The Sterile Field

Surgical Asepsis


A. Involves keeping the clinical setting and objects as free from microorganisms
as possible.

B. Used in operating rooms and in other conditions that are similar to surgical procedures.
C. Involves the use of physical barriers
1. gowns
2. gloves
3. masks
4. drapes

D. Involves extraordinary control measures so contamination does not occur.
E. Involves use of autoclave to kill microorganisms from objects
II. Procedures with high risk for infection
A. All surgeries
B. Insertion of urinary and other catheters
C. Dressing of wounds
D. Giving injectable medications
E. Caring for patients at great risk for infection
1. burns
2. transplants
3. newborns
4. those with suppressed immune systems (e.g. cancer victims, elderly, patient’s with some autoimmune diseases, transplant patients, victims of AIDS, etc.)
III. Process of sterilization
A. Steam under pressure
B. Gas autoclave for heat sensitive items
C. Includes the use of special tape that changes color when sterilization is complete

IV. Sterile Field


A. Any area that is used when doing a sterile procedure
B. Materials used in the procedure are placed within the sterile field
C. Area where the sterile field is placed must be clean and dry
D. The area of sterility is covered by a sterile drape
V. Rules when dealing with a sterile field
A. All sterile equipment is double wrapped
B. If tape used to close the sterile package has not changed color after autoclaving,
it should be considered contaminated.

C. All sterile packages must bear an expiration date.
D. When opening a sterile package, only clean hands can touch the outside of the package.

E. The inside of sterile packages can be touched only with sterile gloves. Only sterile surfaces may contact sterile surfaces.
F. Commercially prepared sterile packages will be sealed. If the package is in poor condition, consider the items to be nonsterile.
G. When opening a sterile package, never reach across the sterile area. Open by walking around the sterile area.
H. Barriers must be used to keep field sterile once opened, i.e. sterile gloves, gowns, drapes, and masks.
I. Your hands must be always kept in front and above the waist. Below the waist is considered contaminated.
J. Do not cough or sneeze over sterile field.
K. Sterile fields must remain dry, if wet it is no longer sterile.
L. Never leave the sterile field unless it is first covered with a sterile drape.
M. Consider 1-½ inches around the edge of a sterile field to be contaminated. DO NOT PLACE ANYTHING STERILE IN THAT AREA.
N. Special rooms might be used to reduce contamination.
O. Transfer forceps are like sterile fingers. Do not tilt tip upward, keep downward and touch sterile items only with the tip.
P. Never turn your back on a sterile field.
VI. Preparing a patient
A. Sterile drapes may be used, depending on the procedure.
B. Antiseptic agents might be used to prepare the patient’s skin.
C. Removal of hair might also be done.

VI. Basic concepts to keep in mind when determining the correct procedures to follow
A. Sterile to Sterile = Sterile
B. Sterile to Unsterile = Unsterile
C. Sterile to Unsure = Contaminated
D. If during a procedure, sterile technique is breached by breaking one of the rules, tell the person(s) involved. A patient’s health and well being is at stake.
E. The health care provider must be aware of all needles and sharps during procedure. Account for them at the finish.
F. Wear gloves when cleaning after procedure; dispose of needles and sharp items in proper containers.

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