When a sterile person tries to catch a falling item, he usually contaminates himself, the item, and the sterile field. Any item extending beyond the sterile boundary must be considered contaminated and cannot be brought back onto the sterile field.
Even though a bacterial barrier may drape over the sides of a surface, only the top of that surface may be considered sterile. To maintain sterility of gloved hands, a sterile person must keep hisher hands at or above waist level. The arms of the sterile person must continually move across the sterile field, thus the sleeves of the gown must be sterile. However, since the back of the gown cannot be observed by the wearer, it cannot be considered sterile. Wrap-around gowns that cover the back may be sterile when first put on. This requires the sterile person to shift levels from footstool to floor. The sterile person should avoid changing levels as would occur if he/she moves from a stationary back table to an elevated operating table. The area of sterility in the front of the gown extends to table level because most sterile team members work adjacent to a sterile table. The areas of the gownĬonsidered sterile must not be so restricted the individual cannot move sufficiently. This principle establishes the sterile areas of a gown. Gowns are considered sterile in front from shoulder to table level the sleeves are also considered sterile. Therefore, it is necessary to use good judgment based on an understanding of aseptic principles when determining sterile boundaries. These hypothetical boundaries may not apply to every situation.
On peel-back packages, the line of demarcation is the inner edge of the heat seal. When a wrapper is used to drape a table, the margin begins at the table edge. A oneinch safety margin is usually considered standard on package wrappers. The boundaries between sterile and unsterile are often intangible. The edges of sterile containers are not considered sterile once the package is opened. Immediately before dispensing a sterile item, one should check the integrity of the package, possible evidence of moisture strike-through, the expiration date, and the appearance of the heat or gas sensitive indicator, if used. This date serves only as a reminder that after this date the package is susceptible to contamination. The time a bacterial barrier becomes ineffective is referred to as its shelf-life and should be indicated by an expiration date on the package. O protect the patient we must exercise our surgical consciences.įree to allow for easy and aseptic preen tat ion.^ Packaging materials differ in their barrier effectiveness. Wrappers should be flexible and memoryĪORN Journal, OctohPr 1976, V o l 2 4, N o 4 It must have a proven seal integrity, and peel-open packages must open without shredding. I t should be durable to resist tearing or puncture and should not pill or delaminate. Packaging material should act as a barrier to microorganisms and dust particles. How can one be sure of this? First, he must be aware of what constitutes a n effective package for a sterile item. Every individual who uses or dispenses a sterile item must be assured the item is sterile and will remain sterile until used. The inadvertent use of unsterile items may bring harmful bacteria to the wound. All items used within a sterile field must be sterile. There are eight principles as described in Berry and Kohn’s Introduction to Operating Room Technique.2 1. Aseptic technique may be used in other areas of nursing if aseptic principles are known and understood. It is mandatory that operating room personnel know the principles and follow them meticulously. Team (relating to scrub and attire), and strict observance of aseptic principles before, during, and after surgery.’ These principles should be reviewed frequently by everyone involved with aseptic technique until they become second nature.
The author would like to acknowledge the assistance of Phyllis Wells whose script from the 1976 AORN film, ‘?Fundamentals of aseptic technique,” was an invaluable reference. She is a member of the AORN Technical Standards Committee, AORN representative to Industry Committee on Aseptic Barriers, a.nd president of AORN of Pittsburgh, Pa. She is a graduate of Butler County Memorial Hospital School o f Nursing, Butler, Pa, and the University of Pittsburgh. Margaret E Huth, R N, is clinical coordinator, OR and R R, Western Pennsylvania Hospital, Pittsburgh. Principles ot asepsis Aseptic technique, the foundation upon which modern surgery is built, demands preoperative sterilization of materials used during surgery, special preparation of the area and operative