FUNDAMENTALS OF NURSING
RLE/ SECOND SEMESTER
PREPARATION OF STERILE FIELD
OVERVIEW
A sterile field is established whenever a patient’s skin is intentionally
punctured or incised, during procedures involving entry into a body
cavity, or when contact with non-intact skin is possible (e.g. surgery
or trauma). Surgical asepsis require adherence to strict principles
and intentional actions to prevent contamination and to maintain the
sterility of specific parts of a sterile field during invasive procedure.
Creating and maintaining a sterile field is foundational to aseptic
technique and encompasses practice standard that are performed
immediately prior to and during a procedure to reduce the risk of
infection, including the following:
There are basic principles of asepsis that are critical to understand
and follow when creating and maintaining a sterile field. The most
basic principle is to allow only sterile supplies within the sterile field
once it is established. This means that prior to using any supplies,
exterior packaging must be checked for any signs of damage, such
as previous exposure to moisture, holes, or tears. Packages should
not be used if they are expired or if sterilization indicators are not
the appropriate color. Sterile contents inside packages are
dispensed onto the sterile field.
DEFINITION
A sterile field is a work surface area prepared to hold sterile
equipment during a sterile technique procedure.
The sterile field provides an area in which sterility is continually
maintained.
EQUIPMENT
USES OF STERILE FIELD
 A sterile field is use for any procedure, in the operating room
or other clinical setting that could introduce microbes into a
patient.
 A sterile field is use in invasive procedure, such as insertion
of central line or a PICC (peripherally inserted central
catheter), Inserting a urinary catheter (quick straight,
catheter or indwelling one), tracheostomy care (cleaning
and caring for a hole that gives directly into the patient’s
lungs), or inserting an arterial line or CVC (Central Venous
Catheter).
 A sterile field is used for minor procedure such as suturing
of lacerated wound.
MEDICAL ASEPSIS VS. SURGICAL ASEPSIS
 Medical asepsis simply means performing routine cleaning
or washing in order to prevent pathogen transmission to
reduce the number of organism and prevent their spread.
 Example. Washing hands, wearing clean gloves, or
wearing a mask are examples of medical asepsis.
 Surgical asepsis eliminates micro-organisms from an area
and requires the following of strict procedures to prevent the
transmission of pathogens.
 Example. Sterilizing all instruments, drapes, and
other objects that may come into contact with a
surgical wound. Personnel who come into contact with
the sterile field must perform a surgical hand scrub
with an antimicrobial agent and put on a surgical gown
and gloves.
TRANSCRIBED BY: NEPOMUCENO, CKC.
CHAPTER 08
WEEK 8
IMPORTANT PRINCIPLES
1. Disinfect any work surfaces and allow to dry thoroughly before
placing any sterile supplies on the surface.
2. Be aware of areas of sterile fields that are considered
contaminated:
 Any part of the field within 1 inch from the edge.
 Any part of the field that extends below the planar surface
(i.e., a drape hanging down below the tray table top.
 Any part of the field below waist level or above shoulder level.
 Any supplies or field that you have not directly monitored
(i.e., turned away from the sterile field or walked out of the
room).
3. Within 1 inch of any visible holes, tears, or moisture wicked from
an unsterile area.
4. When handling sterile kits and trays:
 Sterile Kits and trays generally have an outer protective
wrapper and four inner flaps that must be opened aseptically.
 Open sterile kits away from your body first, touching only the
very edge of the opening flap.
 Using the same technique, open each of the side flaps one
at a time using only one hand, being careful not to allow your
body or arms to be directly above the opened drape. Take
care not to allow already-opened corners to flip back into the
sterile area again.
STEPS IN PREPARING STERILE FIELD
1. Obtain the necessary equipment and supplies. All articles
required for the procedure, which will be within the sterile
field must be sterile.
2. Perform patient care handwash.
3. Locate a suitable surface. Set up the field on a surface
that is clean, flat, dry, and free from drafts.
4. Position all packages so that the top flap will open away
from your body.
5. Open the top flap of the package first; open it away from
you.
6. Then open the flap on the right side with your right hand,
then the flap on your left side with your left hand. This is
to keep you from reaching over the sterile field
7. Open the last flap toward your body.
8. To put an item into a package, open the package and drop
the item from six inches above the field.
OPENING A STERILE KIT
 Before dispensing sterile supplies to a sterile field, do not allow
sterile items to touch any part of the outer packaging once it is
opened, including the former package seal.
 Heavy or irregular items should be opened and held, allowing
a second person with sterile gloves to transfer them to the
sterile field.
 Wrapped sterile items should be opened similarly to a sterile
kit. Tuck each flap securely within your palm, and then open
the flap away from your body first. Then open each side flap;
secure the flap in the palm one at a time and open. Finally,
open the flap (closest to you) toward you, while also protecting
the other opened flaps from springing back onto the wrapped
item.
 Peel pouches (i.e., gloves, gauze, syringes, etc.) can be
opened by firmly grasping each side of the sealed edge with
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FUNDAMENTALS OF NURSING CHAPTER 08
RLE/ SECOND SEMESTER
PREPARATION OF STERILE FIELD
the thumb side of each hand parallel to the seal and pulling 4. Pull the top flap wrapper
carefully apart. between your thumb and index
 Drop items from six inches away from the sterile field. finger away from you.
 Sterile solutions should be poured into a sterile bowl or tray
from the side of the sterile field and not directly over it. Use 5. Open side flaps, opening the
only sealed, sterile, unexpired solutions when pouring onto a top flaps first. Right hand for the
sterile field. Solution should be held six inches away from the right flap, & the left hand for the
field as it is being poured. Avoid splashing solutions because left flap.
this allows wicking and transfer of microbes. After pouring of
solution stops, it should not be restarted because the edge is 6. Pull the innermost flap toward
considered contaminated. you.
 Don sterile gloves away from the sterile field to avoid
contaminating the sterile field.
To open a sterile item on a
sterile field.
7. Open sterile item while holding
outside wrapper.
8. Supplies can be opened
(following packaging directions),
then gently dropped onto the
sterile field.
WEEK 8
Touching only the
outside of the wrapper
maintains the sterility of
the inside of the wrapper.
By using both hands,
you avoid reaching over
the sterile field.
If the inner surface
touches any unsterile
article like the uniform, it
is considered
contaminated.
To free dominant hand
for unwrapping the outer
package.
Items remain sterile,
inner surface of the
wrapper over hands,
making it sterile.

9. Peel wrapper onto dominant To prevent accidental

hand. contamination of the
sterile field.
10. Dispose outer wrapper. To prevent
POURING A SOLUTION INTO A DISH contamination of the
sterile field.
 Remove the bottle cap and place it so that the inside of the To add liquid solution to a
cap is facing up on a non-sterile surface. sterile field.
 Hold the bottle so that the label is in the palm of your hand. 11. Read the solution label and To ensure giving right
This is to protect the label from being damaged due to a splash, strength three times. solution
which could make it difficult to read its contents. 12. Remove the lid and place To prevent
 When pouring, hold the bottle two inches above the receptacle. sterile side up onto a clean contamination of the lid.
Pour slowly to avoid splashing, which would contaminate the surface.
sterile field. 13. Pour the liquid from 6-8 inches To avoid the possibility
above the sterile container in the of the two containers
PROCEDURE & RATIONALE sterile field. touching each other.
14. Pour slowly. If liquid is spilled in
PROCEDURE RATIONALE sterile field, the spot is
To prevent transmission considered
1. Perform hand hygiene, gather of microorganism. To contaminated.
supplies, check equipment for ensure that package is 15. Avoid reaching over the sterile To prevent
sterility, and gather additional clean and dry. Moist field. contamination of the
supplies (gauze, sterile cleaning indicated contamination sterile area.
solution, sterile gloves, etc.). and package must be
discarded. REFERENCE:
Below waist level is ▪ preparing a sterile field
2. Place package on clean, dry,
considered https://www.youtube.com/watch?v=_aCf0HBVO_g
waist-level table.
contaminated. ▪ Adding item on sterile field
Assemble the supplies in the work To promote efficacy. https://www.youtube.com/watch?v=FhYOv5CpUnk
area. ▪ Using forceps in a sterile field
To prevent subsequent https://www.youtube.com/watch?v=JqmoLwfiFm4
reaching over the ▪ Adding solution to sterile field
3. Place the package at the center https://www.youtube.com/watch?v=qDbqB80CZ-I
exposed sterile contents,
of the work area.
this could contaminate
them.
To open a wrapped package on
a surface

TRANSCRIBED BY: NEPOMUCENO, CKC. 2|P a g e