Principles of Sterility – Principles 1 & 2
Definition of terms
Sterile means free of microorganisms including the pores while asepsis means absence of microorganisms that cause disease. Sterile techniques are methods employed inside the operating room to prevent contamination of organisms throughout the surgical procedure. It is very important for nurses to know and understand the principles governing sterility to promote safety of the patient during operation.
When are sterile techniques used or applied?
- Preparation for an invasive procedure
- In preparation of the sterile team to handle sterile supplies and contact to the surgical site (gowning, gloving and scrubbing)
- Skin preparation and draping of the patient
- Sterility maintenance throughout the operation
Principles of Sterility
Principle Number 1: Only sterile items are used within the sterile field.
Drapes, basins, sponges are obtained from a stock room with sterile packages. The instruments used are sterilized and are placed in a sterile table. Any person who holds the sterile equipments should be very cautious to maintain sterility. One important consideration in implementing sterility is this: IF YOU ARE IN DOUBT ABOUT THE STERILITY OF A CERTAIN OBJECT, CONSIDER IT UNSTERILE. Any suspected or known unsterile items should not be placed the sterile field.
- Any sterile package found in an unsterile or contaminated area is considered unsterile.
- If the actual timing or sterilization procedure is undetermined and the nurse is unsure about the sterilization process, the equipments sterilized with the suspected procedure are considered contaminated.
- A sterile table which has been touch or rubbed accidentally by an unsterile person or vice versa is no longer considered sterile.
- If the packaging material is broken or has missing pieces it is no longer sterile.
- Microorganisms can enter a packed sterile package when it is damp or wet. Thus, damp packages are unsterile.
- A sterile package dropped on a floor is considered contaminated.
Principle Number 2: Sterile persons are gown and gloved.
When wearing a gown, the considered sterile area is the part where you can see in front down to the level of the sterile field. Thus, gowns are only considered sterile in front of the chest, sleeves above the elbow to the cuffs down to the level of the sterile field. Certain methods should be employed in the OR:
- Gowning is not done on the sterile table to avoid dripping water onto the sterile equipments. Gloving and self-gowning should be done in a distinct sterile surface.
- Stockinette cuffs of the gowns are absorbent and may retain moisture, thus making it a suitable area for bacteria or microorganisms to thrive in. because of the said principle, stockinette cuffs should be inserted beneath the sterile gloves.