Name: RAMOS, Al-Rajeb M.

Section:B
ESTABLISHING AND MAINTAINING A STERILE FIELD
DEFINITION
A sterile technique involving a set of particular practices and procedures that are followed to ensure that
equipment and surroundings are free of all pathogens and that the sterility is maintained. A sterile field is one
that is free of microorganisms. The inside side of a sterile wrapper or a wrapped sterile drape are frequently
used to create a sterile field.

PURPOSE
To maintain the sterility of the sterile objects.
When a patient's regular body defenses are compromised, this medication is used to protect them from
infection.

EQUIPMENT
• Package containing sterile drape
• Wrapped sterile gauze
• Wrapped sterile bowl
• Sterile forceps
• Antiseptic solution

Considerations before the procedure:

Hand hygiene should be practiced. Gather all of the necessary equipment, supplies, and materials. Before
opening supplies, it's critical to set up the equipment. Ascertain that the necessary equipment is sterile. All
packages must be verified before opening to confirm the integrity of the packing materials. The work area
should be above the level of the waist.

Things to follow up after the procedure:

Take care of yourself afterward. Using the normal protocol, dispose of all used materials and supplies.

Things that need to be documented:

All the procedures done. Sterility was not compromised.

Things to remember to maintain safety:

Sterile fields should always be set up as close to the process as possible and
should never be left unattended. When a sterile field is opened and exposed for
a long time prior to an operation, the chance of airborne germs contaminating
the goods is higher. If the field is left unattended, there is a greater chance that
someone will accidently contaminate it. Do not reach above the drape, do not
allow the sterile surface of the drape to come into contact with the client, and do
not allow the drape to come into contact with the uniform.
PERFORMANCE INDICATORS:
C –The step was correctly performed
X- The step was not performed
N- The execution of the step needs improvement
R- The step was correctly performed after remediation
PROCEDURE RATIONALE CX NR

A. ARRANGING A STERILE FIELD

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1. Wash hands. To prevent transfer of microorganisms.

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2. Choose a flat, hard, dry surface and clear To have a plenty of room to work.
sufficient area on which to prepare a sterile
field.
3. Before sterilization, objects are wrapped and To allow opening without contaminating the
the wrapper when opened provides a sterile contents.
field.
4. Determine the sterility of the package, ensure Most package is considered contaminated
that the package is dry, check the expiration and must be discarded. An expired sterile
dates and look for indications that it has been supply should never be used.
previously opened.

B. ESTABLISHING A STERILE FIELD BY

USING A DRAPE
1. The scrub person drapes an unsterile table To make drape placement easier, and
by: to prevent the gown from coming into
a) Unfolded drape. Placing the drape over the
contact with an unsterile table when the
unsterile surface nearest self first and
far side is covered initially.
carefully completing the coverage of the far
side. Gloved hands are protected by cuffing
a drape over them (Fig. 9.1)
b) Folded Drape. Unfold drape toward self first When the nurse tries to unfold the far
(Figs. 9.2, 9.3, and 9.4). When completing side of the drape, the nurse avoids
the coverage, the rest of the drape is leaning on the near unfolded drape.
unfolded away from self.
2. The scrub person stands back from the To prevent the gown from touching the
unsterile table when draping it. unsterile table.
C. OPENING A STERILE PACK
1. Place the package in the center of the work This stance prevents subsequent
area so that the top flap of the wrapper contamination of the exposed sterile
opens away from you. contents by reaching straight over them.
2. Reaching around the package (not over it),
pinch the first flap on the outside of the The sterility of the internal part of the
wrapper between your thumb and index wrapper is maintained by only touching the
finger. With some folded packages, it may outside of the wrapper..
be necessary to grasp the uppermost flap at
each corner. Pull the flap open, laying it flat
on the far surface.
3. Side flaps are opened one at a time, The possibility of contamination is reduced by
opening the top one first. Use the right hand watching each flap open. Reaching over the
for the right flap, and the left hand for the left sterile contents is avoided by using both
flap. hands.
4. Pull the fourth flap toward you by grasping The inner surface will become contaminated
the corner that is turned down. Make sure if it comes into contact with an unsterile item.
that the flap does not touch your uniform.
D. OPENING A WRAPPED PACKAGE WHILE HOLDING IT.
1. Hold the package in one hand with the top Because the hands are contaminated, they
flap opening away from you. should never contact the contents of the
package.
2. Open the package as described above
using the other hand, pulling the corners of
the flaps well back. Sterility is maintained when sterile objects
are placed within a sterile area.
3. Note: Inside the wrapper is considered
sterile except for the 1 inch border around
the edges, and may be used as base for
sterile field or as a field to add additional
items.

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F. ADDING NECESSARY SUPPLIES
A. To add wrapped sterile supplies to a
To prevent touching the inside surface of
sterile field.
the wrapped item.
1. Hold wrapped item in the dominant hand,
with top flap opening away from the body.
With other hand, reach around the package
and unfold top flap and both sides.
2. Keep a secure hold on the item through the This would expose the item inside the
wrapper with the dominant hand. Grasp the wrapper, taking into account not to touch the
remaining flap of the wrapper closest to the surface of the wrapper or the item.
body, taking care not to touch the inner
surface of the wrapper or the item. Pull the
flap back toward the wrist, so the wrapper
covers the hand and wrist.
3. Grasp all the corners of the wrapper To hold the wrapped item steadily.
together with the non-dominant hand and
pull back toward wrist, covering hand and
wrist. Hold in place.
4. Hold the item 6 inches above the surface of Dropping the item into the sterile field
the sterile field and drop onto the field. Be prevents the hands from touching the item
careful to avoid touching the surface or accidentally.
other items or dropping onto the 1-inch
border.
B. To add commercially packed supplies.
1. Hold package in one hand. Pull back top
cover with other hand. Alternately, carefully This would expose the package freely.
peel the edges apart using both hands.
2. After top cover or edges are partially
separated, hold the item 6 inches above the At a height of 6 inches, the outside of the
surface of the sterile field. Continue package is not likely to touch and
opening the package and drop the item onto contaminate the sterile field.
the field. Be careful to avoid touching the
surface or other items or dropping onto the
1-inch border.
3. Discard wrapper. For cleanliness purposes.

C. To add sterile solution to a sterile bowl

1. Before pouring any liquid, read the label, To avoid error by using the wrong solution.
name of the solution three times to make
sure you have the correct solution.
2. Open solution container according to To avoid introducing microorganisms inside
directions and place cap on table away from the cap when it is turned down. Inverting the
the field with edges up. lid maintain sterility of the inside surface
because it is not allowed to touch an unsterile
area.

3. Hold the bottle so that the label is To prevent the solution from draping down
uppermost. into the label. Any solution that flows down
the outside of the bottle during pouring will
not damage or obliterate the label.

4. Hold the bottle of fluid at a height of 10-15 cm The tip can contaminate the sterile bowl if it
(4-6 in) over the bowl and to the side of the touched the bowl.
sterile field so that as little of the bottle as
possible is over the field (Fig. 10). The tip of
the bottle should never touch a sterile
container or field.

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 5. If the bottle had been previously opened, pour To cleanse the lid of the bottle. Any
small amount of liquid into a waste moisture will contaminate the field by
receptacle without letting the tip of the bottle facilitating the movement of microorganisms
to touch the receptacle. Carefully pour the through the sterile drape.
solution onto a sterile container in the sterile
field so as not to splash the liquid.
6. Replace the lid securely on the bottle if you Replacing the lid immediately maintains
plan to use it again. Touch only the outside the sterility of the inner aspect of the lid and
the solution.

Gravity prevents liquids on the tips of forceps

from flowing to the handles and later back to
the tips making the forceps contaminated.
There is less danger of contamination if the
forceps are held near to eye level.
If forceps out of sight, they may inadvertently
become contaminated.
To maintain sterility.

To handles of the forceps harbor

microorganisms from the bare hand.

Barrier drapes prevent a sterile field from

becoming unsterile when the drape becomes
wet.
To maintain sterility of the forceps and
equipment.

Date of
Completed YES NO Signature
Compilation
Remarks:

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