1. Chapter Twenty-Seven:
Health Protection: Risk for Infection
Sterile Technique
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2. Asepsis
Medical Asepsis – practices designed to reduce the numbers of pathogenic microorganisms in the client’s environment
Sterile Asepsis – practices that are used to prevent the introduction of microorganisms that could cause infection
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3. Principles of Sterile Technique
Sterile means the absence of microorganisms

4. Principles of Sterile Technique
If a sterile object touches a nonsterile object, it is no longer sterile
The edge of a sterile field and 1-2 inches inward is not sterile

5. Principles of Sterile Technique
A wet object is not a sterile object
Strike through from a wet surface
All objects used in a sterile field are sterile
The skin is not sterile

6. Principles of Sterile Technique
Anything you cannot keep in your line of vision (therefore, cannot control) is not sterile
Below the waist
Your back
Below the edge of the table

7. Principles of Sterile Technique
Damaged packages are not sterile.
Is it dirty
Expiration date
Looks like it has been wet
Has it been properly stored
Clearly labeled as sterile

9. Open the package – place in center of table
top flap open away from you; touch only outside of wrapper;
side flaps open with each hand;
4th flap toward you making sure it does not touch your uniform.  If the inner surface touches any unsterile article it is contaminated.

10. What’s wrong with this picture?
Safe Zone
What’s up with the hands? Aren’t they supposed to be held above the waist, but below the axilla?

11. Using a drape to establish a field
with one hand pluck the corner of the drape that is folded back on the top. 
Lift the drape out of the cover and allow it to open freely without touching any objects. 
Lay the drape on a clean dry surface, placing the freely hanging side farthest from you (nurse should not lean over sterile field).

12. Read label to confirm solution.
Commercially packaged supplies: Hold the package above the field and allow contents to drop on center of the field.
Read label to confirm solution. 
Once it is opened, its sterility for that use. 
Remove cap invert cap to put it down
Hold the bottle of fluid at a height of about 4-6” and to the side of the sterile field;
discard a little solution before pouring.

13. Principles of Sterile Technique
Once a liquid has been opened it is not sterile
Can be used for a clean procedure for 24 hours
Sterile objects can become unsterile by prolonged exposure to airborne microorganisms. 

14. Do not cough, sneeze, or talk excessively over a sterile field.
Do not cross over the sterile field

15. Sterile Supplies
With free hand, grasp the corners of the wrapper and hold them against the wrist of the other hand (the unsterile hand is now covered by the sterile wrapper).
Place the sterile item on the field by approaching from an angle not holding the arm over the field.

16. Sterile Gloves Procedure: Remove rings, especially those with stones.
Wash hands. 
Place package on clean, dry surface.
Open outer package, then the inner package.

17. 1st glove (dominant hand): grasp by its cuff with thumb and 1st finger of non-dominant hand, touching only the inside of the glove.  Insert the hand.
2nd glove: Pick up the other glove with the sterile gloved hand, inserting the gloved fingers under the cuff and holding the gloved thumb close to the gloved palm.  Pull on the 2nd glove carefully.  Adjust each glove so that it fits smoothly

18. Principles of Sterile Technique
Consider the environment
Can you do a sterile procedure in a dirty environment?
Plants in the room
Old food
Bedpan has been on the overbed table

19. When to use sterile technique
Invasive procedures
Urinary tract: catheterization
Lungs: tracheal suctioning
Breaks in the skin

20. Chronic wounds
Are contaminated wounds, therefore sterile is not required
However the clean technique should be meticulous
Use sterile if the patient is particularly vulnerable to infection; eg. Low WBC

21. Conscientiousness, alertness, honesty, and humility are essential qualities in maintaning sterile asepsis
Human beings make mistakes; that is why team members watch out for each others sterile technique
Beginning nurse tip: bring extra sterile gloves and supplies if possible when doing the procedure!!!!

22. Practice Donning sterile gloves Opening sterile packages
Setting up a sterile field
Adding liquid to a sterile field