Asepsis refers to the absence of infectious material or infection. Surgical asepsis is the absence of all microorganisms within any type of invasive procedure. Sterile technique is a set
of specific practices and procedures performed to make equipment and areas free from all microorganisms and to maintain that sterility (BC Centre for Disease Control, 2010). In the literature, surgical asepsis and sterile technique are commonly used interchangeably, but they mean different things (Kennedy, 2013). Principles of sterile technique help control and prevent infection, prevent the transmission of all microorganisms in a given area, and include all techniques that are practised to
maintain sterility. Sterile technique is most commonly practised in operating rooms, labour and delivery rooms, and special procedures or diagnostic areas. It is also used when performing a sterile procedure at the bedside, such as inserting devices into sterile areas of the body or cavities (e.g., insertion of chest tube, central venous line, or indwelling urinary catheter). In health care, sterile technique is always used when the integrity of the skin is accessed, impaired, or broken
(e.g., burns or surgical incisions). Sterile technique may include the use of sterile equipment, sterile gowns, and gloves (Perry et al., 2014). Sterile technique is essential to help prevent surgical site infections (SSI), an unintended and oftentimes preventable complication arising from surgery. SSI is defined as an “infection that occurs after surgery in the area of surgery” (CDC, 2010, p. 2). Preventing and reducing SSI are the most important reasons for using sterile
technique during invasive procedures and surgeries. All personnel involved in an aseptic procedure are required to follow the principles and practice set forth by the Association of periOperative Registered Nurses (AORN). These
principles must be strictly applied when performing any aseptic procedures, when assisting with aseptic procedures, and when intervening when the principles of surgical asepsis are breached. It is the responsibility of all health care workers to speak up and protect all patients from infection. See Checklist 9 for the principles of sterile technique. 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. 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. Table drapes are only sterile at waist level. Never turn your back on the sterile field as sterility cannot be guaranteed. 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. 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. 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. Why does the nurse pour out and discard a small amount of sterile solution before each use?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.
Which of the following PPE items should the nurse remove first?The order for removing PPE is Gloves, Apron or Gown, Eye Protection, Surgical Mask. Perform hand hygiene immediately on removal. All PPE should be removed before leaving the area and disposed of as healthcare waste.
Which of the following cleansing agents should the nurse use for hand hygiene?Unless hands are visibly soiled, an alcohol-based hand rub is preferred over soap and water in most clinical situations due to evidence of better compliance compared to soap and water. Hand rubs are generally less irritating to hands and, in the absence of a sink, are an effective method of cleaning hands.
What should a nurse do to maintain standard precautions?Standard precautions consist of the following practices: hand hygiene before and after all patient contact. the use of personal protective equipment, which may include gloves, impermeable gowns, plastic aprons, masks, face shields and eye protection. the safe use and disposal of sharps.
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