Sterility is vital during an invasive procedure, such as procedures that require the intentional perforation of the patient's skin (e.g., the insertion of intravenous catheters or administration of injections). Surgical asepsis aims to eliminate all microorganisms, including pathogens and spores from the object. If contamination occurs, sepsis can result.
Surgical aseptic technique is also used outside of the operating room, such as when the skin's integrity is broken as a result of trauma, surgical incision, or burns. In addition, procedures such as inserting a urinary catheter, reapplying a sterile dressing, and tracheobronchial airway suctioning, all require a surgical aseptic technique.
When washing your hands, never have the water running down your arm and hands. This can lead to dirty water drops from higher up on your arm dripping down and contaminating your hands. Always wash with your hands higher than your elbows. Your hands/sterile gloves should never drop below your waist.
Always keep your eyes on the sterile field. This way, if there is a question about sterility you can confirm what happened. This is also why everything sterile needs to stay above the waist.
Non-sterile objects cannot enter the sterile field. This would contaminate the field. Even brushing up against the sterile drape will contaminate the field.
If a package is labeled sterile, this means that the objects in the package are sterile and not the package itself. You can open a package and without touching the content of the package, drop the content onto the sterile field.
Pay close attention to the edges of a sterile field, because they represent the border beyond which the field is considered contaminated. If a sterile drape is completely covering a table, anything beyond the edge of the table or hanging off it is considered contaminated. If the sterile field doesn't extend to the end of a table, then a 1-inch border around the drape is considered contaminated. Never place anything sterile within the 1-inch border.
If the sterile field is ever questioned, then the field needs to be tossed and set back up using aseptic technique. Always err on the side of caution.
Moisture is a mode of transfer for microorganisms. Many sterile fields will get bodily fluids on them such as blood, which doesn't necessarily compromise the field. However, if a sterile field becomes wet with a contaminated liquid or has had prolonged exposure to air, it should be discarded. When adding a solution into the sterile field have the lip of the bottle 1 to 2 inches above the receiving container and slowly pour to prevent splashing.
Once your eyes leave the sterile field and the field comes into question, everything needs to be discarded. To prevent any issues, never leave the sterile area.
To maintain aseptic technique, there is an order to donning personal protective equipment (PPE). The proper order of PPE according to the CDC and tested on the NCLEX® is as follows: gown, mask or respirator, goggles or face shield then finally gloves.
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