Principles of Sterility – Principles 6, 7, 8 and 9

Principle Number 6: Edges of anything that encloses sterile contents are considered unsterile

  • Sterile supplies are packed. In opening sterile packages, the area within 1 inch from the edges is considered unsterile. Supplies are handled by the circulator. The upper portion of the package is flapped away from the self and turns the side under. In doing so, the end of the flaps is secured by the band of the circulator to prevent it from dangling loosely. The other flap is pulled towards the circulator; hence, the contents are exposed yet away from the unsterile hands.
  • To open a sterile package, the flaps on peel-open packages should be pulled not torn. The sterile contents should be flipped and lifted upward. The circulator should prevent the sterile contents to slide over the unsterile edges.
  • When lifting contents from packages, sterile personnel should lift the object straight up while holding their elbows high.
  • In cases where a sterile wrapper is used as a table cover instead of a drape, it should cover the entire table surface. Only the interior surface of the wrapper is considered sterile.
  • Sterile bottles when opened cannot be recap without contaminating the pouring edges. Thus, all contents must be used or in cases where there is still a solution left, it should be discarded.

Principle Number 7: Sterile field is set-up just before a surgical procedure

  • The longer a sterile item is exposed to air and environment, the higher the possibility of contamination.
  • The practice of covering a sterile set-up does is not in the best interest of the patient. Sterility cannot be guaranteed by just covering a sterile set-up, unless it is under a constant   surveillance.
  • Covering and uncovering a table may contaminate the sterile items.

Principle Number 8: Sterile areas are continuously kept in view.

  • Sterility cannot be guaranteed by just covering a sterile set-up, unless it is under a constant   surveillance.
  • Sterile persons should face the sterile area.
  • While waiting for the patient to come inside the OR, someone must stay in the sterile area to maintain vigilance on the sterile set-up.
  • Direct observation ensures sterility.

Principle Number 9: Sterile persons keep well within sterile area.

  • In draping the patient, sterile persons stay at a safe distance from the operating table to maintain sterility.
  • Movements in a sterile area are done by passing with each other back to back at a 360 degree turn.
  • When a sterile person passes by an unsterile person or area, he or she should turn back to maintain sterility.
  • When sterile persons pass by a sterile field or area, they face towards it.
  • To prevent contamination during movements in an area, the sterile person asks the unsterile personnel to step aside.
  • Movement inside the sterile area is kept at a minimum to avoid contamination.
  • Sterile persons stay inside the sterile field or area.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

What Do You Think?