Other principles that are applied to maintain asepsis include

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All items in a sterile field must be sterile. Sterile packages or fields are opened or created as close as possible to time of actual use. Moist areas are not considered sterile. Contaminated items must be removed immediately from the sterile field. Only areas that can be seen by the clinician are considered sterile, i.e., the back of the clinician is not sterile. Gowns are considered sterile only in the front, from chest to waist and from the hands to slightly above the elbow. Tables are considered sterile only at or above the level of the table. Nonsterile items should not cross above a sterile field. There should be no talking, laughing, coughing, or sneezing across a sterile field. Personnel with colds should avoid working while ill or apply a double mask. Edges of sterile areas or fields (generally the outer inch) are not considered sterile. When in doubt about sterility, discard the potentially contaminated item and begin again. A safe space or margin of safety is maintained between sterile and nonsterile objects and areas. When pouring fluids, only the lip and inner cap of the pouring container is considered sterile. The pouring container should not touch the receiving container, and splashing should be avoided. Tears in barriers are considered breaks in sterility.

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Operating room personnel must practice strict standard precautions (i.e. blood and body substance isolation). All items (e.g. instruments, needles,sutures, dressings, covers, solutions) used in the operating room must be sterile. All operating room personnel must perform a surgical scrub. All operating room personnel are required to wear specific, clean attire, with the goal of ³shedding´ the outside environment. Specific clothing requirements are prescribed and standardized for all operating rooms. Operating room personnel must wear a sterile gown, gloves and special shoe covers. Hair must be completely covered. Masks must be worn at all times in the operating room for the purpose of minimizing airborne contamination; they must be changed between operations or more often if necessary. Any personnel who harbor pathogenic organisms (e.g. those with colds or infections) must report themselves unable to be in the operating room to protect the client from outside pathogens. Scrubbed personnel wearing sterile attire should touch only sterile items. Sterile gowns and sterile drapes have defined borders of sterility. Sterile surfaces or articles may touch other sterile surfaces or articles and remain sterile; contact with unsterile objects at any point renders a sterile area contaminated.

a. b. c. 5. 6. 7.

The circulator and unsterile personnel must stay at the periphery of the sterile operating area to keep the sterile area free from contamination. . 9. The utmost caution and vigilance must be used when handling sterile fluids to prevent splashing or spillage. resterilized. in some cases. Anything that is used for one client must be discarded or. 10.8.

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