Establishing and Maintaining a Sterile Field PDF

Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ Establishing and Maintaining a Sterile Field Definition of sterile field:  It is a desi...

Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ Establishing and Maintaining a Sterile Field Definition of sterile field:  It is a designated area which is free of microbes and other pathogens that can infect someone.  It is a sterile surface on which to place sterile equipment that is considered free from microorganisms. Purposes:  Reduce the number of microbes present to as few as possible  Used in operating room and any surgical procedure outside operating room Safety considerations:  Check physician orders and hospital policy regarding procedure.  Instruct patient how to assist throughout the procedure (e.g., lying still, not talking over the sterile field or touching sterile objects)  Check dressing on wound to assess for required supplies needed for the procedure.  Offer analgesic and/or bathroom to ensure patient comfort throughout the procedure.  Explain procedure to the patient and give an approximate time frame for completing the procedure. Equipment:  Flat work surface.  Package containing a sterile drape  Wrapped sterile gauze B. Bowl & scissors and forceps  Antiseptic solution.  Packaged sterile gloves. 32 Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ The procedure: Steps Rational 1. Perform hand hygiene, gather  Gathering additional supplies at the same supplies, check equipment for time will help avoid leaving the sterile field sterility, and gather additional unattended. Prepackaged sterile kits may supplies (gauze, sterile cleaning not have all the supplies required for each solution, sterile gloves, etc.). procedure. 2. Place package on clean, dry,  A clean, dry surface is required to set up a waist-level table. sterile field.  Items below waist level are considered contaminated.  Prepare sterile field as close to the time of procedure as possible. 3. Remove the outside sterile  This allows more space to set up a sterile packaging and discard. field. 33 Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ 4. Grab the outer surface‘s  The one-inch border on the sterile field is outermost tip (corner of folded considered non-sterile. Make sure your drape) and open the flap away arm is not over the sterile field. from you.  The inside of the sterile packaging is your sterile drape.  Stand away from your sterile field when opening sterile packaging. Open first flap 5. Grab the side flaps and open  Touch only the one-inch border on the outwards, and let it lie flat on the sterile field. Do not reach over the sterile table. field. Second flap Third flap 34 Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ 6. Grasping the outermost corner, This step creates an open sterile field. pull the last flap toward you, and lays it flat on the table. Remove forceps prior to opening last flap Open last flap towards you Adding Sterile Items to a  This step saves time for completing sterile Sterile Field procedure; it also limits the amount of time the sterile field is exposed to air. 7. Using sterile forceps, rearrange sterile equipment on the sterile field in order of usage. Arrange sterile items on field Sterile field 35 Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ 8. Supplies can be opened  Gently drop items onto the sterile field or (following packaging directions), use sterile forceps to place sterile items onto then gently dropped onto the the field. sterile field.  If using equipment wrapped in linen, ensure sterility by checking the tape for date and to view chemical indicator (stripes on the tape ensure sterility has been achieved).  When using paper-wrapped items, they should be dry and free from tears. Confirm expiry date.  Do not flip or toss objects onto the sterile field. Add sterile items to sterile field Add sterile supplies 36 Medical Surgical Nursing Departement Clinical Lectures of Adult Health Nursing I _________________________________________________________________________________________ 9. Add solution to the sterile tray  Do not touch the edge of the solution by pouring the solution carefully receptacle. Place the receptacle near the into the receptacle: edge of the sterile field.  Verify solution and expiry date.  Open cap and place face up on non-sterile surface.  Hold bottle two inches above Sterile solution receptacle and pour the required amount slowly and without splashing.  If bottle is multi-use, recap and label it with the date and time of opening. Most sterile Add sterile solution to the sterile field solutions are good for 24 This ensures the sterility of the solution and hours. the use of the correct solution. It also ensures the bottle of solution does not come in contact with the sterile field. Lastly, it verifies the type of solution required for the procedure. Be careful not to drip solution onto the sterile field, causing contamination. (When liquid permeates a sterile field it is called strike through.) 37