Sterile Field Maintenance (Aseptic Technique) for Certified Perioperative Nurse (CNOR)

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