13 PRINCIPLES OF STERILE TECHNIQUE
1. ONLY STERILE ITEMS ARE USED WITHIN THE STERILE FIELD.
Some items such as linens, sponges, or basins may be obtained from stock supply of sterile packages. Others, such as instruments, may be sterilized immediately proceeding the operation and removed directly from the sterilizer to the sterile tables. Every person who dispenses a sterile article must be sure of its sterility and of its sterile until used. Proper packaging, sterilizing, and handling should provide such assurance. If you are in doubt about the sterility of anything consider it not sterile. Known or potentially contaminated items must not be transferred to the field, for example: a. If sterilized package is found in a nonsterile workroom b. If uncertain about actual timing of operation of sterilizer. Items processed in suspect load considered unsterile. c. If unsterile person comes into close contact with a sterile table and vice versa d. If sterile table or unwrapped sterile items are not under constant observation e. In sterile package falls to the floor; it must be than discarded. 2. GOWNS ARE CONSIDERED STERILE ONLY FROM THE WAIST TO SHOULDER LEVEL INFRONT AND THE SLEEVES. When wearing a gown, consider only the area your can see down to the waist as the sterile area. The following practices must be observed: a. Sterile person keep hands in sight and at or above waist level. b. Hands are kept away from the face. Elbows are kept close to sides. Hands are never folded under arms because of perspiration in the axillary region. c. Changing. Table levels is avoided. If a sterile person must stand on a platform to reach the operative filed, the area of the gown below waist must not brush against sterile tables or draped areas. d. Items dropped below waist level are considered unsterile and must be discarded. 3.
TABLES ARE STERILE ONLY AT TABLE LEVEL.
The result is that
a. Only the top of the table with the sterile drape is considered sterile edges and sides of drape extending below table level are considered unsterile. b. Anything falling or extending over table edge, such as a piece suture, is unsterile. Scrub nurse does not touch the part hanging below the level. c. In unfolding sterile drape, the part that drops below the table surface is not brought back up to table level. 4.
PERSONS WHO ARE STERILE TOUCH ONLY STERILE ITEMS OR AREAS; PERSONS WHO ARE NOT STERILE TOUCH ONLY UNSTERILE ITEMS OR AREA. For example:
a. Sterile team members maintain contact with sterile field by means of gowns and gloves. b. Nonsterile, circulating nurse does not directly come into contact with the sterile field. c. Supplies for sterile team members reach them by means of the circulating nurse who opens wrapper on sterile package.
UNSTERILE PERSONS AVOID REACHING OVER A STERILE FIELD; STERILE PERSONS AVOID LEANING OVER AN UNSTERILE AREA.
a. Unsterile circulating nurse never reach over a sterile field to transfer sterile items. b. In pouring solution into sterile basin, circulating nurse holds only lip of bottle over basin to avoid reaching over sterile area. c. Scrub nurse sets basins or glasses to be filled at edge of the sterile table; circulating nurse stands near the edge of the table to fill them d. Circulating nurse stands at a distance from the sterile field to adjust light over it to avoid microbial flowout over field. e. Surgeon turns away from sterile field to have perspiration removed from brow. f. Scrub nurse drapes a nonsterile table toward self first to protect gown. g. Scrub nurse stands back from nonsterile table when draping it to avoid leaning over an unsterile area. 6.
EDGES OF ANYTHING THAT ENCLOSES STERILE CONTENTS ARE CONSIDERED UNSTERILE.
Boundaries between sterile and unsterile areas are not always rigidly defined, for example, the edges of wrappers on sterile packages are caps on solution bottles are...
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