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Asepsis and Aseptic

Practices in the
Operating Room
Introduction
• The goal of asepsis and aseptic
practice in the operating room is to
prevent the contamination of open
surgical wounds.
• The nurses surgical team
accomplishes this by creating and
maintaining the sterile field and by
following aseptic principles aimed
at preventing microorganisms from
contaminating the surgical wound.
Principles of aseptic
:techniques
1. The patient is the center of the
sterile field.
2. Persons who are sterile touch only
sterile articles; persons who are not
sterile touch only unsterile articles.
3. Unsterile persons do not get close
than 12 inches from a sterile field.
1. sterile persons are gowned and
gloved:
B. Keep hands at waist level and
insight at all times.
C. Keep hands away from the face.
D. Never fold hands under arms.
E. Gowns are considered sterile in
front from the waist to shoulder
level and the sleeves from above
the elbow cuffs>
F. Sit only if sitting for entire
procedure.
G. Articles dropped below waist level
are discarded.
1. Sterile persons keep well within
the sterile area and follow those
rules from passing:
B. Face to face or back to back.
C. Turn back to non-sterile person or
when passing.
D. Faces a sterile area when passing
the area.
E. Step back away from the
F. sterile field to sneeze or cough.
G. Stand back at a safe distance
from the operating table when
draping the patient.
1. Non sterile persons when are
observing a case, please stay in the
room until case is completed. Do not
wander from room to room as
traffic in the operating room should
be kept as a minimum.**patient
privacy needs to be respected.
2. Tables are sterile only at table level:
 Anything over the edge is
considered unsterile, such as a
suture or the table drape.
 Use non-perforating device to
secure tubing and cords to prevent
them sliding to the floor.
1. Sterile drapes are used to create a
sterile field:
B. Only scrubbed personnel should
handle sterile draped.
C. Te drapes should be held higher
than the OR bed.
D. Patient draped from the prepped
incisional site out to the periphery.
1. Sterile persons touch only sterile
items or areas; unsterile persons touch
only unsterile items or areas:
B. Sterile team members maintain contact
with sterile field by wearing gloves and
gowns.
C. Supplies are brought to sterile team
members by the circulator, who opens
wrappers on sterile packages. The
circulator ensures a sterile transfer to
the sterile field. Only sterile touch
sterile surfaces.
1. Unsterile persons avoid reaching
over sterile field; sterile persons
avoid leaning over unsterile area:
B. Scrub person sets basins to be filled
at edge of table to fill them.
C. Circulator pours with lip only over
basin edge.
D. Scrub person drapes an unsterile
table toward self first to avoid
leaning over an unsterile area . Cuff
drapes over gloved hands.
E. Scrub person stands back from the
unsterile table when draping it to
avoid leaning over an unsterile are.
1. Edges of anything that encloses
sterile contents are considered
unsterile:
B. When opening sterile packages,
open away from you first. Secure
flaps so they do not dangle.
C. The wrapper is considered sterile
to within one inch of the wrapper.
D. In peel-open packages, the edges
where glued, are not considered
sterile.
1. Sterile field is created as close as
possible to time of use:
B. Covering sterile tables is not
recommended.
3. Sterile areas are continuously kept
in view:
D. Sterility cannot be ensured without
direct observation. An unguarded
sterile field should be considered
contaminated.
1. Sterile persons keep well within
sterile area:
B. Sterile persons pass each other
back to back or front to front.
C. Sterile person faces a sterile area
to pass it.
D. Sterile persons stay within the
sterile field. They do not walk
around or go outside the room.
E. Movement is kept to a minimum to
avoid contamination of sterile items
or persons.
1. Unsterile persons avoid sterile
areas:
B. Unsterile persons maintain distance
of at least 1 foot from the sterile
field.
C. Unsterile persons face and observe
sterile area when passing it to be
sure they do not touch it.
D. Unsterile persons never walk
between two sterile fields.
E. Circulator restricts to a minimum
all activity near the sterile field.
1. Destruction of integrity of
microbial barriers results in
contamination:
B. Strike through is the soaking
through of barrier from sterile to
non-sterile or vice versa.
C. Sterility is event related.
4. Microorganisms must be kept to
irreducible minimum:
E. Perfect asepsis is an idea. All
microorganisms cannot be
eliminated. Skin cannot be
sterilized. Air is contaminated by
droplets.

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