A SHORT NOTE ON ASEPTIC TECHNIQUES

          A SHORT NOTE ON ASEPTIC TECHNIQUES.  Compiled by OMOLOLA ADAMS. RPHN BNSc

 INTRODUCTION : Surgical Asepsis,  Sterile technique or Aseptic technique refers to those practices that keep an area or object free of all microorganisms;  it includes practices that destroy all microorganisms and spores ( microscopic dormant structures formed by some pathogens that are very hardy and often survive common cleaning techniques ). Surgical Asepsis is used for all procedures involving the sterile areas of the body.  sepsis is the state of infection and can take many forms,  including septic shock.
  Aseptic technique is carried out in a clean environment using sterile equipment. The procedure is carried out in such a way as to minimize the likelihood of infection being introduced to the site. it's used for wound dressings,  urinary catheterization, manipulation of intravenous infusion and other situations where the skin is broken.
  STERILE FIELD: A sterile field is a microorganism -free are.  Nurses often establish a sterile field by using the innermost side of a sterile wrapper or by using drape.  When the field is established,  Sterile supplies and sterile solutions can be placed on it.  Sterile forceps are used in many instancess yo handle and transfer sterile supplies.
PRINCIPLES AND PRACTICES OF ASEPTIC TECHNIQUES
1.  All objects used in a sterile field must be sterile.
All articles are sterilized appropriately by dry or moist heat,  chemical or radiation before use
Always check package for intactness,  dryness,  and expiration
storage area should be clean,  dry,  off the floor and away from sink
Sterile articles can be stored for only prescribed time
2. Sterile objects become unsterile when touched by unsterile object
Handle Sterile objects that will touch open wounds or enter body cavities only with sterile forceps or sterile glove hands
Discard or resterilise objects that come into contact with unsterile object
Whenever the sterility of an object is questionable,  assume the article is unsterile
3. Sterile objects that are out of sight or below the waist or table level are considered unsterile
Once left unattended,  a sterile field is considered unsterile
Sterile objects are always kept in -view. Nurses do not turn thier backs on a sterile field.
Only the front part of a sterile gown,  from shoulder to waist,  and cuff of the sleeves above the elbow are considered sterile
Always keep Sterile gloved hands in sight and above waist / table level; touch only objects that are sterile
Sterile draped tables in the operating room or elsewhere are considered sterile only at surface level.
4. Sterile objects can become unsterile by prolonged exposure to airborne microorganisms.
Keep doors closed andd traffic to a minimum in areas where a sterile procedure is being performed because moving air can carry microorganisms
Keep areas in which sterile procedures are carried out as clean as possible by frequent damp cleaning with detergent germicides
Keep hair clean and short or enclose it in net to precent hair falling on sterile objects
Wear surgical caps in operating rooms,  delivery rooms,  and burn units
Refrain from sneezing or coughing over a sterile field
When working over a sterile field,  Keep talking to a minimum ,  avert the head from the field if talking is necessary.
To prevent microorganisms from falling over a stetile f ieeld,  Refrain from reaching over a sterile field unless stetile gloves are worn and refrain from moving unstetile objects over a sterile field.
5. Flies flow in the direction of gravity
Unless gloves are worn, always hold wet forceps with the tips below the handles.  When the tips are held higher than the handles,  fluid can flow onto the handle and become contaminated by the hands
During a surgical hand wash,  hold the hands higher than the elbows to prevent contaminants from the forearms from reaching the hands.
6. Moisture that passes through a sterile object draws microorganisms from unstetile surfaces above or below to the sterile surface by capillary action.
Sterile moisture-proof barriers are used beneath stetile objects.  Liquidss are frequently poured into containers on a stetile field.
Keep the sterile covers on the sterile equipment dry
Replace sterile drapes that do not have a sterile barrier underneath when they becomee moist.
7. The edges of a sterile field are considered unsterile
A 2. 5cm margin at each edge of an opened drape is considered unsterile because the edges are in contact with unsterile surfaces.
Place all sterile  objects more than 2. 5cm inside the edges of a sterile field.
Any article that falls outside the edges of a sterile field is considered unsterile
8. The skin cannot be sterilised and is unsterile
Use sterile gloves or sterile forceps to handle sterile items
Prior to a surgical aseptic procedures,  cleanse the hands to reduce the number of microorganisms on them.
9. Conscientiousness,  alertness,  and honesty are essential qualities in maintaining surgical Asepsis
When a sterile object becomes unsterile,  it does not necessarily change in appearance
The person who sees a sterile object become contaminated must correct or report the situation
Do not set up a sterile field ahead of time for future use.

 SOURCE
Audrey Berman,  Shirlee Synder (2012),  Kosher and Erb's Fundamentals of Nursing,  Concepts, Process and Practice. 9th Ed. Pearson Education Inc. NJ.

Ethelwynn L. Stellenberg,  Judith C. Bruce (2007). Nursing Practice,  Medical-surgical Nursing for Hospital and Community. Church Livingstone Elsevier,  China.