Nursing Skills Sterile Technique & Dressings Kinda gross subject, but very important Good nursing care should prevent problems as well as treating them See IVD, film Lab practice Sterile technique is important for many things IM, FC, Trach care

Terminology Asepsis= absence of germs Surgical asepsis or sterile technique= practices aimed at eliminating all germs Medical asepsis or clean technique=practices aimed at controlling & reducing # of germs Sterilization= process where all forms of germs and spores are destroyed What procedures are clean ? Bath, vs., NG, enema We disinfect a lot in the hospital but we sterilize kits and things for OR with what? Autoclave- uses steam to get rid of all the germs Can use radiation for sensitive items- i.e. drugs Boiling is used in homes

Clean vs. Sterile Technique Clean technique Use clean gloves Use for routine pt care Involves hand washing Part of BSI -prevent infection spread Used in home settings for procedures Sterile technique Use sterile gloves Use sterile supplies Procedures involving sterile body cavities Involves hand washing Used in hospital & ECF to prevent nosocomial infections

Basic Ideas of Sterility Germs are not visible without a microscope Germs may be transferred directly or indirectly The body has various defensive barriers Cleanse from least contaminated to most contaminated Germs require organic food and moisture to grow Gross contamination is visible germs can be coughed on you or come from the door knob we have skin, chemicals and WBC clean wound to dirtier tube vagina to rectum, tip and out etc germs will die quickly like people s food or water

Principles of Sterile Technique An article is accepted as sterile only if it is completely enclosed in a dry, intact, wrapper and marked “sterile” Principle #2 Wrapped sterile articles have a limited shelf life Look at your own kits- they are not sterile and say so - less $ Some kits are not sterile and they will not say sterile When autoclaved tape turns clear to dark brown, red or black can vary from one month to years This is the last day the product can be used

Sterile Technique (cont.) Principle #3 Sterile supplies are contaminated if their wrappers are torn or wet. Moisture causes contamination by “wicking” or capillary action Principle #4 The outside and edges of wrapper containing sterile articles are considered unsterile to 1 “(inch). Use table edge.

Sterile Technique (cont) Principle #5 Skin can’t be sterilized so contact b/t skin and sterile surfaces cause contamination Principle #6 Only articles above waist and table level are considered sterile Skin can be very clean but not sterile Must have on sterile gloves This is because they are out of range of vision Table is sterile only on the top underneath is buffer zone and no nonsterile should touch

Sterile Technique (cont) Principle #7 Organisms are pulled downward by gravity Principle #8 Organisms are carried by air currents Prolonged air exposure is bad Do not talk or sneeze over field unless have to

Sterile Technique (cont) Principle #9 An article or area is either sterile or non-sterile, it cannot be both (If in doubt it is not sterile) Principle #10 It is only sterile if you can see it Do not turn your back to a sterile field Keep it in line of your vision If you ? is contaminated it is If some one says you contaminated you did

Opening a Sterile Field or package Make sure surface is clean & dry Open away from you first Open sides next Toward you last Only touch outer 1” border and outside If is a package open away from you Be sure to prepare client and family bring extra sterile gloves and maybe supplies

Establishing a Sterile Field Adding supplies to sterile field Open well above sterile field- do not tear Do not touch sterile object Drop on field within 1” border Try not to touch other items c new object

Adding Sterile Solution to a Bowl If old bottle check expiration (usually about 24 hrs after opened) Open bottle carefully and put cap face down (this prevents contamination) Lip liquid to remove germs Pour slowly to prevent splashing Pour with label in palm of your hand

Open Sterile Glove Application Wash hands & proper size Peel open & place on clean flat surface Open up gloves (do not allow to close- fold in half) Grab #1 glove by outside of cuff Slip on glove away from other objects Grab #2 glove by inside cuff with sterile hand Now adjust both Watch for your thumb Get those hands up Rolling Get the proper size

Common Sources of Contamination HC members active infections Poor sterile technique Most contaminations are accidental Contaminations not seen by team Procedure is very long Unsterile person enters sterile area Mask worn improperly or never changed Excessive debris in air from poor air circulation Clients or visitors (they don’t go to nursing school)