Principles of Sterile Technique Maria Hrubes NUR 402

Principles of Sterile Technique Maria Hrubes NUR 402, Spring 2014

ASEPTIC/STERILE TECHNIQUE

Categories of Breaks in Sterile Technique v. Type 1 – the break is recognized immediately v. Type 2 – the break is recognized shortly after it occurs v. Type 3 – the break is recognized later v. Type 4 – the break is not recognized at all

Principles of Sterile Technique (2013 AORN Recommended Practices) Recommendation 1 – Proper Attire • Scrub attire – hospital laundered • Long-sleeved jacket snapped closed w/ cuffs down to the wrists • Surgical head covers that cover all hair & scalp skin, including facial hair, sideburns, and the hair at the nape of the neck

2013 AORN Recommended Practices Recommendation II – Selecting Gowns of Appropriate Size and Sleeve Length • Gown large enough to adequately wrap around the body and completely cover the back • Lower sleeves and gown cuffs should conform to the shape of the wearer’s body

2013 AORN Recommended Practices Closed Assisted Gloving • Used at the initial gowning and gloving

2013 AORN Recommended Practices Recommendation III – Donning Sterile Gloves Open Assisted Gloving • Used when closed assisted gloving is not possible

2013 AORN Recommended Practices Recommendation III – Donning Sterile Gloves • Wear 2 pairs of surgical gloves, one over the other during cases with the potential for exposure to blood, body fluids or other infectious materials. • Use perforation indicator system using colored pair worn beneath a standard pair of surgical gloves • Changing the outer pair every 2 hours

2013 AORN Recommended Practices Recommendation III – Changing Sterile Gloves • After each patient procedure • When suspected or actual contamination occurs • After touching surgical helmet system hood & visors • After adjusting microscope • When gloves begin to swell, expand, and become loose on hand as a result of fluids and fats

2013 AORN Recommended Practices Recommendation IV – Sterile Drapes • Only the top surface of the sterile, draped area should be considered sterile. • Items that fall below the sterile area should be considered contaminated

2013 AORN Recommended Practices Recommendation IV – Sterile Drapes Did you know? • The upper portion of the C-arm drape should be considered contaminated

2013 AORN Recommended Practices Recommendation V – Sterile fields should be constantly monitored • Once created, a sterile field should not be left unattended until the operation is completed. • Observation increases the likelihood of detecting a breech in sterility.

2013 AORN Recommended Practices Recommendation V – Sterile fields should be constantly monitored • The doors in the OR should not be taped closed as alternative to monitoring the sterile field

2013 AORN Recommended Practices Recommendation V – Covering sterile field, use 2 sterile “cuffed” drapes st • The 1 drape is placed with the cuff at the halfway point. • The second drape is placed from the opposite side and completely covers the cuff of the 1 st drape.

2013 AORN Recommended Practices Recommendation VI – Limit of movement within or around the sterile field • Scrubbed team members should not leave the sterile field to retrieve items from the sterilizer. • Scrubbed team members should wear lead apron when x-rays are needed so they will not leave the room.

2013 AORN Recommended Practices Recommendation VI – Limit of movement within or around the sterile field • Scrubbed team members should keep their hands and arms above waist level at all times • Arms should not be folded with the hands in the axillary area.

2013 AORN Recommended Practices Recommendation VI – Limit of movement within or around the sterile field • Scrubbed team members should avoid changing levels and should be seated only when the entire procedure will be performed at that level.

2013 AORN Recommended Practices Recommendation VI – Limit of movement within or around the sterile field • Unscrubbed personnel should face the sterile field on approach • Should not walk between sterile fields or scrubbed persons • Should maintain a distance of at least 12 inches from the sterile filed and scrubbed persons at all times

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