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4. Sterile drapes are positioned over the patient in such a way that only minimal area of
skin around the incision site is exposed. 5.
Drape maybe reusable or disposable. Criteria of drape must be water resistant, lint free, flame resistant and able to provide an effective barrier to prevent passage of
microorganism from non-sterile to sterile area.
6.3.14. Establishing a Sterile Field
1. All items used in the sterile field must be sterile.
2. A sterilization indicator tape must be applied to each sterile package item used.
Where penetration is of concern, a chemical indicator should be inserted into each Packet.
3. All tables and flat surfaces must be dry dust free prior to the placement of sterile
bundles and or supplies. 4.
The instrument table is draped with a repellent drape prior to the placement of instrument and supplies. The instrument table is considered sterile only at top level.
5. All draped tables should be moved by the circulating nurse whose hands should be
placed below the drape, on the table leg. 6.
Ring stands if used, must be draped with a water repellent drape. When the scrub nurse moves the ring stand, she does so by placing her hands inside the basin.
7. The gown is considered sterile from axilla level to the table level in front only and
from the elbow to the stockinette cuff. The gown should have a barrier front and sleeves. Wrap around gowns should be turned by a sterile person. If a sterile instrument
is used by a non sterile person to turn the gown, the instrument should be discarded after use.
6.3.15 Dispensing of the Sterile Supplies
1. Supplies should be opened as close as possible to the time that the surgical procedure
is to commence. 2.
Each package is checked for the expiry date and wrapper integrity prior to opening. Fabric and paper wrapper items should be use within one month, heat sealed
packages for up to one year and commercial items as stated on the package. to check for integrity of the pack and indicator on pack
3. The edges of envelope wrapped packages are opened away from circulating nurse
with corners secured before presenting it to the scrub nurse. 4.
Peel back packages should be carefully opened to ensure proper adhesive separation and prevent tearing of the package.
5. The scrub nurse should take each item directly from the package held by the circulating
nurse. Careful placement of items on the sterile field is acceptable if the hand of the circulating nurse is covered by the wrap and does not extend over the sterile field.
6. Sterile supplies are handled as little as possible and once positioned should not be
moved and or shifted.
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7. Once supplies are opened they should not be left unattended. Sterile set-ups should
not be covered for future use. 8.
Non sterile person should not reach over the sterile field. Sterile persons should not reach over non sterile areas.
9. Fabric or paper wrapped sterile items which are dropped on the floor should be
considered non sterile and should not be used. 10. Once the patient has entered the theatre where sterile supplies have been opened,
those supplies may only be used on that particular patient. These supplies should be discarded in the event of cancellation.
11. Large bundles of packages should be opened on a flat surface and not while holding it in the hand.
12. Opened sterile bottles should be used for only one patient. The entire contents of bottle should be dispensed or the remainder discarded.
13. Care should be taken when pouring solutions to avoid splashing. The scrub nurse should hold the edge of the table so that circulating nurse need not reach over the
sterile field to pour. The solution should be poured in a slow steady stream.
6.3.16 Maintaining the Sterile Field
1. Precautions should be taken to prevent moisture contamination and subsequent
strike-through by using water resistant materials. 2.
The scrub team should remain close to and face the sterile field. Movement is only from sterile to sterile areas. When changing positions the scrub personnel will pass
front to front or back to back. They should avoid changing levels, they either sit or stand. Talking should be kept to a minimum. Scrub personnel should not lean on
sterile areas.
3. The unscrubbed team should remain at least one foot 30cm from the sterile field.
Movement is from non sterile to non sterile area. They should not pass between sterile areas.
4. Breaks in aseptic technique should be monitored, documented and corrective action
taken as soon as possible. 5.
A sterile field is maintained by: •
Placing only sterile items within the sterile field. •
Opening, dispensing, or transferring sterile items without contaminating them. •
Considering items located below the level of the draped client to be non sterile. •
Not allowing sterile personnel to reach across non sterile areas or vice versa or to touch non sterile items.
• Recognizing and maintaining the service provider’s sterile area.
• When gowned this area extends from chest to the level of the sterile field; sleeves
are sterile from 5 cm above the elbow to the cuff. The neckline, shoulders, and back are considered to be non sterile areas of the gown.
