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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)