Surgical Aseptic Technique

N001

See SLO’s in Syllabus

Historical perspectives

Remember germs and how to combat them was discovered in the mid 1800s

Initially ill family members were cared for at home

Now ill members of society are cared for in the hospital

Chances of cross contamination are high

Application

Medical aseptic technique- “Practices intended to confine a specific

microorganisms to a specific area Protective – reduces the numbers of

potentially infectious organisms Clean – absence of almost all microorganisms Dirty – soiled, denotes the likely presence of

microorganisms some of which could cause an infection .”(Kozier)

Surgical Asepsis

Sterile technique “those practices that keep an area free of

all microorganisms” (Kozier) Including pathogens & spores

Application of Surgical Asepsis

During procedures that require internal perforation of a client's skin (IM or IV)

When the skin’s integrity is broken (surgical incisions or burns)

During procedures that involve the insertion of catheters or surgical instruments into sterile body cavities

(Potter & Perry 6thp. 802)

Sterilization Procedures

Steam Ethylene oxide

Gas sterilization Germicidal solutions

Client Preparation

Patient information/education

Pain relief

Elimination needs

Comfort needs

Principles of S.A.T.

The nurse must follow certain principles in order to maintain surgical asepsis

Failure to do could result in placing the client at risk for infection

These principles are same in all situations that requiring sterility. Injections, insertion of catheters etc.

A Sterile Object Remains Sterile Only

When Touched by Another Sterile Object

Sterile touching sterile remains sterile Use of sterile gloves & sterile forceps Sterile touching clean becomes contaminated

A Sterile Object Remains Sterile Only When Touched by Another Sterile Object

Sterile touching contaminated becomes contaminated

Sterile touching questionable is contaminated

When in doubt discard !

Only Sterile Objects May Be Placed on a Sterile Field Storage – must be dry and clean Appropriate preparation Packaging must be intact

A Sterile Object or Field Out of the Range of Vision or an Object Held Blow the Person’s Waist Is Contaminated

Never turn your back on a sterile field Sterile objects must be kept in view

A Sterile Object or Field Becomes Contaminated by Prolonged Exposure to Air Limit air currents Do not laugh, sneeze, or talk over a sterile

field- minimize movement around the sterile field

Reach around the sterile field When opening sterile equipment hold it as

close as possible without touching the field

When a Sterile Surface Comes Into Contact With a Wet, Contaminated Surface, the Sterile Object or Field Becomes Contaminated by Capillary Action

Packages must be intact Note the water proof barriers Work on a dry surface

Fluids Flow in the Direction of Gravity Surgical hand scrub Hold forceps with tip down

Edges of the Sterile Field or Container Are Considered Contaminated

I inch all the way around Pour liquid off open bottle discard and

then pour the liquid

Opening Sterile Packages

Be sure and review Starting p 805 Potter & Perry

Potter & Perry Chapter 33

Opening Sterile Packages

Adding Sterile items to a sterile field

Assisting a surgeon with gowning

Final comments

Professional responsibility Ethical component

Honesty Integrity “Do not harm”

Wrap Up Question

When a nurse is performing a surgical hand scrub he/she must keep hands: A. above the elbows B. Below the elbows C. At a 45 degree angle D. In a comfortable position

References

Potter, P.A., Perry, A. G. (2013) Fundamentals of nursing (8th ed.). St. Louis, MO: Mosby.