Surgical asepsis and sterile technique: Nursing skills

Surgical asepsis, which is also known as “sterile technique,” includes practices that completely kill and eliminate microorganisms. Sterile technique refers to the practices that you may use as a nurse to reduce the chance of exposing your client to microorganisms and maintain sterility during certain procedures.

For some procedures, like surgery, special precautions need to be taken to avoid exposing your client to microorganisms. This can be done with surgical asepsis. Examples of surgical asepsis include the use of disposable sterile supplies, such as syringes, needles, and surgical gloves and the use of reusable sterile equipment, such as surgical instruments.

Most commonly, surgical asepsis is acquired through a process known as sterilization. You can think of sterilization as the highest level of asepsis because it kills both microorganisms and spores. Just like disinfection, sterilization is not used on people; instead, it is used on equipment and instruments that must be totally free of microorganisms. For example, a commonly used device to sterilize surgical instruments is the autoclave which uses high pressure and temperature to kill microorganisms and their spores.

Finally, it’s important to note that before something can be disinfected or sterilized, organic materials, such as blood, feces, or urine, must be removed using sanitization practices and techniques.

As a nurse, some procedures will require you to use “sterile technique,” which is when you use sterilized supplies like gloves, gowns, and drapes to reduce the chance of exposing your client to organisms that might cause infection. Examples of procedures that use sterile technique include indwelling urinary catheter insertion and central line dressing changes.

When preparing for a sterile procedure, you need to set up your sterile field which is a work space covered by a sterile drape where sterile items can be safely placed without contamination. Before setting up your sterile field, wash your hands and put on nonsterile gloves. It’s important to remember while setting up, you can’t touch sterile items on the field or you will contaminate them. There’s a 1-inch border around the perimeter of the field that is “safe” to touch without sterile gloves so you can touch this area when you are unfolding the sterile drape or repositioning it.

Next, when placing sterile supplies onto the sterile field, you may touch the outer packaging with your nonsterile gloves, hold the item above the field and, using your dominant hand, pull open the packaging away from your body, and then gently drop the item onto the field directly from its packaging. Be careful to avoid the 1-inch perimeter of the field! Also be sure to keep the outer packaging from contacting the sterile field. If any sterile item drops off the field, throw it away and get a new one. If a nonsterile item makes contact with your sterile field, collect new supplies and start again.