Nursing SkillsSterile Technique &

Dressings

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

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

Principles of Sterile Technique

• Principle #1– 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

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

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

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

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

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)