2. Principles of Sterile Technique
Maria Hrubes
NUR 402, Spring 2014

3. ASEPTIC/STERILE TECHNIQUE

4. Categories of Breaks in Sterile Technique
Type 1 – the break is recognized immediately
Type 2 – the break is recognized shortly after it occurs
Type 3 – the break is recognized later
Type 4 – the break is not recognized at all

5. Principles of Sterile Technique (2013 AORN Recommended Practices)
Recommendation 1 – Proper Attire
Scrub attire – hospital laundered
Long-sleeved jacket snapped closed w/ cuffs down to the wrists
Surgical head covers that cover all hair & scalp skin, including facial hair, sideburns, and the hair at the nape of the neck

6. 2013 AORN Recommended Practices
Recommendation II – Selecting Gowns of Appropriate Size and Sleeve Length
Gown large enough to adequately wrap around the body and completely cover the back
Lower sleeves and gown cuffs should conform to the shape of the wearer’s body

7. 2013 AORN Recommended Practices
Closed Assisted Gloving
Used at the initial gowning and gloving

8. 2013 AORN Recommended Practices
Recommendation III – Donning Sterile Gloves
Open Assisted Gloving
Used when closed assisted gloving is not possible

9. 2013 AORN Recommended Practices
Recommendation III – Donning Sterile Gloves
Wear 2 pairs of surgical gloves, one over the other during cases with the potential for exposure to blood, body fluids or other infectious materials.
Use perforation indicator system using colored pair worn beneath a standard pair of surgical gloves
Changing the outer pair every 2 hours

10. 2013 AORN Recommended Practices
Recommendation III – Changing Sterile Gloves
After each patient procedure
When suspected or actual contamination occurs
After touching surgical helmet system hood & visors
After adjusting microscope
When gloves begin to swell, expand, and become loose on hand as a result of fluids and fats

11. 2013 AORN Recommended Practices
Recommendation IV – Sterile Drapes
Only the top surface of the sterile, draped area should be considered sterile.
Items that fall below the sterile area should be considered contaminated

12. 2013 AORN Recommended Practices
Recommendation IV – Sterile Drapes
Did you know?
The upper portion of the C-arm drape should be considered contaminated

13. 2013 AORN Recommended Practices
Recommendation V – Sterile fields should be constantly monitored
Once created, a sterile field should not be left unattended until the operation is completed.
Observation increases the likelihood of detecting a breech in sterility.

14. 2013 AORN Recommended Practices
Recommendation V – Sterile fields should be constantly monitored
The doors in the OR should not be taped closed as alternative to monitoring the sterile field

15. 2013 AORN Recommended Practices
Recommendation V – Covering sterile field, use 2 sterile “cuffed” drapes
The 1st drape is placed with the cuff at the halfway point.
The second drape is placed from the opposite side and completely covers the cuff of the 1st drape.

16. 2013 AORN Recommended Practices
Recommendation VI – Limit of movement within or around the sterile field
Scrubbed team members should not leave the sterile field to retrieve items from the sterilizer.
Scrubbed team members should wear lead apron when x-rays are needed so they will not leave the room.

17. 2013 AORN Recommended Practices
Recommendation VI – Limit of movement within or around the sterile field
Scrubbed team members should keep their hands and arms above waist level at all times
Arms should not be folded with the hands in the axillary area.

18. 2013 AORN Recommended Practices
Recommendation VI – Limit of movement within or around the sterile field
Scrubbed team members should avoid changing levels and should be seated only when the entire procedure will be performed at that level.

19. 2013 AORN Recommended Practices
Recommendation VI – Limit of movement within or around the sterile field
Unscrubbed personnel should face the sterile field on approach
Should not walk between sterile fields or scrubbed persons
Should maintain a distance of at least 12 inches from the sterile filed and scrubbed persons at all times

23. THANK YOU!!!