POPE 4023 PRINCIPLES OF ASEPTIC AND STERILE TECHNIQUE (a)

POPE 4023
THE PERIOPERATIVE ENVIRONMENT

PRINCIPLES OF ASEPTIC AND
STERILE TECHNIQUES

SITI ZAIRINI AHMAD
ILKKM KUBANG KERIAN

ASEPTIC AND STERILE TECHNIQUE

Aseptic and An object can be but….
sterile are not aseptic without
synonymous
being sterile

Both term are carried out An object cannot
primarily to prevent the been considered

transmission of sterile even
microorganisms that can though has been
through aseptic
cause infection
process

SPAULDING’S LEVEL

NONCRITICAL SEMICRITICAL CRITICAL

Contact with Contact with Entering the
only intact skin intact skin or bloodstream,
body tissues
or mucous mucous and mucous
membranes membranes membranes

Only clean and Sterility is not Sterility is
unsterile maintained compulsory
during storage

or use

WHAT IS ASEPTIC
TECHNIQUE

Aseptic technique is an effort or collection
of actions been taken to control and
minimize the risk of microorganism
contamination

(microbial contamination is contained in the environment)

ASEPTIC TECHNIQUE IN OR

Aseptic technique is sometimes referred to as clean
technique.

Items have been cleaned and decontaminated so they
are safe to handle with clean, bare hands.

Items in use in patient care are handled with examination
gloves for the protection – patient & caregiver

Items have been cleaned, decontaminated, disinfected,
or terminally sterilized without a wrapper, and stored in a
clean, dry place.

ASEPTIC TECHNIQUE IN OR

Items may start out sterile but are not maintained or
used under sterile conditions. Skin preps may be
packaged sterile, but skin cannot be sterilized.

Contamination is contained. Extraneous contamination is
avoided

Items are set up on clean towels or drapes and used with
examination gloves.

Items are not sterile or maintained sterile during use.
Extraneous contamination is avoided.

ASEPTIC TECHNIQUE IN OR

Disposable items are not cleaned and reused for another
patient.

Items are classified as semi critical or noncritical by
Spaulding’s classification of the importance of patient
care items.

Items can be used outside the confines of the restricted
area

ASEPTIC TECHNIQUE IN OR

Items are used on intact skin or mucous membranes.

Items are not used when the patient’s vascular system
will be entered.

HOW ABOUT STERILE
TECHNIQUE ?

In sterile technique…. all
microorganisms must be maintained
at an irreducible minimum meaning as

low as absolutely possible

(zero microorganism contamination)

STERILE TECHNIQUE IN OR

Items are used only in a sterile field in the restricted
area

Items are used by sterile team members wearing
appropriate sterile attire

Items are used in areas of the patient’s body where
the site has been prepped

Items may be used in invasive surgery

STERILE TECHNIQUE IN OR

Items may be used in body areas with nonintact skin
and membranes and may enter the patient’s vascular
system

Items are classified as critical according to Spaulding’s
level of importance of patient care items

Items have been cleaned, decontaminated, and
packaged before sterilization

STERILE TECHNIQUE IN OR

Items processed by sterilization are stored wrapped
and remain so until use by a sterile team member

Items are for individual patient use only. Reusable
items can be reprocessed and resterilized for use with
another patient. Disposable items are discarded after
use. If opened and unused, disposable items are
discarded

Items that become contaminated are discarded and
replaced immediately

TRANSMISSION OF MICROORGANISM IN OR
ENVIRONMENT

SOURCES OF INFECTION

Preexisting localized
infectious process

A systemic
communicable disease

An acquired perioperative
complication

SOURCES OF INFECTION HEALTH CARE
ACQUIRED INFECTION

SPONTANEOUS
INFECTION

COMMUNICABLE
INFECTION

COMMUNITY
ACQUIRED INFECTION

HUMAN AND NON-BORNE SOURCES

HUMAN-BORNE Skin
NONHUMAN-BORNE Hair
Nasopharynx
Human Error
Cross Infection

Fomites
Air

ENVIRONMENTAL CONTROL IN THE
OPERATION ROOM

ENVIRONMENAL
SERVICES /

HOUSEKEEPING

CONTROL OF ISOLATION
AIRBORNE PRECAUTION

CONTAMINATION

ENVIRONMENTAL SERVICES /
HOUSEKEEPING

• The faucet head should not hold water and should be
removed for terminal sterilization

• No surface should remain wet – prevent biofilm

• Organic debris should be promptly removed from walls and
other surfaces with a disinfectant to prevent drying and
airborne contamination.

ENVIRONMENTAL SERVICES /
HOUSEKEEPING

• Lights should be cleaned after every procedure. Overhead tracks
should be cleaned upon completion of the day’s schedule.

• The entrance to the OR suite and the floors in corridors and
rooms should be cleaned at the end of the day’s schedule.

• Housekeeping equipment should be cleaned and dried for
storage

• Disposable trash should be separated into infectious and
noninfectious waste and put in impervious receptacles.

ENVIRONMENTAL SERVICES /
HOUSEKEEPING

• Service elevators rather than chutes should be used to
remove soiled laundry and waste/trash from the OR suite.

• Waste should be contained at the source of origin to prevent
aerosol generation during handling.

• Adequate time must be allowed between patients for proper
terminal disinfection of the OR.

• All areas and equipment throughout the perioperative
environment should be cleaned on a scheduled basis

ENVIRONMENTAL CONTROL IN THE
OPERATION ROOM

ENVIRONMENAL
SERVICES /

HOUSEKEEPING

CONTROL OF ISOLATION
AIRBORNE PRECAUTION

CONTAMINATION

CONTROL OF AIRBORNE CONTAMINATION

AIR CONDITIONING TRAFFIC AND
SYSTEM MOVEMENT

LAMINAR AIR LINT
SYSTEM

DOORS

ISOLATION PRECAUTION

• Category-specific isolation precautions for patients with
suspected or confirmed communicable disease transmitted
either by droplets via the airborne route (e.g., pulmonary
tuberculosis) or by enteric excretions, drainage, or secretions

• Disease-specific isolation precautions for contact with
patients known to be infected with specific pathogens

ISOLATION PRECAUTION

• Body-substance isolation precautions incorporating standard
precautions for contact with all body substances of all
patients, regardless of the diagnosis (all patients are
considered contaminated)

• Protective isolation for immunosuppressed patients

REMEMBER…….
ISOLATION ….

• Is to prevent the transmission of pathogenic microorganism

• Is to protect both personnel and other patients

• OR staff should be informed before patient come to the OT

• Thorough handwashing before and after touching patient;
after handling contaminated objects, body fluid and
excretion; and between patients

• Must not be implemented in a way that causes the patient to
feel ostracized