Asepsis
Performing Hand Hygiene
1. Gather the necessary supplies. Stand in front of the sink. Do not allow your clothing to
touch the sink during the washing procedure.
Remove jewelry, if possible, and secure in a safe place or allow plain wedding band to
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remain in place.
3. Turn on water and adjust force. Regulate the temperature until the water is warm.
Wet the hands and wrist area. Keep hands lower than elbows to allow water to flow toward
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fingertips.
Use about 1 teaspoon liquid soap from dispenser or rinse bar of soap and lather
5. thoroughly. Cover all areas of hands with the soap product. Rinse soap bar again and
return to soap dish.
6. With firm rubbing and circular motions, wash the palms and backs of the hands, each
finger, the areas between the fingers, the knuckles, wrists, and forearms. Wash at least 1
inch above area of contamination. If hands are not visibly soiled, wash to 1 inch above the
wrists.
7. Continue this friction motion for at least 15 seconds.
Use fingernails of the opposite hand or a clean orangewood stick to clean under
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fingernails.
9. Rinse thoroughly with water flowing toward fingertips.
Pat hands dry, beginning with the fingers and moving upward toward forearms, with a
10. paper towel and discard it immediately. Use another clean towel to turn off the faucet.
Discard towel immediately without touching other clean hand.
11. Use oil-free lotion on hands if desired.
Preparing a Sterile Field (Packaged Drape and Individually Packaged Supplies)
1. Explain the procedure to the patient and perform hand hygiene.
Check that sterile wrapped drape or package is dry and unopened. Also, note expiration
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date, making sure that the date is still valid.
3. Select a work area that is waist level or higher.
Open sterile wrapped drape or commercially prepared sterile package. For sterile wrapped
4. drape, open outer covering. Remove sterile drape, lifting it carefully by its corners. Gently
shake open, hold away from your body, and lay drape on selected work area.
5. Place additional sterile item on field as needed.
Adding a Sterile Item to a Sterile Field
6. a. Hold agency wrapped item in one hand with top flap opening away from you. With
other hand, unfold top flap and both sides. Keeping a secure hold on item, grasp
the corners of the wrapper and pull back toward wrist, covering hand and wrist.
b. If commercially packaged item has an unsealed corner, hold package in one hand
and pull back on top cover with the other hand. If edge is partially sealed, use both
hands to carefully peel apart.
Drop sterile item onto sterile field from a 6-inch (15-cm) height or add item to field from the
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side. Be careful to avoid dropping onto 1-inch border.
8. Discard wrapper.
Putting On Sterile Gloves
1. Perform hand hygiene.
2. Place sterile glove package on clean dry surface at or above your waist.
Open the outside wrapper by carefully peeling back top layer. Remove inner package,
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handling only the outside of it.
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Carefully open inner package using the flaps and expose sterile gloves with the cuff closest
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to you.
With thumb and forefinger of nondominant hand, grasp folded cuff of sterile glove for
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dominant hand.
Lift and hold glove up and off the inner package with fingers down. Be careful it does not
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touch any unsterile object.
7. Carefully insert dominant hand palm up into glove and pull glove on.
Holding thumb outward, slide fingers of gloved hand under cuff of remaining glove and lift
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glove upward.
Carefully insert nondominant hand into glove. Adjust gloves on both hands, touching only
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sterile areas with other sterile areas.
Removing Soiled Gloves
10. Using dominant hand, grasp other glove near cuff end and remove by inverting it, keeping
contaminated area on the inside. Continue to hold onto glove.
Slide fingers of ungloved hand inside remaining glove. Grasp glove on inside and remove
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by turning inside out over hand and other glove.
12. Discard gloves in appropriate container and perform hand hygiene.
Preparing a Sterile Field (Pre-Packaged kits)
1. Explain the procedure to the patient and perform hand hygiene.
Check that sterile wrapped drape or package is dry and unopened. Also, note expiration
2.
date, making sure that the date is still valid.
3. Select a work area that is waist level or higher.
Place commercially prepared package in center of work area. Touching outer surface only,
4. carefully reach around item and fold topmost flap of wrapper away from you. Open right
and left flap before grasping the nearest flap and opening toward you.
5. Discard wrapper.
Putting on Personal Protective Equipment
1. Check physician's order for type of precautions and review precautions in Infection Control
Manual.
2. Plan nursing activities and gather necessary equipment before entering patient's room.
3. Provide instruction about precautions to patient, family members, and visitors.
4. Perform hand hygiene.
5. Put on gown, gloves, mask, and protective eyewear, if recommended, as precaution.
a. Tie gown securely at neck and waist. Obtain waterproof gown if soiling is likely.
b. Use clean disposable gloves. If worn with a gown, draw glove cuffs over gown
sleeves.
c. Securely tie and fit mask to face.
d. Wear eyewear with face shields or protection on side of face.
e. Alternatively, a combination of a mask and barrier device may be used.
Removing Personal Protective Equipment
6. When patient care is completed, untie waist strings of gown, then remove gloves as
follows:
a. Grasp outside of one glove and turn inside out to remove.
b. Insert fingers of ungloved hand inside cuff of remaining glove.
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c. Grasp glove and drop in appropriate container.
7. After removing gloves, remove mask.
Surgical Mask
a. Untie mask and drop by strings into waste container. For a mask with an elastic strap,
lift strap from behind head and drop by strap into waste container.
8. Remove gown.
For Gown that is Visibly Soiled
a. Untie neck strings of gown. Remove gown without touching outside of gown by
keeping one hand up and under gown cuff and using this protected hand to pull
opposite sleeve down and off.
b. Use ungowned arm and hand to grasp gown from the inside and remove from the
remaining arm. Remove gown, turn inside out, and drop in appropriate container.
9. Remove eyewear and clean according to agency policy.
10. Perform hand hygiene.
Unexpected Situations
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