SURGICAL ASEPSIS

Definition:
The techniques that are designed to maintain the sterility of previously sterilized items
and to prevent the introduction of any microorganisms into the body.

Purposes:
1. To eliminate all microorganisms as well as vegetative states such as spores from
objects that comes in contact with the tissues of the body that are normally sterile.
2. To protect patients from possible infection

Principles And Practices Of Surgical Asepsis:

Surgical asepsis is indicated in the following instances:
a. Whenever the skin is unintentionally diseased or injured
b. Whenever a body cavity that is considered sterile such as the urinary bladder, is
inserted by a catheter.
c. Whenever the client’s skin is intentionally perforated or break for therapeutic
purposes like by a scalpel to make a surgical incision.

Nine basic principles of surgical asepsis:

a. All objects used in a sterile field must be sterile.
b. Sterile objects become unsterile when touched by unsterile objects.
c. Sterile items that are out of vision or below the waist level of the nurse are
considered unsterile.
d. Sterile objects can become unsterile by prolonged exposure to air.
e. Fluids flow in the direction of gravity.
f. Moisture that passes through a sterile object draws microorganisms from unsterile
surfaces above or below to the sterile surface.
g. The edge of any sterile field is potentially contaminated by microorganisms’
moving in from the outside.
h. The skin cannot be sterilized and is unsterile.
i. Conscientiousness, alertness and honesty are essential qualities in maintaining
surgical asepsis.

Guidelines For Working In Sterile Attire:

a. Everything below the waist or table height is considered unsterile.
b. Your back is considered potentially contaminated because you cannot see if it touches
anything unsterile.
c. When passing another person in sterile attire, pass either face to face or back to
back.
d. Sterility is a matter of certainty, not conjecture.
e. Moisture allows microorganisms to wick quickly and easily from one area to another.
f. Contamination commonly occurs accidentally.
 SURGICAL HANDWASHING/SCRUBBING

Definition:
Is the process of removing as many microorganisms as possible from the hands and
arms by mechanical washing and chemical antisepsis before participating in an operation

Purpose:
A surgical hand scrub is intended to render the skin of the hands as free of
microorganisms as possible. To wash and scrub hands and arms in a thorough manner inorder
to decrease the bacterial count and in preparation to a procedures that requires surgical
technique.

Indications:
1. To lowers the total count of microorganisms on the hands and arms.
2. To removes dirt and oil from the skin, decreasing the ability of the remaining
microorganisms to multiply.
3. To apply an antimicrobial residue on the skin and reduce the growth of
microorganisms during the operative procedures.

Special Considerations:
The exact technique for a surgical hand scrub varies among agencies. The practices that
follow should be carried out before beginning the scrub.
1. Nails must be short, clean, and free of nail polish
2. Hands and arms should be free of cuts, abrasions and other problems.
3. The cap should be in place and completely cover all the hair.
4. The mask should be in place.

Equipments:
 Antimicrobial solution
 Deep sink with foot, knee or elbow controls
 Towel (sterile) for drying hands
 Nail cleaners (file/orange stick)
 Surgical scrub brushes
 Mask and cap

PROCEDURES RATIONALE
1. Preparation for surgical hand scrub.
a. Begin with proper attire: To provide effective barriers that prevent the
dissemination of microorganisms

 a newly laundered scrub suit A loose-fitting uniform can contaminate the

with short sleeves (above hands if touches them.
elbows) which is well tucked in
the waist
 PROCEDURES RATIONALE
 a scrub cap that completely Hair is a gross contaminant and is also a
covers all hair and pierced-ear source of electrostatic spark.
studs

 a fresh disposable mask that Filters droplets containing microorganisms

fit snugly and comfortably expelled from the mouth and nasopharynx
over nose and mouth during talking, sneezing and coughing.

 shoes/slippers restricted to Reduces microbial transfer from the outside

wear in the department/OR into the area, protects wearer from spills
suit. into or onto shoes during procedures.

 eyewear or face shield if Worn to reduce risk of blood and body fluids
necessary from splashing into eyes.

b. Remove your wristwatch and rings. A wristwatch and rings can harbor
microorganisms and be damaged by water.

c. Inspect hands for cuts, abrasions or Skin integrity of hands and forearms should
other problems. be intact.

d. Ensure that fingernails are trimmed. Prevents harboring microorganisms and

puncturing gloves

2. Turn on the water and adjust the Warm water removes less protective oil from
temperature to lukewarm. the skin than hot water. Soap irritates the
skin more when hot water is used.

3. Holding hands above the level of the The hands will become cleaner than the
elbow, wet hands and forearms under elbows. The water should run from the least
running water from fingertips to the contaminated to the most contaminated
elbows. area.

4. Dispense liberal amount of Antiseptics alert the physical and chemical

soap/antiseptic solution (2-5 ml) into properties of the cell membrane of
hands. microorganisms, thus destroying or
inhibiting cellular function.
 PROCEDURES
5. Beginning at the fingertips, lather hands
and arms to 5 cm (2in.) above the
elbows using firm, rubbing, circular and
interlaced-fingers technique. Move from
fingertips to the elbows of one hand and
repeat to the second hand. Continue
washing for 20-25 seconds.
RATIONALE
Washing wide area reduced risk of
contaminating overlying gown and circular
strokes clean most effectively and rubbing
ensures a thorough mechanical cleaning
action.

6. Hold the hands and arms under the Antiseptic remaining on the skin is irritating.
running water to rinse thoroughly The nurse rinses from the cleanest to the
keeping the hands higher than the least clean area.
elbows.

7. Check the nails, and clean them with a Sediment under the nails is removed more
file or orange stick if necessary. Rinse readily when the hands are moist. Rinsing
the nail tool after each nail is cleaned. the nail tool prevents the transmission of
sediment from one nail to another.

8. Obtain sterile brush from container.

9. A. Using counted brush-stroke method Scrubbing looses bacteria, including those in

a. apply a liquid cleanser if the brush or the creases of the hands.
sponge is not impregnated with one.

b. Begin with fingernails, scrub the nails

of the left hand 30 strokes and all
skin surfaces 20 strokes, using the
anatomical pattern of scrub
previously outlined (Atkinson, 1992)
 four surfaces of each finger ,
thumb to fifth finger

 over dorsal surface of the hand,

small finger to thumb

 over palmar surface of the hand,

small finger to thumb

 over the wrist

 extend the scrub 2 in. (5cm)

above the elbow, giving elbow a
few circular strokes.
 PROCEDURES RATIONALE
c. Repeat step (b) for the right hand
and arm.

B. Time method
 apply a liquid cleanser if the brush
or sponge is not impregnated.

 scrub each hand for 45 seconds

 scrub each side of all fingers

including skin between each of the
fingers and the thumb and the
back and palm of the hand.

 awsdivide each arm into thirds (3

parts), scrub each lower forearm
15 seconds, each upper forearm
15 seconds, and the antecubital
space to marginal area above
elbow (2in.) 15 seconds.

10. Discard the brush without touching any After touching the skin, brush is
part of the sink. contaminated.

11. Rinse the hands and arms thoroughly so Rinsing removes resident and transient
that water flows from the hands to the bacteria and sediment.
elbows.

12. Turn off the water with the foot or knee To avoid contact with the faucet or sink
pedal. which make your hands contaminated.

13. Proceed to the sterile work area.

 WIPING HANDS AND ARMS WITH STERILE TOWEL

Definition:
A way of drying hands inorder to prevent chapping and wiping wet surfaces that is
present in the hands to avoid travels of microorganisms through moisture.

Purpose:
1. To dry hands appropriately.
2. To maintain sterility and prevent contamination.
3. To don gloving easily.

Special Considerations:
1. When one of the edges of the towel is touched by bare hands that area is considered
contaminated but the other edges which have not been touched, are still sterile.
2. Always dry hands from fingers to elbow (from cleanest to least clean area).

Equipments:
 Sterile package
 Sterile towels

PROCEDURE RATIONALE
1. Reach down to the opened sterile package To avoid contamination. Microorganisms
and pick up the towel directly as one, travel rapidly along any moisture area.
holding it away at all times. Be careful not
to drip water onto the pack or touch
sterile field with your bare hands. Be sure
no one is within arm’s reach.

2. Step back and open towel full-length, To prevent sterile towel touching unsterile
holding one full-length, holding one end attire.
away from non-sterile scrub attire. Bend
slightly forward to avoid towel touching
attire.

3. Dry both hands thoroughly by hold the
towel in opposite hand and using an
oscillating motion of the arm (slow,
circular rotating motion) from fingers up
to the elbow. Never return to an area you
already dried.
Moist skin rapidly becomes chapped and
subject to open sores. Thorough drying also
makes it easier to don sterile gloves. The
nurse dries the hands from the cleanest to
least clean area.

4. Push the cuticles of your fingernails back This helps to prevent ragged cuticle edges,
with the towel as you dry your hands. decreasing the possibility of harboring
bacteria
 PROCEDURE RATIONALE
5. Carefully reverse the towel, still holding it If one side of a dry object is touched, that
away from the body. Dry the opposite arm side is contaminated, but the opposite side is
on the unused end of the towel. still considered to be sterile.

6. Discard the towel.

7. Keep the hand in front and above waist. This position maintains the cleanliness of the
hands and prevents accidental contamination.
 GOWNING and CLOSED GLOVING

Definition:
(Gown/Gowning) Is a protective barrier worn over scrub suit to prevent penetration of
blood and body fluids from client to scrub suit and skin of the wearer. A two-person procedure,
that needs an assistant to put on a sterile gown safely.
Closed-glove technique provides a way to put on gloves without the possibility that they
will be touched on the outside by the bare hands. (Ellis, 1996)

Purpose:
1. To protect client from microorganisms which may be carried by the nurse
2. It provides a way to put on gloves without the possibility that they will be touched on
the outside by the bare hand.
3. To protect health workers and clients from transmission of potentially infective
materials.
4. To enable the nurse to work close to a sterile field and handle sterile objects freely.

Special Considerations:
1. Closed gloving method can be used only when a sterile gown is worn because the
gloves are handled through the sleeves of the gown.
2. Before these procedures, the nurse dons a hair cover and a mask and performs a
surgical hand wash.
3. Remember to keep hands above the waist and higher than the elbows at all times to
make sure they do not touch anything unsterile.
4. Do not turn your back from the sterile area.
5. Always remember the basic principles and guidelines in working in the sterile field
wearing sterile attire.

Equipments:
 Sterile package containing sterile gown

PROCEDURE
1. After scrubbing, dry one hand and arm,
starting with the hand and ending at the
elbow, with one end of the towel. Dry the
other hand and arm with the opposite end
of the towel. Drop the towel.
RATIONALE
Moist skin rapidly becomes chapped and
subject to open sores. Thorough drying also
makes it easier to don sterile gloves. The
nurse dries the hands from the cleanest to
least clean area.

2. Pick up the gown in such a manner that To prevent touching the outside area, thus,
hands touch only the inside surface at the maintaining the sterility of the gown.
neck and shoulder seams.

3. Step back away from the table into To prevent gown from touching an unsterile
unobstructed area and extend the arms at object and provide a wide safety while
shoulder level. gowning.
 PROCEDURE RATIONALE
4. Keeping arms extended and elbow slightly The gown will be unsterile if its outer surface
flexed, locate the neck band and hold touches an unsterile article.
gown securely with both hands.

5. Holding the inside front of the gown just To prevent contaminating the outside area
below the neckband with both hands, (sterile) of the gown, this will be in contact in
allow the gown to unfold downward in the sterile field.
front of you by gently shaking it keeping
the inside part of the gown toward the
body. Do not touch the outside of the
gown with bare hands.

6. Locate the arm holes.

7. Work your hands and arms carefully into
the gown and into the sleeves, as far as
the seam between the sleeve and the cuff.
Take your time and proceed slowly. Do not
push your hands out through the ends of
the sleeves and making sure the sleeves
do not touch an unsterile object.
Hands are not sterile and touching would
contaminate the gown. The sleeves should be
considered sterile from 2 inches above the
elbow to the cuff, since arms of a scrubbed
person must move across the sterile field.

8. The circulating nurse brings gown over the The inside of the gown is considered
shoulders by reaching inside to shoulder contaminated and thus may be touched by
and arm seams, pulling it securely onto the unsterile person.
shoulders and tie the neck and back
waistline ties.

9. Using the closed-glove technique, put on

the sterile gloves.
a. Use your left hand still inside the
gown to pick up the folded edge of
the right glove.

b. Hold your right hand out, with the

palm up, still inside the sleeve.

c. Lay the right glove on the right This position helps to wear the gloves easily
palm (which is still inside the and avoiding the gloves to drop into the floor.
sleeve). Position it with the glove
fingers pointing toward the elbow
and the cuff end pointing toward
the fingertips. The thumb of the
glove should be over the thumb of
the right hand.
d. Using the right hand (which is still Contact of gloved hand with exposed hand
 inside the gown sleeve) to grasp results in contamination.
the bottom fold of the cuff end of
the right glove.

e. With the left hand (which is still

inside the gown sleeve), grasp the
right glove cuff by the top fold of
the cuff end, and pull the right
glove cuff up and cover the right
gown cuff.

f. Adjust the right glove cuff over the This helps prevent accidental contamination
right gown cuff keeping the left of the glove by the bare hand. Cuff protects
hand inside the gown. gloved fingers. Sterile to sterile prevents
glove contamination.

g. Pick up the left glove with the

gloved right hand.

h. Hold left hand, palm up, inside the

gown sleeve.

i. Place the left glove on the left palm Ensure smooth fit over fingers.
(which is still inside the gown),
with the glove fingers pointing
toward the elbow and the cuff end
pointing toward fingertips. Position
the glove thumb over the left
thumb of the hand.

j. Using the left hand (which is still

inside the gown) to grasp the
bottom fold of the cuff end of the
left glove.

k. Grasp the top fold of the cuff edge

with the gloved right hand, and pull
the glove cuff up and over the
gown cuff.

l. Work the left hand down into the

left glove.

m. Turn up and adjust the cuffs of

both gloves
n. Pull the glove fingers out at the
 ends to reposition the fingers if
necessary.
10. The gowned nurse bends forward to make
the ties fall away from the gown. These
are then tied by the circulating nurse after
grasping the end of the ties and by not
touching the front of the gown.
11. If the top of the gown drops downward or
contaminated at any point, remove and
discard the gown and repeat the
procedure.
Care must be taken not to permit neckties to
fall forward t the front of the gown as this
would contaminate the gown. Waist ties are
sterile until touched by the circulating nurse.
Contact with any unsterile object makes the
gown unsterile. When worn, sterile gowns
should be considered sterile in front from the
chest to the level of the sterile field.
 ESTABLISHING AND MAINTAINING A STERILE FIELD

Definition:
A sterile field is a microorganisms-free area. A sterile field is often established by using
the innermost side of a sterile wrapper or by using a wrapped sterile drape. Sterile objects may
then be placed on the sterile field and still be sterile.

Purpose:
1. To ensure that sterile items remain sterile.
2. To protect patients from possible infection when normal body defenses are not intact.

Special Considerations:
1. In preparing a sterile field, the nurse may use gloved or ungloved hand.
2. The most important principle to follow in preparing a sterile field is to AVOID
CONTAMINATION by:
a. not reaching over a drape
b. not allowing the drape’s sterile surface to touch the client
c. not allowing the drape to touch the uniform
3. The work area should be above waist level.
4. Sterile supplies should not be opened in a confined space where dirty objects might
fall on or strike them.
5. Before preparing the area, the nurse’s hands must be thoroughly washed before
opening any sterile item.

Equipments:
 Package containing sterile drape
 Sterile equipment as needed, eg, wrapped sterile gauze, a wrapped sterile bowl,
antiseptic solution and sterile forceps

PROCEDURE RATIONALE
A. Arranging a Sterile Field
1. Wash hands. To prevent transfer of microorganisms.

2. Choose a flat, hard, dry surface and To have plenty of room to work.
clear sufficient area on which to
prepare a sterile field.

3. Before sterilization, objects are They can be opened without contamination

wrapped and the wrapper when the contents.
opened provides a sterile field.
 PROCEDURE RATIONALE
4. Determine the sterility of the package, Moist package is considered contaminated
ensure that the package is dry, check and must be discarded. An expired sterile
the expiration dates and look for supply should never be used.
indications that it has been previously
opened.

B. Opening a Sterile Pack

5. Place the package in the center of the This position prevents subsequent reaching
work area so that the top flap of the directly over the exposed sterile contents,
wrapper opens away from you. which could contaminate them.

6. Reaching around the package (not Touching only the outside of the wrapper
over it), pinch the first flap on the maintains the sterility of the inside part of the
outside of the wrapper between your wrapper.
thumb and index finger. With some
folded packages, it may be necessary
to grasp the uppermost flap at each
corner. Pull the flap open, laying it flat
on the far surface.

7. Side flaps are opened one at a time, To watch each flap being opened lowers the
opening the top one first. Use the right risk of contamination. Using both hands
hand for the right flap, and the left avoids reaching over the sterile contents.
hand for the left flap.

8. Pull the fourth flap toward you by If the inner surface touches any unsterile
grasping the corner that is turned article, it is contaminated
down. Make sure that the flap does not
touch your uniform.

C. Opening a wrapped package while

holding it.
9. Hold the package in one hand with the The hands are considered contaminated, and
top flap opening away from you. at no time should they touch the contents of
the package.
 PROCEDURE RATIONALE
10. Open the package as described above Sterility is maintained when sterile objects are
using the other hand, pulling the placed within a sterile area.
corners of the flaps well back.

Note: Inside the wrapper is considered

sterile except for the 1 inch border around
the edges, and may be used as base for
sterile field or as a field to add additional
items.

D. Closing a wrapped package

11. Pick up the flap closest to you, The corner is contaminated because it was
handling it at the corner, and lay it touched, so it should not touch the contents.
over the contents. Make sure the
corner is folded toward you, as it was
before the flap was opened.

12. Select the side you opened third. Pinch
the side flap from the underside and
lay it over the contents. Use right hand
for the right flap and left hand for the
left flap.
By this method the nurse avoids touching the
inner sterile surface of the wrapper and
avoids reaching over the sterile contents and
thereby contaminating them.

13. Repeat for the other side.

14. Pinch the far flap from the underside

by reaching around the package and
bring the flap over the contents. Tuck
it in loosely.

15. Use the rewrapped package

immediately.

16. Reopen the package by using the Although the contents are covered, they will
method above. not remain sterile for any length of time
because the package is loosely wrapped.
 PROCEDURE RATIONALE
E. Opening commercially prepared
packages
17. If the flap of the package has an Using the same sequence of steps should
unsealed corner, hold the container in keep the contents sterile.
one hand, and pull back on the flap
with the other hand.

18. If the package has a partially sealed Commercially prepared sterile packages and
edge, grasp both sides of the edge, containers usually have manufacturer’s
one with each hand and pull apart directions for opening.
gently.

19. Rewrap the sterile package as required

by reversing the order to unwrapping.
Close the proximal flap first to prevent
reaching across the sterile field, the
side flaps next and the distal part last.

F. Establishing a sterile field by using a

drape
20. Open the package containing the drape To perform sterile procedures, the nurse
as described above. needs a sterile work area fro handling and
placing sterile items.

21. Pluck the corner of the drape that is If the drape touches the outside of the
folded back on the top using one hand. package, the uniform or any unsterile surface,
it is considered contaminated.

22. Slowly lift the drape out of the cover

and permit it to open freely without
touching any articles. Discard the
cover.

23. With the other hand, gently pick up

another corner of the drape holding it
well away from the body.

24. Put the drape on a clean, dry surface, Placing the lowermost side farthest away, the
placing the bottom farthest from you. nurse avoids leaning over the sterile field and
contaminating it.
 PROCEDURE RATIONALE
25. Allow the top half of the drape to be
placed over the work surface last.

26. Grasp the 1-inch border around the If gloves are not worn, the nurse may touch
edge to position as needed. only a 1-inch border along the drape’s edge
which is considered unsterile.

G. Adding necessary supplies

A. To add wrapped supplies to a
sterile field.
27. Open each wrapped package as
described above.

28. With the free hand, grasp the corners The unsterile hand is now covered by the
of the wrapper and hold them against sterile wrapper.
the wrist of the other hand.

29. Place the sterile bowl, drape and other

supplies on the sterile field by
approaching from an angle rather than
holding the arm over the field.

30. Discard the wrapper.

B. To add commercially packed

supplies.
31. Open each package.

32. Hold the package 15 cm (6 in.) above At a height of 15 cm (6 in.), the outside of
the field and permit the contents to the package is not likely to touch and
drop on the field. Keep in mind that contaminate the sterile field.
2.5 cm (1 in.) around the edge of the
field is considered contaminated.

C. To add sterile solution to a sterile

bowl
33. Before pouring any liquid, read the To prevent error by using the wrong solution.
label, name of the solution three times
to make sure you have the correct
solution.
 PROCEDURE
34. Obtain the exact amount of the
solution as possible.
35. Remove the lid or cap from the bottle
and invert the lid before placing it on a
surface that is not sterile.
36. Hold the bottle so that the label is
uppermost.
37. Hold the bottle of fluid at a height of
10-15 cm (4-6 in) over the bowl and to
the side of the sterile field so that as
little of the bottle as possible is over
the field.
38. If the bottle had been previously
opened, pour small amount of liquid
into a waste receptacle without letting
the tip of the bottle to touch the
receptacle. Carefully pour the solution
so as not to splash the liquid.
39. Replace the lid securely on the bottle if
you plan to use it again, label it with
date and time of opening.
H. Handling sterile forceps
40. Keep the tips of wet forceps lower than
the wrist at all times unless wearing
sterile gloves.
41. Hold sterile forceps above waist level.
42. Hold sterile forceps within sight.
RATIONALE
Once a sterile container has been opened, its
sterility cannot be assured for a future use
unless it is used again immediately.
Inverting the lid maintain the sterility of the
inside surface because it is not allowed to
touch an unsterile area.
Any solution that flows down the outside of
the bottle during pouring will not damage or
obliterate the label.
At this height there is less likelihood of
contaminating the sterile field by touching the
field or by reaching an arm over it.
Cleanses the lid of the bottle, any moisture
will contaminate the field by facilitating the
movement of microorganisms through the
sterile drape.
Replacing the lid immediately maintains the
sterility of the inner aspect of the lid and the
solution.
Gravity prevents liquids on the tips of the
forceps from flowing to the handles and later
back to the tips making the forceps
contaminated. The handles are contaminated
once they are handled by bare hands.
There is less danger of contamination if the
forceps are held near to eye level.
Forceps that are out of sight may
inadvertently become contaminated and
therefore should be considered contaminated.
 PROCEDURE RATIONALE
43. When using forceps to lift sterile The edges and outside of the package are
supplies out of a commercially exposed to the air and handles and are thus
prepared package, be sure that the contaminated.
forceps do not touch the edges or
outside of the package.

44. When the handles of the forceps were The handles of the forceps harbor
in contact with the bare hands, microorganisms from bare hand.
position the handles outside the sterile
area.

45. Deposit a sterile item on a sterile field Barrier drapes prevent a sterile field from
without permitting moist forceps to becoming unsterile when the drape becomes
touch the sterile field when the surface wet.
under the absorbent sterile field is
unsterile and a barrier drape is not
used.

46. Discard disposable forceps after use or To maintain sterility of the

send reusable forceps fro repacking forceps/equipments.

and sterilization or immersing them in

a solution.
 ISOLATION

Definition:
Isolation techniques are practices that limit the spread of communicable pathogen. To set
apart from the environment so that organisms cannot be readily transferred from one person to
another.

Purpose:
1. To create a physical barrier that prevents the transfer of infectious agents.
2. To prevent secondary infection in the isolated client.
3. To prevent the spread of microorganisms from the patient to the environment or from
environment to the patient.
4. To reduce the number of pathogens and confine them to a specific area.

Two Main Systems for placing the patient in isolation:

A. Disease-specific precautions – each infectious disease is considered separately and
necessary guidelines and procedures need to be followed to attain a goal.
B. Category-specific precautions – approach that divides infectious diseases into a few
broad categories, which are determined by how the organisms are transmitted.

Equipments:
The equipment required depends upon the type of isolation precautions.
 Sink with liquid antimicrobial soap
 Paper towels
 Waste container
 Laundry hampers to collect used linens
 Table to place supplies, e.g stethoscope, thermometer and other supplies
 Clean supplies like gowns, plastic bag, disinfectant solutions, masks, disposable
gloves and plastic disposal bags

PROCEDURE RATIONALE
1. Check the type of isolation ordered for the When traditional isolation precaution are to
patient. be implemented the nurse first confirms the
precautions that are appropriate for the
client, and determines the type of isolation
required and the reason to prevent acquiring
and spreading the disease.

2. Identify the type of infection or the reason

for protective precautions.

3. Check the equipment on the stand outside To be sure you have everything you need.
the door or in the anteroom and inside the
room.

PROCEDURE RATIONALE
4. Perform handwashing. For infection control.
5. Gather and arrange all the equipments For client’s safety, comfort and for effective
needed. practice.

6. Identify the patient from the door and. To be sure you are performing the procedure
for the correct patient.

7. Explain the procedure to the patient and To alleviate patient’s anxiety and to validate if
assess client’s understanding of the the patient understands the procedure.
procedures and need for information.

8. Upon entering the room, carry out the

aspects of isolation technique necessary
for the patient according to the type of
isolation used.

9. Give care as planned, using appropriate

techniques.

10. During the employment of isolation To plan actions necessary to avoid arising
precautions, continually assess the client’s complications.
need for stimulation. Note the clinical
signs of boredom, sensory deprivation and
anxiety.

11. Arrange a teaching plan as needed for the

client and support persons.

12. Carry out techniques necessary to leave To avoid cross-contamination and for safety
room. reasons.

13. Reassess the client regularly to determine To assess if continuity of isolation precaution
if isolation precautions continue to be still be necessary.
necessary.
 PROCEDURE RATIONALE
14. Record on the client’s chart those isolation To document and would serve as a basis of
precautions have been implemented. Cite continuity of care and for legal purposes.
the type, time and client’s response.

15. Evaluate using the following criteria:

a. Necessary equipment readily
available
b. Isolation procedure correctly
carried out
c. Patient left comfortable and safe
d. No nasocomial infections originate
from this patient.