Nurse advocacy for sterile technique?
String surgical conscience
- speaking up if break in sterile technique occurs
Ethical + moral responsibility
Maintaining sterile field and monitoring activity in room
What is asepsis?
Absence of infectious organisms
Event related sterility?
Sterility based on factors such as packaging, storage, transport, handling or environmental conditions
Isolation technique?
Contaminated instruments and equipment are removed from sterile field
- bowl technique, contamination technique
Perforation indicator technique?
Double gloving system
Coloured pair of gloves worn beneath standard pair of gloves
What does sterile mean?
Free of living organisms
What is a sterile field?
Area surrounding the site of surgery that has been prepared for invasive procedure
- working areas
- furniture
- equipment covered with sterile drapes/accessories
Personnel sterile attire
Sterile technique?
Specific concerns and sci-fi vids to prevent contamination and maintain sterility
Surgical helmet system?
A non sterile, reusable helmet with a built in ventilation fan covered with a single use disposable mask/hood
“Space suit”
What is a wound protector?
A double ring, self retaining device that is designed to protect the incision during surgical manipulation
Used in abd surgeries
- decreases incision area from becoming infected with bacteria from GI/biliary tract
When should a sterile field be prepared?
In location it will be used
As close to time of use as possible
What are items with doubtful sterility considered to be?
Contaminated
Ex - break in packaging
A sterile field can have non sterile items in it?
No.
Use only sterile items in sterile field
A sterile field is contaminated when a non sterile item comes in contact with it
Sterile persons touch only sterile items
Where is a sterile field?
Front of sterile gown from chest to level of instrument table/OR bed
From sleeve up to 2inch above elbow
-cuff considered unsterile and need to remain covered by gloves
Movement in the OR around sterile field
Cover during periods of high activity
- repositioning
Limit movement and door opening
Cover if not being used right away
What are edge of sterile packs considered?
Non sterile
What if there is more than one wound class in a surgery?
May need more than one sterile field
Before preparing sterile field?
Surgical attire - change when contaminated - remove at end of shift Hand hygiene Surgical mask Opening supplies
This to check when opening sterile supplies?
Check packaging
Expiration date
Single use item sterility
Chemical indicators of sterilization
Why do rigid containers have filters?
Holes in lid and bottom
- filters allow sterilant to enter and exit container and prevent contamination from entering the container through holes
How to open rigid container?
Inspect for damage and debris that may affect seal
Identify external indicators - intact/Color change
Remove external indicators entirely 
Lift lid up and away from container towards self as you back away
Inspect the interval indicators and filters before removing instrument basket
Wrapped items?
Blue wraps used to wrap items for sterilization
- inside usually has alternate colour
How to open wrapped items?
Inspect - integrity, Color change Open top away from you Open side flap and contain in hand Open 2nd flap Open final flap towards self
Opening peel packs?
Intended for use when additional or replacement items is needed in strike field
- broken seal = contaminated
Double peel packs?
Small pack inside large
Clear sides match up to see inside item
Opening peel pack?
Inspect
Open corners at chevron end
Gently pull apart
Present to scrub personnel
Contamination of peel pack occurs when?
Peel pack rips
Flaps fall back on item
Contents slide over the unsterile edge
Transferring medications into sterile field?
One med/solution at a time
Transfer close to time of use
Scrub nurse and circulator nurse verify med/solution
Circulator nurse pours into sterile transfer device that is placed at edge of sterile field
Scrub brush immediately labels
What should circulator and scrub nurse verify for solution/med before adding to sterile field?
Name
Strength
Dosage
Expiration date
Why is hand hygiene so important for sterile technique?
Most effective measure to prevent the transmission of pathogenic microorganisms
Transient vs resident flora
Transient - acquired by direct contact and removed by mechanical friction
Resident - flora below the skin surface and removed by chemical action
