Sterile technique
Equipment
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Sterile gloves
Personal protective equipment
Sterile supplies, as required by the procedure to be performed
Optional: sterile bowl, sterile normal saline solution, sterile drape, sterile transfer device
Preparation of equipment
Check each package carefully and discard any package that is wet or has a hole or tear.1 Note the expiration dates and discard any packages that are expired.1 Report the expiration or defect as directed by your facility. Ensure that the sterilization tape has turned the appropriate color. (See your facility's guidelines; color depends on the product used and the sterilization method.) Prepare a clean surface on which to set up the equipment for the sterile procedure.
implentation
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Verify the practitioner's order to ensure that you're performing the right procedure on the right patient at the right time.
Review the patient's medical record for history of allergies to latex or medications.
If required, confirm that the practitioner has obtained informed consent and that the consent form is in the patient's medical record.
Gather all of the necessary equipment in the patient's room.
Perform hand hygiene.
Confirm the patient's identity using at least two patient identifiers.
Provide privacy.
Explain the procedure to the patient and family(if appropriate) according to their individual communication and learning needs to increase their understanding, allay their fears, and enhance cooperation.
Screen and assess the patient's pain using facility-defined criteria that are consistent with the patient's age, condition, and ability to understand.
Treat the patient’s pain, as needed and ordered, using nonpharmacologic, pharmacologic, or a combination of approaches. Base the treatment plan on evidence-based practices and the patient’s clinical condition, past medical history, and pain management goals.20 Consider administering an analgesic 20 to 30 minutes before the procedure, as needed and ordered, following safe medication administration practices, to promote patient comfort.
Remove your rings, watch, and bracelets.
Perform hand hygiene
Opening sterile kids
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Remove the plastic outer wrapper from the procedure kit if one is present.
Place the inner wrapped kit on a clean, dry, flat surface because the wrapper may absorb moisture on the table, contaminating the sterile supplies.
Position the kit so that you can open the farthest wrapper flap first because doing so prevents contamination that may occur from moving your unsterile arm over the sterile items.1
Grasp the outer portion of the flap and open the flap away from your body, keeping your arm outstretched to the side so that it doesn't cross over the sterile field
Grasp the outer surface of the first side flap with your hand on the same side as the flap to avoid crossing over the sterile field. Be sure to open the flap fully to avoid allowing the wrapper to spring back into place.
Grasp the outer surface of the second side flap and open it with your hand on the same side as the flap.1
Grasp the outer surface of the innermost flap and open it toward your body
Opening wrapped sterile items
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Grasp the sterile item wrapped in paper or linen in your nondominant hand.
Break the sterilization tape.
Use your dominant hand to grasp the outer surface of the top outermost flap to avoid touching a sterile surface.Opening a wrapped sterile item
Open the flap away from your body.
Grasp the outer surface of the first side flap and open it fully to the side.
Repeat with the other side flap.
Secure all flaps in your nondominant hand to avoid dangling, which would contaminate the sterile field.
Grasp the outer surface of the inner flap and open it toward you.
Place the item on the sterile field, ensuring that only sterile surfaces touch other sterile surfaces to avoid contamination.1
Be sure to place the item at least 1″ (2.5 cm) from the edge of the sterile field
Opening Sterile gloves
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Open the package containing sterile gloves, touching only the outer side of the glove wrapper. Be aware that some commercially prepared kits (such as the kit for inserting an indwelling urinary catheter) include a pair of sterile gloves; if gloves are included, they'll be the uppermost item in the pack.
Perform hand hygiene.
Grasp the paper glove wrapper and place it on a clean, dry, flat surface.
Open the inner package, touching only the outer edges of the wrapper, a
Use the thumb and fingers of your nondominant hand to grasp the folded inner surface portion of the glove for the dominant hand, touching only the inner portion of the glove, to avoid contaminating the outer portion of the glove.
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Pull down the cuff by touching only the inner surface of the glove. Gently stretch the glove over your hand, making sure that the outside of the glove doesn't touch a nonsterile surface.27
Insert the four fingers of your dominant gloved hand into the sterile outer cuff of the other glove, keeping your thumb pulled back and out of the way,
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Lift up the glove and insert your dominant hand into the glove, palm side up
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Lift up the glove and insert your nondominant hand into it. Allow the cuff to come uncuffed as you finish putting it on, but don't touch the skin of your arm with your gloved hand.
Adjust the fingers of the gloves after you've gloved both your hands.
Keep your hands above waist level to decrease the potential for contaminatio