Sterile Field Maintenance (Aseptic Technique) for Certified Perioperative Nurse (CNOR)
Included In This Lesson
Outline
Sterile Field Maintenance (Aseptic Technique)
Guidelines:
- Perioperative patient care is based on surgical aseptic principles
- Careful adherence to surgical aseptic principles supports infection prevention and control and ultimately improves surgical
patient safety and outcomes - Infection control practices primarily focus on prevention
- Standard precautions should apply to all patients
Considerations:
- Follow manufacturer’s instructions for all surgical prep solutions
- Application
- Dry time
- If hair must be removed from surgical site, use clippers
- Create the sterile field with surgical drapes
- Create an appropriate barrier to microorganisms, particulate matter, and fluids
Nurse’s role:
- Patient Advocate
- Aseptic Technique
- Instruments, Equipment, and Supplies
- Environmental Factors
- Traffic Control
- Conflict Management
- Constant Vigilance
Pitfalls:
- Remember, Sterility is event-related
- If in doubt, throw it out! Items of doubtful sterility must be considered unsterile
- If sterile barrier is permeated, it is contaminated
- Sterile gowns are considered sterile in front from chest to level of sterile field and at the sleeves from 2 inches above the elbow to the cuff
- Once a drape is placed, it should not be moved
- Movement with or around sterile field must not contaminate the field
- When opening sterile items, unsterile person opens the side furthest away from the body first, then sides, then the side nearest the body. Opposite for sterile person opening sterile supplies
- If solution must be poured into a sterile receptacle on sterile table, scrub person holds it away from table or sets it near the edge to eliminate reach over sterile field
Examples:
- What is the most likely cause of contamination in the OR?
- The personnel
- That is why vigilance is key and if there is a question about whether or not sterility has been compromised, consider it compromised and take necessary steps to correct.
Linchpins (Key Points):
- Sterility is event-related
- If there is a question, it is contaminated
- Vigilance is a team effort and responsibility
- Protect the sterile field to protect the patient
Transcript
References
- Rothrock, J. (2019). Alexander’s Care of the Patient in Surgery (16th ed.). Elsevier Health Sciences.
- Association of perioperative Registered Nurses (AORN): Guideline Essentials (website), 2022, https://www.aorn.org/guidelines-resources/guidelines-for-perioperative-practice/guideline-essentials
NCLEX
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