1. Chapter 57:
Surgical Asepsis

2. Terms That Apply to Asepsis
*Dirty: any object that has not been cleaned or sterilized to remove microorganisms
*Contaminated: any object that is not sterile
Grossly contaminated: contains visible body fluids, discharges, or dirt
*Clean: many of the most harmful microorganisms have been removed
Sterile: the item or area is free of all microorganisms and spores; if a sterile item touches a nonsterile item, the sterile item becomes contaminated

3. Disinfection *Disinfection
The process that results in the destruction of most pathogens but not necessarily their spores
Methods
Use of alcohol wipes, a hexachlorophene or chlorhexidine gluconate soap scrub, or a povidone- iodine scrub, surgical hand scrub
*Stronger disinfectants: Phenol or chlorine is used to disinfect floors and surfaces

4. Sterilization *Sterilization
The process of exposing articles to steam heat under pressure or to chemical disinfectants long enough to kill all microorganisms and spores
Methods
Autoclave, chemical disinfectants, radiation, and gas sterilization
Autoclave
18 pound, at a temp of 125 C for 15 minutes*

5. Medical Asepsis: Clean Technique
**The purpose of maintaining medical asepsis is to prevent the spread of disease from one person to another
Handwashing
Standard Precautions

6. Surgical Asepsis: Sterile Technique
All microorganisms and spores are destroyed before they can enter the body.
Often, clean technique (medical asepsis) is performed using sterile supplies.
Sterile to clean, dirty, or contaminated becomes contaminated.
*see nursing care guidelines 57-1

7. Sterile Technique
Sterile technique is used to prevent the spread of infection
Supplies used for surgical and other sterile procedures
Used when administering injectable medication and performing surgical and other procedures, such as urinary catheterization*
Anything that either touches an open wound or skin break, enters a sterile body cavity, or punctures the skin
Surgical towels or drapes are packaged, secured with special masking tape, labeled, and sterilized

8. Educating the Client Client and family teaching
Demonstrate the skill to be performed
Ask the client and family to demonstrate the skill before discharge
Explain how to recognize problems or complications
Describe when to seek medical care immediately
If indicated, make a referral for home care nursing follow-up

9. Sterile Technique in Nursing
Do not touch anything after sterile gloves or gown have been put on.
Reaching over a sterile field contaminates the sterile area.
If a sterile wrapper or mask becomes wet, they are no longer sterile.
When wearing sterile gloves, perform a sterile procedure.
A person’s back is not sterile. Skin can only be made clean, not sterile.
When in doubt, consider the objects in question to be contaminated.

10. Sterile Technique Hair covering Surgical mask and eye protection
Sterile gown
Sterile gloves
Open gloving
Closed gloving
Removal of sterile or nonsterile gloves

11. Typical Procedures Requiring Sterile Technique
Care of the indwelling catheter
Surgical intervention and invasive procedures
Sterile dressing change
Suture and staple removal
Administration of parenteral medications
Venipuncture and management of IVs

12. Urinary Catheterization
Self-catheterization
Catheterizing the female client
The side-lying position
Catheterizing the male client
*Coude tip catheter
*remove no more than ml of urine at one time
Caring for the client after catheterization
Removing the retention catheter

13. **Nursing Procedures
57-1
57-2
57-3
Use fr catheter
57-4
57-5