chapter002 sterile procedures

Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 2Sterile Technique

Chapter 2Sterile Technique


Hospital Acquired Infections (HAI) Hospital Acquired Infections (HAI)

• “nosocomial infections”

• Acquired by pt. whose natural defenses against infection are missing or overridden in the health care setting

• very $$$$ - money & human life


Hospital Acquired Infections (HAI) (cont.) Hospital Acquired Infections (HAI) (cont.)

According to CDC -250,000 pts/yr have HAI from urinary catheters

-10% - 25% pts w HAI die

• Requires- ↑ tx, ↑ hospital stays, & costs


Risk factors con’tRisk factors con’t

• Re-infection- get same illness again

• Cross-infection-get infection from another pt. or staff member

• Noscomial infection- acquired in a healthcare setting


CarriersCarriers


risk factors risk factors

• 1. Lines of defense against infection

• break in skin

• invasive procedure

• Spores in hospital

• Elderly, children

• Medications


Types of micro-organismsTypes of micro-organisms

• Bacteria- strept throat, TB, pneumonia

• Virus- HIV, Hepatitis A,B,C, flu, cold

• Fungus- athletes foot, yeast infections


TermsTerms

• Pathogen

• Non-pathogen

• Aerobic pathogen

• Non-aerobic pathogen


Types of asepsisTypes of asepsis

• Medical

• Clean technique

• General disinfection

• Ex.- vital signs, bathing, tube-feeding

• Surgical

• Sterile technique

• Ex.- wound care, surgery, invasive procedures, trauma


Modes of transmissionModes of transmission

• Direct contact

• Indirect contact

• Droplet

• Vehicle

• Vector

• Airborne


Principles of asepsisPrinciples of asepsis

• Control m.o-

grooming

handwashing

disinfection

* destroys most m.o.

* spores still live

* Wash off visible contaminates then disinfect


Principles con’tPrinciples con’t

• Sterilization

• Kills all m.o- including spores

• Types:

• -Steam

• - Dry Heat

• -Gas

• -Chemicals


Sterile TechniqueSterile Technique

• Involves:

- a sterile field (a microbe-free area to work in)

– Using equipment & supplies that are sterile (completely free of microbes) to ↓ risk of infection


Levels of Sterilization for Equipment and SuppliesLevels of Sterilization for Equipment and Supplies

Category I: Critical— carry a very high risk b/c they penetrate the skin or are placed in body cavities that are normally free of microbes. Ex. - catheter

Category II: Semi-critical—come into contact with mucous membranes & carry a moderate risk for causing infection ex.-dental

Category III: Non-critical— come into contact with intact skin & carry a lower risk for causing infection


SterilizationSterilization• The most complete method of killing all microbes

• Kills microbes as well as endospores


QuestionQuestion

What is the most complete method of killing all microbes as well as endospores?

A. High-level disinfection

B. Sanitation

C. Sterilization

D. Disinfection


AnswerAnswer

C. Sterilization

Sterilization is the most complete method of killing all microbes; it kills microbes as well as endospores.


Sterile PackagesSterile Packages

• Fabric-wrapped: items inside sterilized onsite

• Envelope-wrapped package: one corner is opened at a time to create a sterile field; may be fabric or paper

• Peel/sterilization pouches: small sterile items wrapped in a combination of paper & plastic.


Using an Envelope-Wrapped PackageUsing an Envelope-Wrapped Package


Using a Sterile DrapeUsing a Sterile Drape


Indications That an Item Is SterileIndications That an Item Is Sterile

• Commercially prepared items - writing on outside of package

• Items that are sterilized onsite have 2 chemical indicator strips

– Outside strip changes color after being processed

– Indicator strip inside the package will also change color to show the sterilizing agent penetrated the packaging


Indications That an Item Is Sterile (cont.)Indications That an Item Is Sterile (cont.)

• The sterility of items is maintained as long as a sterile package is stored properly & the package is not damaged or wet surface


True or falseTrue or false

Sterilized items usually reach expiration in about 1 year. ?


AnswerAnswer

B. False

Sterilized items have no expiration date.


Principles of sterile asepsisPrinciples of sterile asepsis

• Sterile + sterile = sterile

• Sterile object out of site = contaminated

• Sterile object with prolonged exposure air=contaminated

• Sterile object + water exposure = contaminated

• 1 inch outside border= contaminated

• Think before moving or touching

• Skin= clean


• Inside of body= sterile

• Sterile water good for 24 hours

• Rinse lip of sterile water

• Palm bottle


When Creating a Sterile Field, You Need: When Creating a Sterile Field, You Need:

• An area where sterile supplies can be opened, arranged, & moved around & not contaminate other items

• Sterile gloves to arrange & use sterile supplies within the sterile field,

• sterile transfer forceps may be used to move items around within the sterile field.


Transfer ForcepsTransfer Forceps


Sterile Gloves Sterile Gloves


Procedures That Require a Sterile FieldProcedures That Require a Sterile Field

Inserting urinary catheters

Giving injections

Starting intravenous (IV) lines

Changing sterile dressings


QuestionQuestion

All instruments, supplies, and gloved hands remain sterile so that _______ are not introduced into the body

A. Asepsis

B. Calories

C. Microbes

D. Disinfection


AnswerAnswer

C. Microbes

Sterilization prevents endospores and microbes from entering the body.


Pouring Liquid Into a Sterile ContainerPouring Liquid Into a Sterile Container


Discussion Questions:Discussion Questions:

• You are assisting the RN with wound care and a sterile drsg. change. She asks you to open a peel pouch pkg. containing scissors that were processed at the hospital. You place the scissors on the sterile field prepped by the RN.

• A. How will you determine the scissors are sterile?

• B. How will you open this pkg. & place on the sterile field?


Discussion questionsDiscussion questions

• While you are assisting the RN with the sterile drsg. Change, the RN wants you to hand sterile items to her as needed:

• A. Identify 2 methods that can be used to work within the sterile field. What are the advantages & disadvantages of each way?

• B. As you assist with the drsg change, your gloved hand brushes against the RN’s forearm. What should you do?

chapter002 sterile procedures

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