Define Principles of Sterile Technique Flashcards

The sterile field should be created as close as possible to the time of use and be monitored at all times. As time passes, the likelihood that a sterile field has become contaminated by error or airborne contamination increases. After the sterile supplies have been opened, the room must be constantly monitored to prevent unintentional contamination by personnel; monitoring the room also is required if a case is delayed.

If a case is switched to another OR, and the sterile supplies and instruments have already been opened and the sterile field created in the originally assigned OR, the sterile field should never be covered with a sterile drape to be moved to the other OR because it is impossible to remove the drape without contaminating the sterile supplies and instruments. Sterile supplies and instruments should be obtained for the procedure in the newly assigned OR.

The STSR must check the chemical indicators to ensure the instruments have been exposed to the sterilization process. If the chemical indicator(s) have not changed to the proper color, the instruments should be considered non- sterile, passed off the field, and not used on the patient.

Instruments, such as scalpel blades, that come into contact with the skin of the patient should not be reused. The instruments should be returned to a designated area of the Mayo stand or back table by the STSR to prevent further use on deeper tissue.

For clean-contaminated and contaminated procedures, such as cases where the bowel is opened, separate setups should be used for the clean and dirty portions of the procedure. Personnel should not reuse the instruments used during the open bowel or dirty portion of the procedure and should regown and reglove before returning to the use of sterile instruments from the clean setup.

When removing contents from the autoclave, the STSR must not touch the edge of the sterilizer with the instruments, instrument tray, gown or gloves. Sterile transfer handles may be used by the STSR, or, if the sterile items are within a tray, the circulator can remove the tray using the transfer handles and the STSR can remove the items inside the tray.

The inner edge of a heat-sealed peel pack is considered the line between sterile and nonsterile. The flaps of the peel pack should be pulled back when opening with no tears in the pack itself. The contents should then be transferred onto the sterile field or the STSR should grasp only the edge of the inner contents without touching the peel pack, lifting upward. The contents must never be allowed to slide over the edge of the peel pack when delivered to the sterile field.

The inside of paper wrappers containing linens or other sterile items is considered sterile except for a one-inch perimeter around the outside edge of the wrapper. Sterile items must not be placed within this one-inch border. If the paper wrap has been opened on a table, the STSR must remove the sterile item without touching the one- inch border.

The circulator is responsible for opening a sterile package using aseptic technique to prevent contamination of the enclosed sterile item(s). When opening a sterile package, the circulator opens the top flap away from the body, grasping it in the hand holding the package. The side flaps are then opened downward, securing them in the same hand, and the last flap is pulled toward the body, exposing the sterile contents while covering the nonsterile hand. The item is then transferred onto the sterile field or is taken from the package by the STSR.

The top of a sterile, draped table is the only portion that is considered sterile. Any part of the drape extending below the top of the table is considered nonsterile.

Any item extending or falling below the table edge is considered nonsterile. Examples are suction tubing or the cord to a power instrument hanging below the table edge. The portion hanging below the table edge must not be brought onto the sterile field.

Once sterile drapes have been placed, they should not be repositioned. The portion of the drape that falls below the table edge is considered nonsterile, and repositioning the drape exposes the sterile field to contaminated portions of the drape.

If in doubt about the sterility of an item, consider it non-sterile and do not use. "If in doubt, throw it out"

The integrity of sterile packages must be checked before opening. There must be no evidence of strike-through, tears or punctures; all seals must be intact; and chemical indicators must have turned color to indicate exposure to sterilizing conditions.

Sterile packages found in storage areas commonly used for storage of nonsterile items must not be used. The package should be opened and if it contains resusable items, they should be taken to the central sterile processing department for repackaging and sterilization.