Operating Room Nurses Knowledge and Practice of Sterile Technique 2167 1168.1000113
Chapter 2 Sterile Technique
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Transcript of Chapter 2 Sterile Technique
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 2Sterile Technique
Chapter 2Sterile Technique
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Hospital Acquired Infections (HAI) Hospital Acquired Infections (HAI)
• Also known as nosocomial infections
• Acquired by patients whose natural defenses against infection are often missing or overridden in the health care setting
• HAIs are very expensive in terms of money and human life
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Hospital Acquired Infections (HAI) (cont.) Hospital Acquired Infections (HAI) (cont.)
• The CDC estimates that 250,000 patients a year get an HAI just from urinary catheters alone
• Patients with an HAI need additional treatment and longer hospital stays, and incur higher health care costs
• The CDC also reports that between 10% and 25% of patients who acquire an HAI die
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Sterile TechniqueSterile Technique
• Involves:
– Creating a sterile field (a microbe-free area to work in)
– Using equipment and supplies that have been made sterile (completely free of microbes) to minimize the risk of infection
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Levels of Sterilization for Equipment and SuppliesLevels of Sterilization for Equipment and Supplies
Category I: Critical—for items that carry a very high risk because they penetrate the skin or are placed in body cavities that are normally free of microbes
Category II: Semi-critical—for items that come into contact with mucous membranes and carry a moderate risk for causing infection
Category III: Non-critical—for items that come into contact with intact skin and carry a lower risk for causing infection
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
High-level DisinfectionHigh-level Disinfection
• Involves using a very strong chemical to kill microbes on items that will come in contact with a person’s skin or mucous membranes
• Kills almost all microbes except for some bacterial endospores
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SterilizationSterilization
• The most complete method of killing all microbes
• Kills microbes as well as endospores
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
QuestionQuestion
What is the most complete method of killing all microbes as well as endospores?
A. High-level disinfection
B. Sanitation
C. Sterilization
D. Disinfection
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
C. Sterilization
Sterilization is the most complete method of killing all microbes; it kills microbes as well as endospores.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Sterile PackagesSterile Packages
• Fabric-wrapped: items inside are sterilized onsite
• Envelope-wrapped package: one corner is opened at a time to create a sterile field; may be made of fabric or paper
• Peel/sterilization pouches: small sterile items wrapped in a combination of paper and plastic. Both sides are peeled at the same time, enabling the user to carefully drop the item onto the sterile field
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Indications That an Item Is SterileIndications That an Item Is Sterile
• Commercially prepared items have writing on the outside of the packaging
• Items that are sterilized onsite will have two chemical indicator strips
– Outside strip changes color after being processed
– Indicator strip inside the package will also change color to show the sterilizing agent penetrated the packaging
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Indications That an Item Is Sterile (cont.)Indications That an Item Is Sterile (cont.)
• The sterility of items is maintained as long as a sterile package is stored properly and the packaging material is not damaged or placed on a wet surface
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
QuestionQuestion
Tell whether the following statement is true or false.
Sterilized items usually reach expiration in about one (1) year
A. True
B. False
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
B. False
Sterilized items have no expiration date.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
When Creating a Sterile Field, You Need: When Creating a Sterile Field, You Need:
• A sterile area where other sterile supplies can be opened, arranged, and moved around
• A place where sterile supplies can be opened in a manner that does not contaminate them or the sterile field
• Sterile gloves to arrange and use sterile supplies within the sterile field, and, if you wish, sterile transfer forceps to move items around within the sterile field.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Procedures That Require a Sterile FieldProcedures That Require a Sterile Field
Inserting urinary catheters
Giving injections
Starting intravenous (IV) lines
Changing sterile dressings
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
QuestionQuestion
All instruments, supplies, and gloved hands remain sterile so that _______ are not introduced into the body
A. Asepsis
B. Calories
C. Microbes
D. Disinfection
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
AnswerAnswer
C. Microbes
Sterilization prevents endospores and microbes from entering the body.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Guidelines for sterile itemsGuidelines for sterile items• a sterile object may not touch a nonsterile object
• sterile objects must not be wet. Moisture draws microorganisms into the sterile object
• a one in border is between an sterile area and a nonsterile area (place sterile items in the center of the sterile field away from the edges)
• do not turn your back on a sterile field ( you can’t see the field and don’t know what touched it)
• Anything below the waist is considered out of the sterile range (all surgery trays should be positioned above the waist, hold all above waist)
• All sterile objects must be held in front and away from the body
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Do not cough, sneeze, or talk over a sterile field
Do not reach over the sterile area
Do not pass contaminated dressings or instruments
over the sterile field.
Contaminated instruments should be placed in a
separate container or area
Be aware of actions in order to determine if the
sterile field has been compromised
Guidelines for sterile item
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Outer wrapper of sterile packages are contaminated
and should be opened without touching the inner
contents
Sterile solutions in bottles should be poured into
sterile basins or sups on the sterile field without
touching the rim of the bottle and without splashing
solution onto the sterile
Guidelines for sterile items
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Using an Envelope-Wrapped PackageUsing an Envelope-Wrapped Package
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
Using a Sterile DrapeUsing a Sterile Drape
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Pouring Liquid Into a Sterile ContainerPouring Liquid Into a Sterile Container
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Transfer ForcepsTransfer Forceps
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Sterile Gloves Sterile Gloves
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THINK ABOUT ITTHINK ABOUT IT
• You are working at the bedside of Mrs. Thomas, preparing to assist the nurse with a sterile dressing change. You have created a sterile field on the over-bed table and you are arranging the supplies for the nurse to use. Mrs. Thomas is occasionally a bit disoriented as the result of her pain medication. Suddenly, she reaches up to the field and removes a stack of gauze sponges you have just arranged. What should you do? What steps could you take to prevent this from happening in the future?
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
• You must discard the sterile field and set up a new one. Explaining to Mrs. Thomas that sterile technique is being used to lower her risk of infection and helping her to understand how sterility is maintained may help to prevent this from happening in the future.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
THINK ABOUT ITTHINK ABOUT IT
• You are preparing to set up a sterile field and open sterile supplies for a procedure in a patient’s room. You plan to arrange your sterile field on the over-bed table. What must you do to prepare this area before setting up the sterile field?
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
• The over-bed table must be cleaned with a disinfectant, and dried thoroughly.
Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins
THINK ABOUT ITTHINK ABOUT IT
• It is time for the sutures to be removed from Mr. Wilson’s wound. Kari, the nurse you are working with, is preparing to carry out this procedure using sterile technique. You have assisted her by setting up the sterile field and opening the sterile supplies. You are now wearing sterile gloves and have everything neatly arranged for the procedure. Right before Kari starts to clean Mr. Wilson’s wound, you notice a hole in one of your gloves, and you are not sure how it got there. What should you do?