have put on your protective gloves.If you accidentally touch something else, remove the gloves, wash your hands again, and repeat the process of opening and putting on a new pair of gloves.If you are having trouble using the sterile technique, call your provider.Sterile gloves; Wound care – sterile technique; Catheter care – sterile techniqueSmith SF, Duell DJ, Martin BC, Aebersold M, Gonzalez L.Wound care and dressings.In: Duell DJ, Martin BC, Aeber Aebersold M and Gonzalez L are editors of the book: Smith SF, Duell DJ, Martin BC, Martin BC, Aebersold M and Gonzalez L (eds.).Clinical Nursing Skills: From the Fundamentals to the Advanced.

    1. 9th ed., 9th edition Pearson Publishing Company, Hoboken, NJ, 2017:chap 25.
    2. This version has been updated by: David C.
    3. Dugdale III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA.
    4. This version has also been reviewed by David Zieve, MD MHA, Medical Director, Brenda Conaway, Editorial Director, and members of the American Dental Association for Medical Education editorial team.

    1.7 Sterile Procedures and Sterile Attire – Clinical Procedures for Safer Patient Care

    Chapter 1: Infection Prevention and Control Sterile procedures must be followed before and during certain patient care activities in order to keep the area free of germs and to prevent infection from spreading.It is possible to avoid and decrease infection during surgeries or other invasive operations by using surgical hand scrubs, wearing sterile gloves, and setting up a sterilized field in advance of the surgery.

    Surgical Hand Scrub

    Skin is a primary source of germs as well as a major source of contamination in the operating room environment (CDC, 2010).Because skin cannot be sanitized, members of the surgical team must wear sterile gloves while performing their procedures.In order to drastically minimize the amount of skin bacteria present on the hands and arms of OR staff, a surgical hand scrub is performed before to each procedure (Kennedy, 2013).Perry and colleagues (2014) defined a surgical hand scrub as an antiseptic surgical scrub or an antiseptic hand massage administered before to donning surgical garb that lasts two to five minutes, depending on the product used and the hospital policy in place.Hands should be cleansed with an antimicrobial soap before putting on surgical gloves, according to research, whereas a surgical hand scrub will reduce the growth of germs on gloved hands, according to research (Kennedy, 2013).

    Types of surgical hand scrubs

    Surgical hand scrub procedures and the products used to clean hands will differ from one health care facility to the next.The majority of procedures will need a three- to five-minute hand scrub treatment using antimicrobial soap and water.Some organizations may employ a waterless hand scrub product that has been authorized by the FDA.The measures must be followed when cleaning with medicated soap are detailed in Checklist 11.

    Checklist 11: Surgical Hand Scrub with Medicated Soap

    Disclaimer: Always review and follow your hospital policy regarding this specific skill.
    Safety considerations:
    • Surgical hand scrubs must be performed by all workers prior to entering the operating room (OR) or performing a specific sterile operation. Rings, watches, and bracelets must be removed from the hands prior to entering the OR. Nail enhancements, artificial extenders, acrylics, wraps, and tips should not be used on the nails, and the nails should be clean. Chips or cracks in the nail polish must be avoided at all costs. According to research, the number of germs on rings and on the area beneath the fingernails is nine times higher than on the rest of the body.
    • Any open lesions or breakdowns in skin integrity on the forearm and hands (particularly the cuticles) should be avoided at all costs. Anyone who has a reaction to the cleaning chemicals should notify the management.
    • If the hands come into contact with anything when cleaning, the entire cleaning procedure must be restarted from the beginning.

     Steps

     Additional Information

    1. Remove all jewellery. Jewellery harbours microorganisms.
    2. No artificial nails, extenders, or chipped nail polish should be worn in the OR. Artificial nails, extenders, and chipped nail polish can harbour microorganisms.
    3. Inspect hands for sores or abrasions; cover or report to supervisor as required. Open sores can harbour microorganisms.
    4. Ensure sleeves are at least two to three inches above the elbows. This step prevents sleeves from becoming moist.
    5. Clean hands with ABHR or soap and water to remove visible debris. Hand hygiene is recommended by the Association of periOperative Registered Nurses (AORN).
    6. Turn on water. Regulate the temperature of the water. Warm water is recommended to prevent drying out of hands.
    7. Apply the required amount of microbial soap to hands. A good amount of soap is required to create lather for a three- to five-minute scrub.
    8. Keeping hands above elbows, start timing; scrub each side of each finger, between fingers, under each nail with a nail file, and the back and front of hands for the recommended time, according to agency policy. Nail files work more effectively than a nail brush. Clean the subungal area (under the fingernails) with a nail file. Nail brushes are not recommended as they may damage the skin around the nail.
    9. Scrub the arms, using an up-and-down motion, keeping hands above the elbows at all times. Wash each side of the arm from wrist to elbow for one minute. Keeping hands above the wrist allows for the microorganisms to slide off the hands into the sink.
    10. Repeat the entire process with the other hand and forearm. Use an equal amount of time to wash each hand.
    11. With hands raised, rinse hands and arms by passing them through running water, letting the water drip down from the fingertips to the elbow. This step allows for all the soap to be rinsed off from cleanest to dirtiest area.
    12. Proceed into the operating room (keep hands above the waist), and dry arms using a sterile towel, starting at the fingertips and working down toward the forearms using a dabbing motion. This step prevents contamination of the hands and adheres to the principles of sterile technique.
    Data source: ATI, 2015a; Bartlett, Pollard, Bowker, & Bannister, 2002; Kennedy, 2013; WHO, 2009a

    Applying Sterile Gloves

    Hand protection that is devoid of any germs is known as sterile gloves.They are essential for every invasive procedure and whenever there is a possibility of contact with a sterile spot, tissue, or bodily cavity (PIDAC, 2012).Sterile gloves aid in the prevention of surgical site infections and the reduction of the risk of exposure to pathogens found in blood and bodily fluids for health care workers.In studies, it has been shown that between 18% and 35% of all sterile gloves contain microscopic holes after surgery, and that up to 80% of the tiny puncture sites go unreported by the surgeon (Kennedy, 2013).It is well-known that double gloving can lower the danger of exposure and has become normal practice; nevertheless, it does not lessen the risk of cross-contamination following surgery (Kennedy, 2013).Follow the procedures outlined in Checklist 12 to put on sterile gloves.

    Checklist 12: Donning Sterile Gloves

    Disclaimer: Always review and follow your hospital policy regarding this specific skill.
    Safety considerations:
    • Make sure you get the correct size gloves. Gloves are available in a variety of sizes. Make certain that the gloves are snug enough so that items can be easily picked up with them.
    • Hand washing is not a substitute for sterile gloving. Hands must be thoroughly cleaned before and after any operation.
    • Before donning gloves, make sure you have all of your equipment together and that your patient is ready for the treatment.
    • Before using sterile gloves, be sure the patient does not have a latex allergy.

     Steps

     Additional Information

    1. Remove all jewellery. Jewellery harbours more microorganisms than do hands.
    2. No artificial nails, extenders, or chipped nail polish should be worn. Artificial nails, extenders, and chipped nail polish can harbour additional microorganisms.
    3. Inspect hands for sores and abrasions. Cover or report to supervisor as required. Open sores can harbour microorganisms.
    4. Ensure sleeves are at least two to three inches above the elbows. This step prevents sleeves from becoming moist, and prevents the transfer of microorganisms from the sleeves.
    5. Clean hands with ABHR or soap and water. This step decreases the bacterial count on hands and prevents contamination of sterile equipment.
    6. Clean surface to open sterile field and raise its height to waist level. All sterile items must be kept above waist level.
    7. Inspect packaging for sterility. All sterile items must be checked for sterility prior to use. Always examine sterile glove packaging for expiry date, intactness, and tears. The package should be dry. Sterile gloves have outer packaging that must be removed prior to starting the procedure of applying sterile gloves.
    8. Open sterile packaging by peeling open the top seam and pulling down. Open sterile packaging without contaminating inner package.
    9. Place inner package on working surface and open up to see right and left gloves. Start with dominant hand first. Open packaging. This step prepares sterile surface to perform sterile application of gloves.
    10. Pick up glove for dominant hand by touching the inside cuff of the glove. Do not touch the outside of the glove. Pull glove completely over dominant hand.  This step allows ease of application.
    11. Insert gloved hand into the cuff of the remaining glove. Pull remaining glove on non-dominant hand and insert fingers. Adjust gloves if necessary. This ensures proper fit of gloves.
    12. Once gloves are on, interlock gloved hands and keep at least six inches away from clothing, keeping hands above waist level and below the shoulders. This step prevents the accidental touching of non-sterile objects or the front of the gown.
    13. To remove gloves, grasp the outside of the cuff or palm of glove and gently pull the glove off, turning it inside out and placing it into gloved hand. Doing this, prevents the contamination of the hand when removing glove.
    14. Take ungloved hand, place fingers inside the other glove, and pull glove off inside out. This step prevents the contamination of gloved hand touching ungloved hand.
    15. Perform hand hygiene. This removes powder from the gloves, which can irritate the skin; it also prevents contamination from potential pinholes in the gloves.
    Data source: ATI, 2015b; Berman & Snyder, 2016; Kennedy, 2013; Perry et al., 2014; Rothrock, 2014

    Video 1.3

    You may learn how to put on sterile gloves by watching this Donning Sterile Gloves video.

    Setting up a Sterile Field

    1. Aseptic procedures necessitate the use of a sterile environment in which to perform work using sterile objects.
    2. Uncontaminated surfaces on which to install sterile equipment that has been determined to be free of germs are known as sterile fields (Perry et al., 2014).
    3. It is necessary to maintain a sterile field for all invasive operations in order to avoid the transmission of germs and to limit the risk of surgical site infections.
    4. The creation of sterile fields can be accomplished in the operating room using curtains, or at the bedside with a packed set of materials for a sterile surgery or for wound care management.
    5. Many sterile kits are equipped with a waterproof inner drape that may be used to create a sterile area in the field.
    6. Depending on whether the item is intended for single or several uses, sterile things can be wrapped in either linen or paper.

    If a sterile field is necessary for a procedure, make sure to verify the hospital’s policy and doctor’s orders first.The steps for establishing a sterile field are outlined in Checklist No.13.

    Checklist 13: Preparing a Sterile Field

    Disclaimer: Always review and follow your hospital policy regarding this specific skill.
    Safety considerations:
    • A sterile environment in which to work with sterile items is necessary for aseptic processes. Uncontaminated surfaces on which to install sterile equipment that has been determined to be free of germs are known as ″sterile fields″ (Perry et al., 2014). For all invasive operations, a sterile field must be maintained in order to avoid the transmission of germs and the development of surgical site infections. The creation of sterile fields can be accomplished in the operating room using curtains, or at the bedside with a packed set of materials for a sterile surgery or wound care. Many sterile kits are equipped with a waterproof inner drape that may be used to create a sterile area as necessary. Depending on whether they are intended for single or multiple uses, sterile products might be wrapped in linen or paper. If a sterile area is necessary for an operation, always double-check hospital policy and doctor directions. The processes for establishing a sterile field are detailed in Checklist 13.

    Steps

     Additional Information

    1. Perform hand hygiene, gather supplies, check equipment for sterility, and gather additional supplies (gauze, sterile cleaning solution, sterile gloves, etc.). Gathering additional supplies at the same time will help avoid leaving the sterile field unattended. Prepackaged sterile kits may not have all the supplies required for each procedure.
    2. Place package on clean, dry, waist-level table. A clean, dry surface is required to set up a sterile field. Items below waist level are considered contaminated. Prepare sterile field as close to the time of procedure as possible.
    3. Remove the outside sterile packaging and discard. This allows more space to set up a sterile field.
    4. Grab the outer surface’s outermost tip (corner of folded drape) and open the flap away from you. The one-inch border on the sterile field is considered non-sterile. Make sure your arm is not over the sterile field. The inside of the sterile packaging is your sterile drape. Stand away from your sterile field when opening sterile packaging.
    5. Grab the side flaps and open outwards, and let it lie flat on the table. Touch only the one-inch border on the sterile field. Do not reach over the sterile field.
    6. Grasping the outermost corner, pull the last flap toward you, and lay it flat on the table. This step creates an open sterile field.
    7. Using sterile forceps, rearrange sterile equipment on the sterile field in order of usage. This step saves time for completing sterile procedure; it also limits the amount of time the sterile field is exposed to air.

    Adding Sterile Items to a Sterile Field

    • 8. Supplies can be opened (in accordance with the instructions on the packing) and then carefully placed into the sterile field. Things should be gently dropped into the sterile field, or sterile forceps should be used to place sterile items onto the field. Ensure sterility of equipment wrapped in linen by checking the date on the tape and looking for a chemical indication (stripes on the tape ensure sterility has been achieved). When utilizing paper-wrapped things, make sure that they are dry and free of rips before using them. Confirm the expiration date. Objects should not be flipped or thrown onto the sterile field. 9. Fill the sterile tray with solution by gently pouring the solution into the receptacle: Check the solution and the expiration date
    • Remove the cap and lay the bottle face up on a non-sterile surface
    • Holding the bottle two inches above the receptacle, gently and carefully pour the desired amount into the receptacle
    • If the bottle is intended for several uses, recap it and label it with the date and time of the first usage. The majority of sterile solutions are effective for 24 hours.
    Do not touch the edge of the solution receptacle. Place the receptacle near the edge of the sterile field. This ensures the sterility of the solution and the use of the correct solution. It also ensures the bottle of solution does not come in contact with the sterile field. Lastly, it verifies the type of solution required for the procedure. Be careful not to drip solution onto the sterile field, causing contamination. (When liquid permeates a sterile field it is called strike through.)
    Data source: ATI, 2015c; Berman & Snyder, 2016; Kennedy, 2013; Perry et al., 2014; Rothrock, 2014

    Read this Surgical Aseptic Technique and Sterile Field PDF for further information on surgical asepsis and how to build up a sterile field at the bedside for your patients.

    Sterile Attire in the OR

    1. To keep the limited and semi-restricted regions clean and to reduce the likelihood of microbiological transmission and contamination, it is critical to dress in sterile surgical gear (sterile gowns, closed gloving, and masks) and personal protective equipment (PPE).
    2. It is critical to minimize the patient’s exposure to the skin, mucous membranes, and hair of the surgical team by wearing the appropriate surgical gear.
    3. Recommended surgical dress may be found on the Association of periOperative Registered Nurses (AORN) website at Recommendations for surgical attire, which has a comprehensive list of guidelines for surgical gowns (Braswell & Spruce, 2012).
    1. What are the four main distinctions between a medical hand wash made of soap and water and a surgical hand scrub?
    2. Is the initial flap of a sterile field opened toward the health care provider or away from the health care provider while preparing a sterile field?
    3. Give two reasons why hand hygiene should be performed before and after the use of sterile gloves
    4. and

    Continuing Education Activity

    • In order to minimize the amount of germs present, it is necessary to create a sterile environment. Many scenarios outside of the operating room, as well as inside the operating room, necessitate the utilization of the sterile field when performing surgical procedures. When conducting any treatment that has the potential to introduce germs into a patient outside of the operating room, sterile fields should be uti

    Leave a Reply

    Your email address will not be published.