1. Surgical Aseptic Technique

2. See SLO’s in Syllabus

3. Historical perspectives
Remember germs and how to combat them was discovered in the mid 1800s
Initially ill family members were cared for at home
Now ill members of society are cared for in the hospital
Chances of cross contamination are high

4. Application Medical aseptic technique-
“Practices intended to confine a specific microorganisms to a specific area
Protective – reduces the numbers of potentially infectious organisms
Clean – absence of almost all microorganisms
Dirty – soiled, denotes the likely presence of microorganisms some of which could cause an infection .”(Kozier)

5. Surgical Asepsis Sterile technique
“those practices that keep an area free of all microorganisms” (Kozier)
Including pathogens & spores

6. Application of Surgical Asepsis
During procedures that require internal perforation of a client's skin (IM or IV)
When the skin’s integrity is broken (surgical incisions or burns)
During procedures that involve the insertion of catheters or surgical instruments into sterile body cavities
(Potter & Perry 6thp. 802)

8. Sterilization Procedures
Steam
Ethylene oxide
Gas sterilization
Germicidal solutions

9. Client Preparation Patient information/education Pain relief
Elimination needs
Comfort needs

10. Principles of S.A.T.
The nurse must follow certain principles in order to maintain surgical asepsis
Failure to do could result in placing the client at risk for infection
These principles are same in all situations that requiring sterility.
Injections, insertion of catheters etc.

11. A Sterile Object Remains Sterile Only When Touched by Another Sterile Object
Sterile touching sterile remains sterile
Use of sterile gloves & sterile forceps
Sterile touching clean becomes contaminated

12. A Sterile Object Remains Sterile Only When Touched by Another Sterile Object
Sterile touching contaminated becomes contaminated
Sterile touching questionable is contaminated
When in doubt discard !

13. Only Sterile Objects May Be Placed on a Sterile Field
Storage – must be dry and clean
Appropriate preparation
Packaging must be intact

14. A Sterile Object or Field Out of the Range of Vision or an Object Held Blow the Person’s Waist Is Contaminated
Never turn your back on a sterile field
Sterile objects must be kept in view

15. A Sterile Object or Field Becomes Contaminated by Prolonged Exposure to Air
Limit air currents
Do not laugh, sneeze, or talk over a sterile field- minimize movement around the sterile field
Reach around the sterile field
When opening sterile equipment hold it as close as possible without touching the field

16. When a Sterile Surface Comes Into Contact With a Wet, Contaminated Surface, the Sterile Object or Field Becomes Contaminated by Capillary Action
Packages must be intact
Note the water proof barriers
Work on a dry surface

17. Fluids Flow in the Direction of Gravity
Surgical hand scrub
Hold forceps with tip down

18. Edges of the Sterile Field or Container Are Considered Contaminated
I inch all the way around
Pour liquid off open bottle discard and then pour the liquid

19. Opening Sterile Packages
Be sure and review
Starting p 805 Potter & Perry

20. Potter & Perry Chapter 33

21. Opening Sterile Packages

22. Adding Sterile items to a sterile field

23. Assisting a surgeon with gowning

24. Final comments Professional responsibility Ethical component Honesty
Integrity
“Do not harm”

25. Wrap Up Question
When a nurse is performing a surgical hand scrub he/she must keep hands:
A. above the elbows
B. Below the elbows
C. At a 45 degree angle
D. In a comfortable position

26. References
Potter, P.A., Perry, A. G. (2013) Fundamentals of nursing (8th ed.). St. Louis, MO: Mosby.