ASEPTIC TECHNIQUE for Nurses
PRINCIPLES OF ASEPTIC TECHNIQUE
• 1. Only sterile items are used within sterile field
Drapes, sponges, basins and instruments are sterilized and can be obtained from a stock supply of sterile packages
Must be sure of its sterility and expiry date
If in doubt of sterility, consider it unsterile
Autoclave tape is used is used to indicate sterility
2. Sterile persons are gowned and gloved
Gowns are considered sterile only in front from the chest to level of sterile field, and the sleeves from above elbow to cuffs.
When wearing a gown, consider sterile only the area you can see in front down to the level of the sterile field.
Self gowning and gloving should be done from a separate area to avoid dripping water onto sterile supplies or to a sterile field.
Hands are kept away from the face. Hands are never folded under arms because of perspiration in axillary region.
3. Tables are sterile only at table level.
Only the top of a sterile, draped table is considered sterile.
Edges and sides of the drapes extending below table level are considered unsterile.
Anything falling or extending over the table edges, such as piece of suture is unsterile.
The scrub nurse does not touch the part hanging below the table level.
4. Sterile persons touch only sterile items or areas; unsterile persons touch only sterile items or areas
Sterile team members maintain contact with the sterile field by means of sterile gowns and gloves.
Unsterile circulator does not directly contact the sterile field.
Supplies are brought to sterile team members by the circulator, who opens wrappers of sterile packages.
The circulator ensures a sterile transfer to the sterile field.
5. Unsterile persons avoid reaching over the sterile field; sterile persons avoid leaning over unsterile area.
Unsterile circulator never reaches over a sterile field to transfer sterile items.
In pouring solution into a sterile basin- maintain sterility
Scrub persons sets basin or glasses to be filled at the edge of the table to fill them.
Circulator adjust operating light.
6. Edges of anything that encloses sterile contents are considered unsterile.
Sterile persons lift contents from packages by reaching down and lifting them straight up, holding their elbows high.
7. Sterile field is created as close as possible to time of use.
Degree of contamination is proportionate to length of time sterile items are uncovered and exposed to environment.
Sterile tables are set up just before the surgical procedure
It is virtually impossible to uncover a table of sterile contents without contamination.
Covering sterile tables for later use is not recommended.
8. Sterile areas are continuously kept in view.
Sterile persons face sterile areas
When sterile packs are open in a room or a sterile field is set up, someone must remain in the room to maintain vigilance.
Sterility cannot be ensured without direct observation. An unguarded sterile field should be considered contaminated.
9. Sterile persons keep well within sterile area.
Sterile persons stand back at a safe distance from the operating table when draping the patient.
Sterile persons pass each other at a back to back at a 360 degrees turn.
Sterile person stand back to an unsterile person or area when passing.
Sterile person faces a sterile area to pass it.
Sterile person ask an unsterile person to step aside rather than risk contamination.
Sterile person stay within the sterile field. They do not walk around or go outside the room.
Movement within and around the sterile area is kept to a minimum to avoid contamination of sterile item or person.
10. Sterile persons keep contact with sterile areas to minimum.
11. Unsterile persons avoid contact with sterile persons.
Unsterile persons avoid contact with sterile persons.
Unsterile persons maintain a distance of at least 1 foot from an area of the sterile field.
Unsterile person face and observe the sterile area when passing it to be sure they do not touch it.
Unsterile persons never walk between two sterile areas ( between two sterile tables )
Circulator restricts to a minimum all activity near the sterile field.
Destruction of Integrity of Microbial barrier Results in Contamination
Integrity of a sterile package of sterile drape is destroyed by perforation, puncture or strike-through.
To ensure sterility:
Sterile packages are laid on dry surface
Sterile items are stored in clean dry areas
Sterile packages are handles with clean dry hands.
Undue pressure on sterile packs is avoided to prevent forcing sterile air out and pulling unsterile air into the pack.
Microorganisms Must be Kept to an Irreducible Minimum
Skin cannot be sterilized
Some areas cannot be scrubbed when the operative field includes the mouth, nose, throat, or anus.
However, the following steps may be taken to reduce the number of microorganisms present in these areas and to avoid scattering them.
Surgeon makes an effort to use a sponge only once, then discards it.
GI tract esp. the colon is contaminated. Enema, Castor Oil is given.
• 1. Only sterile items are used within sterile field
Drapes, sponges, basins and instruments are sterilized and can be obtained from a stock supply of sterile packages
Must be sure of its sterility and expiry date
If in doubt of sterility, consider it unsterile
Autoclave tape is used is used to indicate sterility
2. Sterile persons are gowned and gloved
Gowns are considered sterile only in front from the chest to level of sterile field, and the sleeves from above elbow to cuffs.
When wearing a gown, consider sterile only the area you can see in front down to the level of the sterile field.
Self gowning and gloving should be done from a separate area to avoid dripping water onto sterile supplies or to a sterile field.
Hands are kept away from the face. Hands are never folded under arms because of perspiration in axillary region.
3. Tables are sterile only at table level.
Only the top of a sterile, draped table is considered sterile.
Edges and sides of the drapes extending below table level are considered unsterile.
Anything falling or extending over the table edges, such as piece of suture is unsterile.
The scrub nurse does not touch the part hanging below the table level.
4. Sterile persons touch only sterile items or areas; unsterile persons touch only sterile items or areas
Sterile team members maintain contact with the sterile field by means of sterile gowns and gloves.
Unsterile circulator does not directly contact the sterile field.
Supplies are brought to sterile team members by the circulator, who opens wrappers of sterile packages.
The circulator ensures a sterile transfer to the sterile field.
5. Unsterile persons avoid reaching over the sterile field; sterile persons avoid leaning over unsterile area.
Unsterile circulator never reaches over a sterile field to transfer sterile items.
In pouring solution into a sterile basin- maintain sterility
Scrub persons sets basin or glasses to be filled at the edge of the table to fill them.
Circulator adjust operating light.
6. Edges of anything that encloses sterile contents are considered unsterile.
Sterile persons lift contents from packages by reaching down and lifting them straight up, holding their elbows high.
7. Sterile field is created as close as possible to time of use.
Degree of contamination is proportionate to length of time sterile items are uncovered and exposed to environment.
Sterile tables are set up just before the surgical procedure
It is virtually impossible to uncover a table of sterile contents without contamination.
Covering sterile tables for later use is not recommended.
8. Sterile areas are continuously kept in view.
Sterile persons face sterile areas
When sterile packs are open in a room or a sterile field is set up, someone must remain in the room to maintain vigilance.
Sterility cannot be ensured without direct observation. An unguarded sterile field should be considered contaminated.
9. Sterile persons keep well within sterile area.
Sterile persons stand back at a safe distance from the operating table when draping the patient.
Sterile persons pass each other at a back to back at a 360 degrees turn.
Sterile person stand back to an unsterile person or area when passing.
Sterile person faces a sterile area to pass it.
Sterile person ask an unsterile person to step aside rather than risk contamination.
Sterile person stay within the sterile field. They do not walk around or go outside the room.
Movement within and around the sterile area is kept to a minimum to avoid contamination of sterile item or person.
10. Sterile persons keep contact with sterile areas to minimum.
11. Unsterile persons avoid contact with sterile persons.
Unsterile persons avoid contact with sterile persons.
Unsterile persons maintain a distance of at least 1 foot from an area of the sterile field.
Unsterile person face and observe the sterile area when passing it to be sure they do not touch it.
Unsterile persons never walk between two sterile areas ( between two sterile tables )
Circulator restricts to a minimum all activity near the sterile field.
Destruction of Integrity of Microbial barrier Results in Contamination
Integrity of a sterile package of sterile drape is destroyed by perforation, puncture or strike-through.
To ensure sterility:
Sterile packages are laid on dry surface
Sterile items are stored in clean dry areas
Sterile packages are handles with clean dry hands.
Undue pressure on sterile packs is avoided to prevent forcing sterile air out and pulling unsterile air into the pack.
Microorganisms Must be Kept to an Irreducible Minimum
Skin cannot be sterilized
Some areas cannot be scrubbed when the operative field includes the mouth, nose, throat, or anus.
However, the following steps may be taken to reduce the number of microorganisms present in these areas and to avoid scattering them.
Surgeon makes an effort to use a sponge only once, then discards it.
GI tract esp. the colon is contaminated. Enema, Castor Oil is given.
