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Principles of Sterile Technique

the circulating nurse must be an RN who

is fully trained in sterile technique

this nurse is regarded as clean but not

sterile and is charged with observing

the practices of correct sterile

technique throughout the procedure

should it breach in a sepsis occur the

circulating nurse who is responsible for

overseeing sterility is charged with

immediately notifying the surgeon and

team members then taking action to

correct this breach and prevent further

contamination the association of

perioperative registered nurses has

established standards and recommended

practices as guidelines to assist the

surgical team in achieving the highest

possible level of technical skill and

surgical asepsis

these guidelines include seven

principles principle one states that

scrubbed persons function within a

sterile field this means that in

addition to appropriate hand preparation

clean scrubs head covers shoe covers and

masks these individuals wear sterile

cover gowns and gloves and remain close

to the sterile field they must not come

in direct contact with non sterile

surfaces equipment or team members

during the procedure they also wear eye

protection and if facial hair is present

outside the confines of the mask this

must also be covered principle 2 states

that sterile drapes are used to create a

sterile field sterile drapes minimize

the transmission of microorganisms from

non sterile to sterile areas the patient

furniture and equipment included within

the sterile field are all draped leaving

only the surgical site exposed it is

important to remember that once placed

these drapes should not be moved

only the top surface that is the surface

above table or waist height is

considered sterile rearranging drapes

can mean that a portion of the drape not

considered sterile is moved up into the

sterile field compromising the sterility

of the sterile field principle 3 states

that all items used within a sterile

field must be sterile sterile and

non-sterile equipment and supplies must

never be mixed and if the protective

cover of any sterile package has been

compromised it must be considered

contaminated and not be used facility

policy may allow a dropped item to be

used for the current procedure if it has

an impervious outer wrapper that remains

intact but it must not be returned to

the shelf for later use if a dropped

item does not have an impervious wrapper

or if this wrapper has

damaged the pack must be returned for

reprocessing and a new package obtained

principle for states that all items

introduced onto a sterile field should

be opened dispensed and transferred by

methods that maintain sterility and

integrity principle five states that a

sterile field should be maintained and

monitored constantly this includes

preparing it as close to the beginning

of the procedure as possible left

unobserved the field is at risk from

airborne contaminants insects liquids

and inadvertent contamination by other

personnel principle six states that all

personnel moving within or around a

sterile field should do so in a manner

which maintains the sterile field all

scrubbed personnel should remain close

to the center of the field which is the

patient moving into the non sterile area

of the o.r or standing so you cannot

observe the field or touching anyone or

any surface while changing places with

another individual can all result in

contamination of the field finally

principle seven states that policies and

procedures for maintaining a sterile

field should be written reviewed

annually and readily available within

the practice setting